http://www.medicine.mcgill.ca/MJM/issues/v08n02/crossroads/82157.pdf
ACCESS TO ABORTION SERVICES IN CANADA
AND THE U.S.
In spite of the legality of abortion in the U.S. and
Canada, many women continue to lack access to
abortion services. Two factors in particular- the
declining number of abortion providers and a change in
the distribution of abortion facilities- have significant
adverse consequences for women's health, particularly
for poor and rural women (17, 18). In Canada, only
17.8% of hospitals provide the service, and some
provinces have no provider (17). Similarly, in the
United States, in 2000, 87% of counties had no provider
(18).
A variety of factors have contributed to the decline in
the number of providers. They range from physicians'
personal moral objections to fears of becoming targets
of violence or harassment (19-26). In addition, certain
laws in the U.S. targeting abortion providers create
barriers, while physician-only laws restrict other
medical personnel such as nurse practitioners from
providing abortions (27, 28).
Abortion education in
medical schools and residency programs is limited,
which has been shown in several studies to decrease the
likelihood of physicians choosing to provide abortions
(25, 26, 29, 30).
30. Westhoff C. Abortion training in residency programs. Journal of
American Medical Women's Association 49(5): 150-154; 1994.
ABORTION IN MEDICAL SCHOOL
CURRICULA: THE REALITY
As 48% of women aged 30-34 in the U.S. have
experienced an unintended pregnancy, and 4 out of 10
women seek abortion services sometime during their
reproductive life, the lack of abortion education in
medical curricula significantly affects medical students'
ability to address women's reproductive needs (1).
Espey et al. (2005) (3) surveyed Obstetrics and
Gynecology clerkship directors to determine the extent
of abortion education in U.S. medical schools. They
found that 17% of schools had no abortion education at
all and that in many other schools, coverage was
minimal (3). One organization, Medical Students for
Choice (MSFC), is currently surveying medical schools
in the U.S. and Canada about their individual curricula.
The preliminary results of MSFC's study of the
reproductive health content of preclinical medical
education found that nearly 40% of the more than 50
schools surveyed do not teach any aspect of abortion in
the preclinical years (4). Indeed, the study found that,
on average, more class time is dedicated to Viagra than
to abortion procedures, pregnancy options counseling,
or abortion law and policy (4). This glimpse into U.S.
and Canadian medical curricula reveals that abortion is
not a standard component of preclinical education.
