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Chapter 9 - Abortion Training in the USA

Prevalence, Outcomes and Challenges

from Section II - Integration of Abortion into Graduate Medical Education

Published online by Cambridge University Press:  30 July 2021

By
Jody Steinauer  and
Jema Turk
Edited by
Uta Landy ,
Philip D Darney  and
Jody Steinauer
Uta Landy
Affiliation:
University of California, San Francisco
Philip D Darney
Affiliation:
University of California, San Francisco
Jody Steinauer
Affiliation:
University of California, San Francisco
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Summary

Abortion is common medical procedure and the shortage of providers has been widely reported. This chapter describes the history of abortion training in the United States, including the establishment of the Ryan Residency Training Program, and reiterates that to meet patients’ needs, all clinicians who care for women’s reproductive health must be trained in abortion skills – including counseling, preoperative assessment, ultrasound, medication abortion management, uterine evacuation techniques, pain management, and postoperative care.  This chapter describes the impacts of abortion training on learners’ clinical skills, attitudes toward patients and abortion provision, and on their professional practice. We describe the challenges in integrating abortion into resident curriculum, and how to find support and resources. We provide evidence of the many benefits of integrated training – including improving resident education and more comprehensive patient care, and argue that training in uterine evacuation skills is critical for all obstetrician-gynecologists.

Keywords

medical educationabortionresidency trainingpain managementultrasoundcontraceptioncounseling
Type
Chapter
Information
Advancing Women's Health Through Medical Education
A Systems Approach in Family Planning and Abortion
 , pp. 101 - 109
Publisher: Cambridge University Press
Print publication year: 2021

