Physicians’ Abortion Training on Decrease

The proportion of hospitals that don’t offer abortion training to intern and resident physicians has increased dramatically since 1976 and women today should not assume their gynecologists have been formally taught to perform the procedure.

While women in urban areas--where the majority of abortions are performed at specialized clinics--stand little risk of having an untrained doctor perform the procedure, the decrease in abortion training rates may have other public health implications.

Those are conclusions of a San Francisco General Hospital research team that compared abortion training patterns in 1976 and 1985.

The researchers found that because of restrictions on military hospitals imposed by conservative politicians, abortion training in military facilities is significantly less available even than in Catholic hospitals.

Few Offer Training

A total of 83% of military hospitals don’t train young doctors in performing abortions at all, none offers such training routinely and only 17% of military facilities offer it on an elective basis.

Figures for the proportion of military hospitals that offered abortion training in 1976 were not available but there were no restrictions at the time. Of Catholic hospitals, between 60% and 65% offered no abortion training in 1976, a percentage that rose from 73.2% to 75.6% in 1985, depending on whether the abortion in question was in the first or second trimester.

Public and non-Catholic private hospitals dropped abortion training programs, too, with 27.8% of all hospitals providing no first-trimester training in 1985--up from only 7.5% a decade earlier--and 26.2% not offering second-trimester training, an increase from 16%. Results were based on a survey of 286 obstetrics and gynecology residency programs nationwide.

Even though abortion has become more of a specialty service provided by clinics that do little else, Dr. Philip Darney, director of San Francisco General’s family planning clinic, noted that it is the most common operation performed on women. Not understanding abortion as surgery, the San Francisco researchers concluded, could mean that a gynecologist in practice has an inadequate background in complete women’s health care.

The study, published in Family Planning Perspectives, a reproductive health journal, suggested that residency programs make arrangements with free-standing abortion clinics to train young doctors in common abortion techniques. Such training would ensure physicians are medically familiar with abortions even if they do not intend to perform them in practice.