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Obstacles to the Integration of Abortion Into Obstetrics and Gynecology Practice
Author(s) -
Freedman Lori,
Landy Uta,
Darney Philip,
Steinauer Jody
Publication year - 2010
Publication title -
perspectives on sexual and reproductive health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.818
H-Index - 93
eISSN - 1931-2393
pISSN - 1538-6341
DOI - 10.1363/4214610
Subject(s) - abortion , medicine , autonomy , obstetrics and gynaecology , context (archaeology) , competence (human resources) , family medicine , family planning , nursing , medical education , obstetrics , psychology , pregnancy , population , social psychology , research methodology , law , political science , genetics , environmental health , biology , paleontology
CONTEXT : Obstetrics and gynecology residents who are trained in family planning and intend to provide abortions after residency often do not ultimately do so. The extent of the professional barriers physicians face trying to integrate abortion into their practice is unknown.METHODS : In 2006, in‐depth interviews were conducted with 30 obstetrician‐gynecologists who had graduated 5–10 years earlier from residency programs that included abortion training. Interviews about physicians’ experiences with abortion training and practice were coded and analyzed using a grounded theoretical approach.RESULTS : Eighteen physicians had wanted to offer elective abortions after residency, but only three were doing so at the time of the interview. The majority were unable to provide abortions because of formal and informal policies imposed by their private group practices, employers and hospitals, as well as the strain that doing so might put on relationships with superiors and coworkers. Restrictions on abortion provision sometimes were made explicit when new physicians interviewed for a job, but sometimes became apparent only after they had joined a practice or institution. Several physicians mentioned the threat of violence as an obstacle to providing abortions, but few considered this the greatest deterrent.CONCLUSIONS : The stigma and ideological contention surrounding abortion manifest themselves in professional environments as barriers to the integration of abortion into medical practice. New physicians often lack the professional support and autonomy necessary to offer abortion services.