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 Two little-known training programs say they have expanded rapidly in
recent years, fueled by robust private funding and strong demand.
Launched nearly a quarter century ago amid protest and violence, the
programs now train more than 1,000 doctors and medical students
annually in reproductive services, from contraception to all types
of abortion, according to interviews with Reuters.
But their impact is limited. Most of the doctors end up working near
where they train, not in several Southern and Midwestern states that
have imposed waiting periods, mandated counseling and enacted other
controls.
"I don’t think we have a provider shortage anymore," said Sarah W.
Prager, a University of Washington Medical School professor. "What
we have is a distribution problem. We have a lot of providers in
some of our city centers, but in rural areas there are very few
people willing or able to provide care."
Texas is emblematic of areas of scarcity. More than half the clinics
in the state have closed since 2013 when a law went into effect that
required clinics to meet surgery center standards and abortion
providers to have hospital admitting privileges.
In its first abortion case in nearly a decade, the U.S. Supreme
Court is considering whether the Texas law violates the right to
abortion. The case focused attention on a decline in clinics in the
United States. According to a survey by the Guttmacher Institute, a
nonprofit research organization that supports abortion rights, the
number of clinics dropped nearly 40 percent after peaking in 1982.
MORE TRAINING
Medical Students for Choice was started in 1993 by a student at the
University of California, San Francisco. The nonprofit now has 185
chapters and a $1.4 million annual budget funded by the William and
Flora Hewlett Foundation, the Rockefeller Family Fund and others.
Last year, it sent 137 medical students and residents for abortion
training, more than twice as many as in 2010. Its two-day and
three-day Abortion Training Institute has received 321 applications
so far this year, surpassing the 228 who applied in all of 2015.
The Kenneth J. Ryan Residency Training Program was started in 1999
by Uta Landy, who ran one of the first abortion clinics after the
procedure was legalized.
While obstetric-gynecology residencies are required to offer
abortion training, not all do. The Ryan program has helped set up
and expand family planning and abortion training at 85 teaching
hospitals - including 31 since 2010 - which train about 1,000
residents a year.
The program declined to discuss its budget or funding. It is a part
of the Bixby Center for Global Reproductive Health at the University
of California, San Francisco, which does not disclose contributions
at the program level.
Tax disclosures show the Susan Thompson Buffett Foundation, which
supports abortion rights, donates to many of the universities that
host Ryan program training. But it does not disclose the purpose of
those donations, and representatives did not respond to phone
queries.
UNEVEN IMPACT
At a hearing before the Supreme Court in March, lawyers for clinic
operators argued that the new standards in Texas caused or
contributed to the shutdown of 22 clinics. The Texas state solicitor
general argued that Whole Women's Health, the lead plaintiff in the
case, failed to show that the law was the only reason the clinics
shut down.
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A study funded by abortion rights groups recently reported that
waits in Texas grew as long as 23 days, and some women have traveled
more than 250 miles to get an abortion.
Some doctors also travel to bring abortion services to areas where
they are scarce. Bhavik Kumar went to New York for Ryan residency
training because it was not offered at his Texas medical school. He
returned to Texas and travels more than 2,000 miles a month
providing abortions at clinics in San Antonio and Fort Worth.
"Rights are being taken away from not just patients but us as well,"
Kumar said. "A lot of us are angry. We're trying to get back what
the opposition has taken."
Randall K. O'Bannon, director of education and research for the
anti-abortion National Right to Life organization, said the training
programs are recruiting medical students with rhetoric he views as
dishonest.
"They have been promoting and recasting the image of the
abortionists in the United States," O'Bannon said. "They want to
make them appear more noble - heroic. But they're not."
Lois V. Backus, executive director of Medical Students for Choice,
said the students who go the extra mile to seek training are heroes
who "deserve the gratitude and admiration of all of us for their
willingness to meet all the needs of their patients."
Landy, the Ryan program founder, said laws limiting abortion are
stoking interest in training.
"The more controversy there is," she said, "the more motivation,
commitment and passion grows and responds."
Most of the new providers are women, who comprise 80 percent of
ob-gyn residents. Some, like Jennifer Conti, are vocal about the
need for women to have access to a full range of reproductive care.
Growing up in a traditional Mexican-American family, Conti opposed
abortion as "this hypothetical thing that bad people did." But her
views changed in her teens when an acquaintance got pregnant.
Now, as an ob-gyn, she teaches and provides reproductive care,
including abortion, at Stanford University School of Medicine, and
she writes for Slate and other outlets.
"There is a new generation of activist doctors," said Lori
Carpentier, who runs Planned Parenthood clinics in Michigan. "They
choose to do terminations of pregnancies because it is a deeply held
and passionate belief that women should have access to care."
(Reporting By Jilian Mincer; Editing by Michele Gershberg and Lisa
Girion)
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