Tag Archives: women’s choice

As more clinics close, young docs turn to abortion training

Even as scores of abortion clinics have shut down, the number of doctors trained to provide the procedure has surged — but only in some parts of the country.

Two little-known training programs say they have expanded rapidly in recent years, fueled by robust private funding and 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.

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.

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.”

Protesters demonstrate in front of the U.S. Supreme Court as the court takes up a major abortion case in Washington, in this file photo taken March 2. — PHOTO: REUTERS/Kevin Lamarque/Files
Protesters demonstrate in front of the U.S. Supreme Court as the court takes up a major abortion case in Washington, in this file photo taken March 2. — PHOTO: REUTERS/Kevin Lamarque/Files

Supreme Court rules Monday on Hobby Lobby suit claiming a religious right to deny contraceptive coverage for women workers

When the Supreme Court meets on Monday for the final time this session, the justices will issue their much-anticipated ruling on a case pitting the religious rights of employers against the right of women to choose their form of birth control.

Under President Barack Obama’s Affordable Care Act, employers must cover contraception for women at no extra charge as part of a range of preventive benefits required in employee health plans. But dozens of Christian-right employers, including the owners of the crafts chain Hobby Lobby, say that providing certain contraceptive coverage impinges on their freedom of religion. Hobby Lobby and furniture maker Conestoga Wood Specialties Corp. object particularly to contraceptive forms they believe can work after conception, including Plan B, ella and expensive intrauterine devices.

The Obama administration says coverage for birth control is important to women’s health and reduces the number of unwanted pregnancies and abortions.

The court has never recognized a for-profit corporation’s religious rights under federal law or the Constitution. But court watchers say it’s very possible that the right-wing majority on the bench will do just that on Monday. Some observers expect a limited ruling that reserves the right only for corporations that are held under tight family control.

During a hearing on the case in March, several justices expressed concerns that such a decision could lead to religious objections to covering blood transfusions or vaccinations.

Prominent Washington lawyer Paul Smith told The Associated Press that another important question is how the decision would apply to “laws that protect people from discrimination, particularly LGBT people.”

In the Hobby Lobby case, even if the court finds the company has a right to enact workplace policies based on the owners’ religious beliefs, it still has to weigh whether the government’s decision to have employee health plans pay for birth control takes precedence over companies’ religious objections.

Business pundits say that although Hobby Lobby might win the case, it could tarnish the company’s brand as anti-woman and politically divisive. Hobby Lobby does not object to covering male employees’ costs for vasectomies.

The company has 560 locations that bring in a total of $3.3 billion in revenue and employ over 23,000 people. Hobby Lobby has increased sales by roughly 50 percent since 2011, according to a Huffington Post blog.

The company’s growth is taking it into new markets where the Supreme Court case will overshadow the first impression it makes on many prospective customers.

Hobby Lobby has already gotten caught in the headlights for its religious extremism. During last year’s holiday season, a Jewish customer in New Jersey asked the employee of a local Hobby Lobby why the store does not carry Hanukkah items. The employee replied it was due to the owners’ religious beliefs. “We don’t cater to you people,” he said.

The incident set off a national brouhaha that is likely to be repeated on Monday.

Perry signs anti-abortion bill into law

Texas Gov. Rick Perry on July 18 signed into law an anti-abortion bill expected to force the closure of most women’s health clinics that provide abortions in the state.

The measure also prohibits abortions after 20 weeks of pregnancy.

Perry, at the bill-signing, said, “This is an important day for those who support life and for those who support the health of Texas women. In signing House Bill 2, we celebrate and further cement the foundation on which the culture of life in Texas is built.”

Thousands of protesters had demonstrated at the state Capitol against the legislation. Perry called a special session of the Legislature after the bill was defeated last month following a dramatic filibuster by State Sen. Wendy Davis.

Leading medical groups, including the American College of Obstetricians and Gynecologists and the Texas Hospital Association, oppose the measure as an unwarranted intrusion into the doctor patient relationship and unnecessary for patient safety. The measure says that doctors who perform abortions must have hospital admitting privileges at a facility within 30 miles and that clinics must be equipped as ambulatory surgical centers even though abortion is not a surgery.

A legal challenge is likely.

In a statement released on July 18, Jennifer Dalven of the ACLU Reproductive Freedom Project said, “The Texas measure is part of an orchestrated, nationwide plan to outlaw abortion clinic by clinic, state by state. As what happened in Texas shows, women aren’t stupid. We won’t sit quietly by while politicians take away our right to make our own, personal and private medical decisions just to score political points.”

Terri Burke with the ACLU of Texas added, “The passage of this legislation is a clear example of an extreme minority imposing its will on the majority, all in an attempt to win more supporters in political primaries. As polls of Texas voters have repeatedly shown, the majority of Texans don’t want legislators passing more restrictions on a woman’s right to have safe and legal abortions. Even after tens of thousands have stood up in the state Capitol and in cities across the state to tell them loud and clear that politicians should not be interfering in a woman’s personal and private decision-making, some politicians are still not getting message.”