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[whitespace] Violence and controversy spark an abortion-provider shortage

By Janet Wells

WITH TWO THIRDS of all OB-GYNs who perform abortions being over the age of 65 and on the verge of retirement, who will be doing abortions in the near future? The next crop of doctors may not know how. Abortion is the most common surgical procedure performed on women, with 50 percent of women undergoing the procedure by age 45, according to medical statistics.

But between 1976 and 1991 the percentage of OB-GYN programs providing routine first-trimester abortion training dropped 53 percent. Almost half of the chief residents in OB-GYN programs have never performed a first-trimester abortion. Only 12 percent of family-practice residency programs offer even optional training in abortion, and less than half of the residents choose to participate, according to a 1993 national survey.

"It's easy to opt out," says Petaluma family-practice physician Susan Lewis, who asked that her real name not be used. "All you have to do is not try to get training. Even for people who are mostly pro-choice, it's a hassle. It's extra work to learn, and you're going to stand out in the community as an abortion doctor.

"No one wants that label."

When Stanford University medical student Sarah Morgan interviews for residency programs in family- practice medicine, one of her first questions will be about abortion. "There isn't a single family-practice residency that requires training," she says.

"I'd like to see how many even offer it as an opportunity. And how easy they make it for you," adds Morgan, who is the regional coordinator for Medical Students for Choice. The 4,500-member group formed in 1993, galvanized to action by an anti-abortion mailer titled "Bottom Feeders" that was sent to the homes of 35,000 medical students. "Abortion is a legal procedure available for women. It seems outrageous that it's not part of training for gynecological care," Morgan says.

In response to lobbying by Medical Students for Choice, the Accreditation Council for Graduate Medical Education required in 1995 that all OB-GYN programs include abortion as a routine component of training.

The Sutter Medical Health Clinic family-practice residency program does offer optional training in abortion, through Commonwoman's Health Project in Santa Rosa. There is no residency program in OB-GYN at Sutter locally, and few OB-GYN residency educators nationally know about the requirement.

Furthermore, programs affiliated with religious groups may opt out on moral grounds.

Yet abortion training is part of being fully qualified, Lewis says. "As long as abortion is legal in this country, doctors, especially pro-choice family-practice doctors and OB-GYNs, have a responsibility to learn how to do the procedure."

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From the February 25-March 3, 1999 issue of the Sonoma County Independent.

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