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 public: choice:   reproductive choice means nothing without access to services
fear of anti-choice terrorism is not the cause of the shortage of abortion providers {US} • 

  In the early 1990s, reports began surfacing that the number of abortion providers in the United States was dwindling. While many attributed this to potential providers fearing attack from anti-choice terrorism – clinics were being bombed and doctors and staff killed – a closer look revealed that it wasn't fear that was behind fewer providers offering abortion services, but attrition – Ob/Gyns trained in abortion services were retiring and not being replaced.

Abortion services training never made it into the regular medical school curriculum*, and the rise and success of family planning clinics inadvertently reinforced the idea that abortion was a specialized service oustide the scope of Ob/Gyn training. While abortion is the second most common surgical procedure performed in the U.S., with most procedures being performed in clinics, hospitals were less motivated to make training available, nor to keep up with advancements.

Seeing this, NARAL/NY launched the Residency Training Initiative – first to identify the availability of training in New York teaching programs, and then, in conjunction with medical community leaders, to develop and implement a strategy for remedying the provider shortage.

In New York City, many private hospital-sponsored Ob/Gyn programs have affiliated with NYC public hospitals to expand hands-on training. This provides public hospitals with needed staffing and residents with abundant training opportunities. Eight of the NYC public hosplitals are managed and operated by the Health and Hospitals Corporation (HHC). Over 150 Ob/Gyn doctors are trained thorugh HHC each year, but few were leaving prepared to offer comprehensive abortion care. The Board of Directors of the HHC is almost entirely appointed by the mayor of NYC.

Working with providers in HHC facilities, NARAL/NY wrote a recommendation report, outlining specific tasks that would improve resident training, as well as make it more cost-effective to provide abortion services.

In 2001, prior to the NYC mayoral election, NARAL/NY presented their recommendation report to each candidate, and each agreed to it. Four days after his innauguration, Mayor Mike Bloomberg's plan to require abortion training as part of Ob/Gyn residencies in city public hospitals was announced in an article by Sharon Lerner in the Village Voice.

The staff of the Residency Training Initiative continues to monitor the progress of the HHC training initiative.

* In 1995 the Accreditation Council for Graduate Medical Education set forth abortion training requirements, which also allowed residents to opt-out. Congress, bowing to anti-choice pressure, then nullified this in 1996, and replaced it with an unclear, ineffective requirement: "No program or resident with religious or moral objection shall be required to provide training in or to perform induced abortion. Otherwise, access to experience with induced abortion must be part of residency education."

In order to comply with this directive, simply having a single abortion take place at a facility could cover accreditation requirements. This is no way motivated, much less required, that steps be taken to provide routine, nor up-to-date abortion services training.

To read more about access success: NARAL/NY's Residency Training Initiative Success in New York City's Hospitals, download the pdf.

  NARAL ProChoice – The National Abortion and Reproductive Rights Action League  
NARAL/NY is the New York State affiliate of the National Abortion and Reproductive Rights Action League. With more than 30,000 members, NARAL/NY works to protect safe, legal, affordable and accessible abortion care and expand the full range of reproductive rights for all New Yorkers, regardless of age or income. The NARAL/NY Foundation is the 501(c)(3), tax-exempt research, educational and training arm of NARAL/NY. The Foundation produces a variety of educational materials and training programs to educate members, advocates, and the general public about reproductive rights issues.

NARAL's goal is to help find workable answers that will ultimately reduce the need for abortions. It advocates access to contraception, reproductive health care, and sex education in order to avoid unintended pregnancies and more abortions.
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