Healthcare system “cracking” around abortion access; “Medical Students for Choice” steps in with help

Young people today are stunned by the possibility of losing Roe v. Wade. That includes medical students who see first hand how inadequate the formal curriculum is covering female reproductive choice at most medical schools.

As more states enact increasingly restrictive and unscientific barriers to accessing abortion and the Supreme Court is no longer a reliable safeguard, the specter of losing Roe v. Wade now looms as a real possibility. But one organization started planning for this possibility more than a quarter of a century ago.

“At one time, the idea Roe could be overturned seemed very unlikely to most people. But after chipping away and chipping away, this year all eyes are open, and we see this could happen,” said Lois Backus, executive director of Medical Students for Choice, a not-for-profit organization that started in 1993 at the University of California Medical School in San Francisco and now has chapters at 165 medical schools in the United States as well as chapters in 23 other countries. As more restrictions are implemented blocking access to abortion, students at more medical schools in more countries are forming chapters.

A new chapter was formed last year at the University of Illinois College of Medicine at Peoria. Chapters operate at 90 percent of medical schools in the United States.

“It is fair to say most medical schools have deficits” in the curriculum covering abortion, Backus said.

“Abortion and contraception are fundamental needs of every child-bearing woman, and lack of access is a concern in this country.

“This is an incredible scandal. Everyone should be alarmed,” Backus said. Increasing maternal mortality is “powerfully telling us the healthcare system is cracking around maternity care. It is outrageous. Everyone is at risk when this is happening.”

Alumni from MSFC now perform abortions in 42 states and some are running for elected positions in government to help influence public policy.

As physicians in African countries are seeing more and more women with septic infections resulting in death following inept abortions, MSFC chapters are being formed there.

However, even if Roe is maintained, access is lost if there are no healthcare providers trained in the procedure, Backus said.

She was an executive director of a Planned Parenthood region in Pennsylvania that decided to add abortion to its services. It took three years to find a doctor to come to the area.

“Every doctor needs a solid base of information about this to be good care providers,” Backus said. “Many schools in the U.S. have a lecture on abortion and discussion of the moral and ethical issues but no clinical training.”

Medical Students for Choice works to fill the gaps in the formal curriculum. The organization offers workshops, lectures and conferences. It also works to change the medical school curriculum.

Second year medical students Andy Bank and Brittani Steinberg were the co-founders of a chapter in Peoria last year. They were both raised in liberal households that view comprehensive reproductive health care including access to abortion as a universal basic human right.

When they applied for medical school at the University of Illinois College of Medicine, they did not know if their campus would be Chicago, Rockford or Peoria.

When they came to Peoria, they were both surprised to understand how restrictive access to abortion is for women in Peoria.

“I had not thought I wanted to specialize in this area until I came here and realized how hard it is here to access pro-choice options,” Steinberg said.

Bank said, “Being in Peoria helps us realize the need.”

One of their first undertakings was to join with chapters at the two other campuses in Rockford and Chicago and start dialogue with the school administration to enhance the curriculum.

In Peoria, the topic was covered in the last few months of the second year and focused on the Supreme Court decision, religious objections and objections of conscience. Not covered was safety, medical techniques and preventive measures.

Steinberg said 17% of medical schools in the United States don’t offer abortion training. At 32%, training is a single lecture. By the third year of medical school, 45% of students had been offered an optional clinical experience.

Bank and Steinberg spoke at a recent meeting of the NOW Chapter in Peoria. Steinberg said 1-in-4 American women will have an abortion in their lifetimes, 92 percent of abortions are in the first trimester and abortion is safer than childbirth.

“A lot of the tactics used by anti-choice are not science based but emotional,” Steinberg said. “But it is not just the anti-choice rhetoric, it is the stigma around the issue.”

Bank said, “I may not even want to go into this field, but I want people to have accurate science-based information.”

Steinberg: “Our goal is not to make the world pro-choice, but to spread accurate information.”

A young physician in central Illinois specializing in women’s health care said she was lucky to train in Chicago and receive more integrated coverage of abortion.

She spoke on condition her name not be used.

One of her colleagues who worked in a clinic providing abortions was targeted by anti-choice picketers. Her license plates where photographed and someone convinced a friend in law enforcement to illegally run the plates. With information about her name and address, the picketers leafleted her neighborhood. The literature stated she may look young and sweet, but in reality she’s a baby murderer. However, rather than the desired reaction, neighbors thanked the doctor for helping women who want abortions.

“This topic is so stigmatized that women don’t even feel they can talk about it with their doctors,” the young physician said.

She sought out a residency program that integrated the topic into the regular curriculum.

Legislation, restrictions and bans will not stop abortion but will make it more hazardous to women’s health, she said.

Since the Affordable Care Act was passed and women could access comprehensive contraception, abortion rates have declined. But that decline is jeopardized as more states enact restrictions.

“Family planning should not be based on religious beliefs,” she said. Just as physicians can tell patients about diet and exercise to prevent diabetes, they should be able to tell patients about comprehensive contraception and abortion to prevent unwanted pregnancies.

Solutions may lie with the expansion of telemedicine that allows doctors to remotely prescribe pills for medical abortions.

Another solution may come from a petition asking the Food and Drug Administration to loosen regulations on mifepristone and misoprostol to induce abortion.

If family physicians are able to prescribe these medications, they will be able to provide abortion care in their offices.

“Restrictions hurt poor women the most. I am privileged, have access to contraception, and I know my options,” she said. “This issue highlights disparities accessing health care and hurts poor women and rural women the most.”

Priorities should be supporting more comprehensive training, raising awareness about need and de-stigmatizing the issue, she said.

“Use the A-word. Say abortion. It is normal. One in four women has an abortion. Stop the shame. Stop the stigma. This is a normal part of medical care,” she said.

She is unwilling to be targeted and jeopardize her medical career. Rather than continuing to allow pro-choice providers to shoulder responsibility for access, society must learn the difference between religious dogma, emotional misinformation and science-based medical care, she said, adding “Abortion is a normal part of comprehensive reproductive medical care.”

Medical Students for Choice is a 501(c)3. Donations help support the organization and its annual conferences and training programs. For more information go to www.medicalstudentsforchoice.org.

The Peoria chapter is raising money to help more students attend the annual conference in Philadelphia in early December. Donations to the national organization can be earmarked for “Univ. Ill. – Peoria Trust” and mailed to:

MSFC, P.O. Box 40935, Philadelphia, PA 19107



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