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Abortion care training is banned in some states. A new bill could help OB-GYNs get it

Democratic Sen. Tammy Baldwin in Washington, D.C., in 2019. Her state of Wisconsin now has near total ban on abortion under an 1849 law.
Mark Wilson
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Democratic Sen. Tammy Baldwin in Washington, D.C., in 2019. Her state of Wisconsin now has near total ban on abortion under an 1849 law.

Sami Stroebel, an aspiring obstetrician-gynecologist, started medical school at the University of Wisconsin in Madison last summer within weeks of the Supreme Court's decision to overturn the constitutional right to an abortion.

"I sat there and was like, 'How is this going to change the education that I'm going to get and how is this going to change my experience wanting to provide this care to patients in the future?'"

Sen. Tammy Baldwin, the Democrat from Wisconsin, has an answer to that question.

Today, she and Sen. Patty Murray (D-Wash.), the chair of the powerful Senate appropriations committee, are introducing the Reproductive Health Care Training Act. It establishes a grant program, to provide $25 million each year – for the next five years – to fund medical students who leave their states to learn abortion care, and programs that train them. It's especially important in states like Wisconsin that have near total bans on abortion.

"Students and their supervising clinicians have to travel out of state to get that component of their training," Baldwin tells NPR. "Meanwhile, neighboring states — and this is happening across the United States, are accepting an influx of students."

Stroebel, who co-leads her school's chapter of the national advocacy group Medical Students for Choice, wants to learn to provide abortion care. The same procedures and medications used to provide abortion are also needed when a pregnancy ends in miscarriage and in other women's health care that has nothing to do with pregnancy.

To be licensed, aspiring OB-GYNs must learn to perform the procedures and prescribe the medications. But in Dobbs vs. Jackson Women's Health, the Supreme Court essentially made abortion rights a state-by-state issue.

"Wisconsin reverted to the 1849 law where abortion is essentially completely illegal, except in cases where they say that the woman's life is in imminent danger," Stroebel says.

Medical schools in Wisconsin and the other states with near total bans can't teach abortion care.

Baldwin says that, since the Dobbs decision, there's been a documented drop in OB-GYN medical residents who are applying to practice in Wisconsin and other states with bans.

"It is exacerbating what was already a shortage of providers in the state providing maternity care and cancer screenings and other routine care," Baldwin says.

Dr. Christina Francis, head of the American Association of Pro-Life OB-GYNs, says medical training in pregnancy care does need to be better, but from her perspective, it should focus on routine care for issues that make pregnancy complicated and unsafe such as preeclampsia, diabetes and all the problems that lead to the high rate of cesarean sections in the U.S.

"We need to be investing money into taking better care of women during their pregnancies and after, and not investing money in ending the life of one of our patients and harming our other patient in the process," Francis says.

Studies show that most patients who have had abortions don't regret getting one, and abortion procedures are far safer than pregnancy and childbirth itself.

Francis also says miscarriage care and other gynecological problems give aspiring doctors all the training they need. "I trained in a Catholic hospital. We did not perform abortions," Francis says. "We were very well-trained in how to empty a woman's uterus. That's just part of normal OB residency."

But state laws in the wake of Dobbs are upending miscarriage care, too. Abortion care training has been a problem for years in states like Texas that began severely restricting abortion long before the Dobbs ruling.

Given the new legal landscape, Stroebel's not sure how or where she'll practice in the future. For now, she wants to finish her medical education with the state school where she's enrolled, but she worries about her classmates and other students in abortion-restricted states.

"It is scary to think that, you know, if a lot of OB-GYNs and up and coming medical students want this training and they can't get it in places like Wisconsin or Idaho or Alabama or Texas, you know what's going to happen to the people who need that care in those states?"

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Pien Huang is a health reporter on the Science desk. She was NPR's first Reflect America Fellow, working with shows, desks and podcasts to bring more diverse voices to air and online.

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