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References

Jones, R, Witwer, E, Jerman, J. Abortion Incidence and Service Availability in the United States, 2017. New York: Guttmacher Institute; 2019.CrossRefGoogle Scholar
ACOG Practice Bulletin No. 200: early pregnancy loss. Obstet Gynecol. 2018;132(5):e197–e207.CrossRefGoogle Scholar
Almeling, R, Tews, L, Dudley, S. Abortion training in U.S. obstetrics and gynecology residency programs, 1998. Fam Plann Perspect. 2000;32(6):268–271, 320.CrossRefGoogle Scholar
Eastwood, KL, Kacmar, JE, Steinauer, J, Weitzen, S, Boardman, LA. Abortion training in United States obstetrics and gynecology residency programs. Obstet Gynecol. 2006;108(2):303–308.Google Scholar
Steinauer, JE, Turk, JK, Pomerantz, T, Simonson, K, Learman, LA, Landy, U. Abortion training in US obstetrics and gynecology residency programs. Am J Obstet Gynecol. 2018;219(1):86.e81–86.e86.CrossRefGoogle ScholarPubMed
Liauw, J, Dineley, B, Gerster, K, Hill, N, Costescu, D. Abortion training in Canadian obstetrics and gynecology residency programs. Contraception. 2016;94(5):478–482.CrossRefGoogle ScholarPubMed
Kennth, J. Ryan Residency Training Program in Abortion and Family Planning. https://ryanprogram.org/. Accessed 2019.Google Scholar
Steinauer, JE, Turk, JK, Fulton, MC, Simonson, KH, Landy, U. The benefits of family planning training: a 10-year review of the Ryan Residency Training Program. Contraception. 2013;88(2):275–280.Google Scholar
AMA Freida Residency Database of ACGME Accredited Programs.Google Scholar
Maternity and gynecologic care. Recommended Core Educational Guidelines for Family Practice Residents. American Academy of Family Physicians. Am Fam Physician. 1998;58(1):275–277.Google Scholar
Recommended curriculum guidelines for family medicine residents: women’s health and gynecologic care. American Academy of Family Physicians; 2018.Google Scholar
Position statement: midwives as abortion providers. American College of Nurse-Midwives; 2018.Google Scholar
Summit, AK, Gold, M. The effects of abortion training on family medicine residents’ clinical experience. Fam Med. 2017;49(1):22–27.Google Scholar
Turk, JK, Preskill, F, Landy, U, Rocca, CH, Steinauer, JE. Availability and characteristics of abortion training in US ob-gyn residency programs: a national survey. Contraception. 2014;89(4):271–277.CrossRefGoogle ScholarPubMed
MacIsaac, L, Vickery, Z. Routine training is not enough: structured training in family planning and abortion improves residents’ competency scores and intentions to provide abortion after graduation more than ad hoc training. Contraception. 2012;85(3):294–298.Google Scholar
Levi, A, Goodman, S, Weitz, T, et al. Training in aspiration abortion care: an observational cohort study of achieving procedural competence. Int J Nurs Stud. 2018;88:53–59.CrossRefGoogle ScholarPubMed
Dermish, A, Turok, DK, Jacobson, J, Murphy, PA, Saltzman, HM, Sanders, JN. Evaluation of an intervention designed to improve the management of difficult IUD insertions by advanced practice clinicians. Contraception. 2016;93(6):533–538.CrossRefGoogle ScholarPubMed
Patil, E, Darney, B, Orme-Evans, K,et al. Aspiration abortion with immediate intrauterine device insertion: comparing outcomes of advanced practice clinicians and physicians. J Midwifery Womens Health. 2016;61(3):325–330.CrossRefGoogle ScholarPubMed
Greenberg, S, Nothnagle, M. An “invaluable skill”: reflections on abortion training and postresidency practice. Fam Med. 2018;50(9):691–693.CrossRefGoogle ScholarPubMed
Kenneth, J. Ryan Residency Training Program in Abortion and Family Planning, unpublished evaluation data from 1999–2009; 2013.Google Scholar
Steinauer, J, Landy, U, Filippone, H, Laube, D, Darney, PD, Jackson, RA. Predictors of abortion provision among practicing obstetrician-gynecologists: a national survey. Am J Obstet Gynecol. 2008;198(1):39.e31–36.Google Scholar
Romero, D, Maldonado, L, Fuentes, L, Prine, L. Association of reproductive health training on intention to provide services after residency: the family physician resident survey. Fam Med. 2015;47(1):22–30.Google ScholarPubMed
Steinauer, JE, Landy, U, Jackson, RA, Darney, PD. The effect of training on the provision of elective abortion: a survey of five residency programs. Am J Obstet Gynecol. 2003;188(5):1161–1163.Google Scholar
Block, A, Dehlendorf, C, Biggs, MA, McNeil, S, Goodman, S. Postgraduate experiences with an advanced reproductive health and abortion training and leadership program. Fam Med. 2017;49(9):706–713.Google ScholarPubMed
Greenberg, M, Herbitter, C, Gawinski, BA, Fletcher, J, Gold, M. Barriers and enablers to becoming abortion providers: the reproductive health program. Fam Med. 2012;44(7):493–500.Google Scholar
Turk, JK, Preskill, F, Landy, U, Koenemann, K, Steinauer, J. Abortion provision among obstetrician-gynecologists who trained at Ryan Programs. Paper presented at the National Abortion Federation annual meeting; 2017.Google Scholar
Darney, PD, Landy, U, MacPherson, S, Sweet, RL. Abortion training in U.S. obstetrics and gynecology residency programs. Fam Plann Perspect. 1987;19(4):158–162.Google Scholar
Kenneth, J. Ryan Residency Training Program in Abortion and Family Planning, unpublished evaluation data; 2019Google Scholar
Steinauer, JE, Hawkins, M, Turk, JK, Darney, P, Preskill, F, Landy, U. Opting out of abortion training: benefits of partial participation in a dedicated family planning rotation for ob-gyn residents. Contraception. 2013;87(1):88–92.CrossRefGoogle Scholar
Steinauer, JE, Turk, JK, Preskill, F, Devaskar, S, Freedman, L, Landy, U. Impact of partial participation in integrated family planning training on medical knowledge, patient communication and professionalism. Contraception. 2014;89(4):278–285.Google Scholar
Turk, JK, Landy, U, Chien, J, Steinauer, JE. Sources of support for and resistance to abortion training in obstetrics and gynecology residency programs. Am J Obstet Gynecol. 2019;221(2):156.e151–156.e156.Google Scholar
Nothnagle, M, Prine, L, Goodman, S. Benefits of comprehensive reproductive health education in family medicine residency. Fam Med. 2008;40(3):204–207.Google ScholarPubMed

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