How overturning Roe impacted family medicine abortion training

As of August 2023—a little more than a year after the Supreme Court eliminated the constitutional right to abortion—17 states had banned or severely restricted abortion. These bans have raised concerns about how to give clinicians comprehensive reproductive health training.

While much attention has focused on ob-gyn training, abortion training in family medicine is safe and appropriate, and both residents and patients support it. People increasingly recognize the role of family doctors in abortion care, especially because they practice in communities where they may be the only health care clinicians, and abortion care aligns well with family medicine’s core values of continuity and whole-person care.

New research from the Person-Centered Reproductive Health Program explores the implications of overturning Roe on family medicine residency programs. They found:

  • Nearly 4,000 residents (29%) were training in states where abortion was banned or very restricted.
  • Most programs were in states with at least some restrictions, but 36% of programs were in states with laws protecting abortion.
  • Of 40 programs known to offer abortion training, one was in a state that had banned abortion. Most residency programs that offered abortion training were in states with protective policies.

Regardless of the policy environment where they practice, family physicians need to be able to care for patients seeking abortion or follow-up care. Requests for self-managed medication abortion have gone up since the Supreme Court decision, especially in states with bans. While self-managed medication abortion is very safe, some patients will seek follow-up care from their family physicians.

The impact of state bans extends beyond abortion training and care. Residents who receive abortion training are more likely to provide abortion care, early pregnancy loss care, pregnancy options counseling, and long-acting reversible contraception.

Overturning Roe will have long-term effects on family physicians’ ability to provide abortion and follow-up care, manage early pregnancy loss, and care for patient and community reproductive health needs. Residency program leadership teams and family medicine organizations must work to optimize training in restrictive states and expand abortion training where possible to promote equitable, high-quality reproductive health care.