Ob-Gyn teaching hospitals often restrict abortion beyond state law

Many women, especially those with complex medical needs, often rely on hospital-based abortions. Obstetrics and gynecology residency programs are required to provide access to abortion training but graduates frequently report that hospital policies interfere with their training. These facility-level abortion restrictions can affect both patient care and clinician instruction in teaching hospital settings. 

Teaching hospital

ANSIRH researchers conducted a national survey of 169 OB-GYN teaching hospitals and found that the majority (57%) of residency training program directors reported that their facility had some sort of written or unwritten policy that restricted abortion provision beyond what their state law allowed. They found these policies to be more common at hospitals in the South and the Midwest. Furthermore, it was more common for policies to restrict “non-medically indicated” or “elective” abortions, or those sought for reasons other than maternal or fetal health, rape, or incest. A quarter of all surveyed sites prohibited non-medically indicated abortions altogether, and many limited care for such procedures to a more restrictive gestational limit than state law requirements. Additionally, a quarter of institutions restricted both medically indicated and non-medically indicated abortions beyond state law.

These restrictive policies were created by those with institutional power, including hospital leadership and obstetrics and gynecology department chairs, and were perceived to be motivated by personal beliefs and a desire to avoid controversy. It is likely that patients presenting to hospitals with such policies are unaware of those restrictions.

ANSIRH’s findings are especially relevant during the COVID-19 crisis, when elected officials and hospitals have targeted abortion as a “nonessential” procedure. Abortion is essential and time-sensitive, given that both health risks and difficulty accessing care increase with delay. Still, the restrictions imposed during the pandemic will only exacerbate the kinds of restrictions ANSIRH researchers found in place at hospital training facilities, further depriving people of full bodily autonomy.