Barriers to abortion training persist in ob-gyn residency programs

More than 20 years ago, the Accreditation Council for Graduate Medical Education enacted a policy requiring routine abortion training in ob-gyn residency programs. Since then, there’s been a slow increase in integrating training, but still only 64% of ob-gyn residency program directors report routine, scheduled abortion training. New Bixby Center research explores the barriers to expanding abortion training and preparing graduates to better serve their patients.

Researchers found that despite the ACGME mandate, there continue to be major obstacles to providing training. The majority of programs that have restrictions on specific aspects of abortion training reported that individual hospital policies were the biggest barrier. The most common reason for gestational limits was state laws. Sources of support for abortion training were most often ob-gyn department leadership, faculty and residents. Opposition came from hospital administration and operating room or labor and delivery nurses.

When restrictions are minimal, programs are not only likely to offer routine, integrated training. They also ran to higher gestations and were less likely to report interference from hospital leadership. That may reflect that it’s easier to have routine training in those circumstances, but it may also imply that there’s positive impact of the program on hospital, university and nursing leadership.

Hospital culture and commitment to providing abortion services is a complex mixture of political, personal, professional and economic factors. Programs should continue to work toward routine, integrated training so graduates are prepared to care for patients and teaching hospitals are providing adequate patient care. The reasons for these barriers should be better identified and understood to help develop effective strategies for change.