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
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
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."
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
ProChoice – The National Abortion and Reproductive Rights
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.