Pro-Lifers at War with the Medical Profession

Republican law-makers have been up to their old tricks bashing abortion and passing invasive restrictions on women seeking it. Less publicized, but even more consequential I believe, are efforts that target a key institutional component of the issue: the teaching of abortion procedures in medical schools and residency programs. Such efforts to undermine accepted teaching protocols have been occurring both at the national and state level.

Several bills and amendments are typical of this new conservative approach. In May, 2011, for example, Rep. Virginia Foxx (R-NC) attempted to prohibit taxpayer funds, which are critical for graduate medical education, from going to pay for abortion training nationwide (it passed the U.S. House, but failed to pass the U.S. Senate). Early the same year at the state level, the governor of Arizona signed into law a pro-life bill that forbade the use of public funds for abortion training in state universities. And this spring, the Kansas legislature brought up a bill that would have banned abortion training in all state-funded institutions and medical residency programs. The Kansas bill would have made it virtually impossible for students to obtain the necessary training even outside of the state system. The measure passed the Kansas house, but died in the senate this May only because of the strong opposition of Kansas’s flagship medical institution, the University of Kansas Medical Center.

The anti-abortion movement’s focus on abortion providers, in this case the training of future ones, is hardly a new trend. Activist Randall Terry famously declared in the early 1990’s, as the wave of assassinations of medical personnel was just beginning, that the doctor was the “weak link” in the system. A central aim of the movement was, by terrorizing and demonizing those who performed abortions, to separate them from the mainstream medical profession and diminish their numbers.

This strategy seemed for a while to be working, as doctors practicing abortion declined steadily in the years following Roe v. Wade. But at a certain point the medical establishment could no longer ignore the growing gaps in health care that came as a result. Abortion, it was increasingly realized (thanks in good part to women in medicine standing up for women’s health concerns), was an integral part of providing complete OB-GYN care. The patient undergoing a dangerous pregnancy as well as the one seeking a safe abortion required dependable treatment by experienced, trained physicians.

As a result, the Accreditation Council for Graduate Medical Education (ACGME), the medical profession’s chief accrediting organization, in 1995 made abortion training a requirement for the accreditation of OB-GYN residency programs. This crucial requirement halted a trend by medical institutions to leave the issue to outside clinics to worry about. Almost all medical schools and teaching hospitals have since brought their programs into conformity with the ACGME standards. Today 90% of OB-GYN residency programs offer abortion training as either a regular or elective component. Increasingly, though still in small numbers, doctors in family and women’s health are viewing abortion as an integral part of their health care responsibilities.

Predictably enough, social conservatives have  reacted furiously to this trend since it negates their effort to marginalize abortion and place it outside of mainstream medicine. Shortly after the ACGME’s action, conservatives  attached an amendment to health legislation (the Coats Amendment of 1996) that upheld the legal status of institutions eschewing abortion training, making it more difficult to enforce ACGME standards. The recent proposals of today’s tea party Republicans are an even more overt attempt to eviscerate those standards and prevent them from being followed.

Make no mistake: the current pro-life movement’s war is not limited to a war against Planned Parenthood and feminist activists, if indeed it ever was. It is one waged against the medical profession itself and the fundamental health standards it seeks to uphold. This fact needs to be highlighted when progressives fight to hold the line against reactionary abortion legislation.

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