Medical Developments and Disagreements
After Roe v. Wade was overturned in 2022, many states have decided to either restrict or completely ban abortion. This has caused several issues within the medical world, specifically with the training of OB/GYNs. Many medical schools have done away with their abortion training, leaving students underqualified and limited in their future opportunities. Texas, Missouri, and Idaho have been especially open about their refusal to even teach abortion skills or allow a resident to receive an abortion even if in another state, in Missouri’s case. This leaves future physicians confused and worried, possibly throwing a wrench in their “methodically plotted career paths” (Varney). Students attending institutions that do not provide abortion training will have to seek it in another state or learn it through another program, after already spending the time and money on medical school. Those that do not learn this treatment will be “less skilled” at performing “lifesaving procedures” that are needed due to the likelihood of maternal death (Varney). In connection with the concepts in Care & Cure by Jacob Stegenga this development goes against the well-being of patients and decreases physicians’ abilities to properly care for their patients.
In chapter one of Stegenga’s Care & Cure, the definition of health is debated. According to the World Health Organization, “to be healthy involves more than merely being free of diseases” (Stegenga 11). This is what is known as positive health which deems a person as healthy if they are able to “flourish in various respects” (Stegenga 7). This theory of health is more consistent with the idea that well-being plays a big part in whether someone is truly healthy or not. The well-being of the pregnant patient and all those involved in the pregnancy can be extremely degraded if they have no choice other than to raise the baby to full term. Imagine there is a sixteen-year-old girl who uses contraceptives such as birth control and still ends up pregnant. She would likely be labeled as unhealthy by standards of the positive health theory because of all the stress and turmoil in her life. Social, mental, and physical effects of the pregnancy could negatively impact her such as having to drop out of school or facing backlash from her family and peers. Although she does not have a disease in the sense of a biological misfunction, she does have internal and external factors that are inhibiting her from flourishing.
In addition, not all abortions are performed because the person pregnant simply does not want the baby. Sometimes a pregnancy is terminated because the developing baby has a serious condition or because the pregnancy is putting the mother’s or child’s life at risk. Although most states still allow the termination of a pregnancy for medical emergencies, many physicians and patients have become scared to perform these procedures due to the possible repercussions. According to Missouri laws, anyone who performs an abortion can be charged with a class B felony, “as well as subject to suspension or revocation of his or her professional license” unless it is in a case of medical emergency (Revisor of Missouri). Dr. Eve Espey, a professor at the University of New Mexico in Albuquerque, says that more Texas residents have been coming to New Mexico to terminate their pregnancies, some even with “serious pregnancy complications” (Varney). Both the providers and patients in Texas (and Missouri) are afraid to deal with abortion situations due to the fear of prosecution since the term “medical emergency” has a lot of legal ambiguity. If a pregnant person is having to board a plane or drive hours for a procedure when their health is in serious danger, then that is putting the person’s life at risk as well. The well-being of this patient is drastically decreased because not only is there added stress, but it is costing even more money and having to put themselves in an uncomfortable situation in order to get the care they desire. Therefore, their overall health is negatively affected by what some argue is supposed to be a beneficial development.
Now let’s look at this development from more of a physician’s point of view. In chapter ten of Stegenga’s Care & Cure he discusses the effectiveness of certain medical treatments, but what about the effectiveness of the physician? If the positive view of health is taken into account, then a medical treatment is effective if it “contributes to a person’s state of complete physical, mental and social well-being” (Stegenga 160). Certainly, the skills needed to terminate a pregnancy can contribute to a person’s well-being, especially if it is a situation where the pregnant person’s life is at risk. Thus, by taking away the skills to potentially perform life-saving treatment or procedures, the physician is also rendered virtually ineffective. What happens if an OB/GYN’s patient comes in with a blood clot due to elevated hormones and stress on the heart? In this case, it is either perform the abortion or it is very likely that the patient will die. If a physician has no training in these skills, they will not be able to effectively treat and save their patient.
From the perspective of students striving to become OB/GYNs, being perceived as less than due to a lack of opportunity to gain this knowledge is terrifying. The decrease in medical schools teaching these skills has limited prospective medical students in their options as to which school they can even apply to. For example, once the abortion ban took place and many schools stopped offering the training, some schools that do offer the training, like the University of Washington in Seattle, “decided to admit only residents committed to providing abortion care” in response to schools in states such as Texas and Missouri. Consequently, students looking to be OB/GYNs are given less opportunity to get into medical schools based on whether that school offers the training. After finding out about this development from articles such as Vanger’s, some medical students have been swayed to switch specialties because they do not want to have to seek out more training on top of their eight years of schooling. This is troubling for both the health field and the general population due to the fact that there is already a doctor shortage, with the number OB/GYNs declining recently.
When the common public reads this article, one of the main takeaways is that future OB/GYNs may not be totally qualified or knowledgeable in their specialty. This notion could cause a very skeptical environment between the patient and physician because the patient might doubt the physician’s capabilities. A huge part of healthcare is the relationship between physician and patient which needs a lot of trust in order for the best outcomes. OB/GYNs require some of the most trust since there is a lot of invasions of privacy along with literally helping people bring life into this world. Most will choose to go to a doctor that has the skills to save the patient’s life if a medical emergency were to occur. Thus, those that do not have the training seem less appealing to the public and it may be harder for them to get a job or patients.
Not only does the decrease in abortion training affect physician capabilities, but it limits patient autonomy and safety. When the public consumes this information, they could fall under the notion that many OB/GYNs will be less qualified, a notion that happens to be true if they lack the abortion training. This could create an untrustworthy environment, especially if the patient is not confident their physician has the skills to save their life in case of an emergency. Furthermore, much like the patients that are forced to seek medical treatment in another state, future physicians that are not offered the training at their medical school but wish to have it will have to seek out another program. This article not only highlights the possible inefficiency of future OB/GYNs, but it also shows the public how their well-being could be affected by medical schools taking abortion training out of their curriculum. Although it is important to share this information, the way the article presents the information may strike fear into both students and patients, rightfully so.
Work Cited
“Right to Life of the Unborn Child Act.” Revisor.mo.gov, 24 June 2022, revisor.mo.gov/main/OneSection.aspx?section=188.017#:~:text=Any%20person%20who%20knowingly%20performs. Accessed 11 Oct. 2023.
Stegenga, Jacob. Care and Cure. University of Chicago Press, 13 Nov. 2018.
Varney, Sarah. “Fewer Medical Students Trained for Abortion Procedures.” NBC News, 22 Mar. 2022, www.nbcnews.com/health/womens-health/fewer-medical-students-trained-abortion-procedures-rcna21003.