ACOG Committee Opinion on Training and Education for Safe Abortion Care

Overview and Support

Committee Opinion CO Number 612 (Replaces Committee Opinion Number 424, January 2009.) This information should not be construed as dictating an exclusive course of treatment or procedure to be followed.

ABSTRACT: Access to safe abortion hinges upon the availability of trained abortion providers. The American College of Obstetricians and Gynecologists supports education for students in health care fields as well as clinical training for residents and advanced practice clinicians in abortion care in order to increase the availability of trained abortion providers. The American College of Obstetricians and Gynecologists supports the expansion of abortion education and an increase in the number and types of trained abortion providers in order to ensure women’s access to safe abortions.

This Committee Opinion reviews the current status of abortion education, describes initiatives to ensure the availability of appropriate and up-to-date abortion training, and recommends efforts for integrating and improving abortion education in medical schools, residency programs, and advanced practice clinician training programs. Integrated medical education and universal opt-out training policies help to lessen the stigma of abortion provision and improve access by increasing the number of abortion providers.

Background: Need for Trained Providers

Access to safe abortion services is a key component of women’s health care 1. Safe, accessible abortion care requires sufficient numbers of trained health care providers who offer the service. However, the number of abortion providers in the United States has not met the level of need 2.

In the United States, 94% of abortions are provided in facilities outside of the traditional learning environment of the medical trainee, requiring concentrated efforts to integrate abortion training into medical school and residency curricula 2. Legal, regulatory, and other restrictions form barriers to education and ...

Recommendations for Training and Access

The American College of Obstetricians and Gynecologists (the College) supports women’s access to safe abortion care, which hinges upon the availability of sufficient numbers of trained abortion providers. To increase the availability of trained abortion providers, the College makes the following recommendations:

Improving Residency and Medical School Education

• Implement the Accreditation Council for Graduate Medical Education (ACGME) requirement that all obstetrics and gynecology residency programs provide training in comprehensive women’s reproductive health care, including opt-out abortion training, in which training is routinely integrated into residency but residents with religious or moral objections can opt out of participation.
• Continue efforts to destigmatize and integrate abortion training into medical education as a critical element of women’s reproductive health care.
• Include abortion education in the curricula of all medical schools.

Expanding the Provider Pool

The College also recommends supporting the expansion of the trained pool of non-obstetrician–gynecologist abortion providers, such as family physicians and advanced practice clinicians (APCs), by:

• integrating first-trimester abortion training into family medicine and APC training programs
• opposing restrictions that limit abortion provision to physicians only or obstetrician–gynecologists only

Addressing Legislative Barriers

• Support opposition to legislative restrictions that impede access to abortion and increase difficulty in abortion provision and training, including restrictions on public funding of abortion education and training.