A group of 100 reproductive health experts are preparing to publish an open letter asking hospitals to start providing more abortion care. According to TIME, which obtained a copy of the letter in advance of its publication in the American Journal of Obstetrics and Gynecology, the OB-GYNs are ultimately urging hospitals to “reverse a decades-long trend that has isolated abortion providers from the mainstream medical community.”
Right around the time that Roe v. Wade first legalized abortion, the medical community assumed that hospitals would perform the majority of abortions in the country, and freestanding clinics wouldn’t bear much of that burden. In the four decades since, the exact opposite has happened.
As abortion has become increasingly politicized — and as mounting piles of anti-choice legislation make it increasingly more complicated for doctors to perform it — public hospitals and medical schools have shied away from it. Political pressure has convinced many public hospitals to stop providing abortion care. Women’s health advocates began starting their own clinics rather than attempting to navigate the male-dominated health industry. And now, according to Guttmacher, hospitals perform just four percent of the abortions in the U.S.
“In our view, hospitals have disregarded the responsibility that our academic predecessors expected them to assume,” the doctors write in their forthcoming letter. “The savings in lives and money from legalization were soon forgotten and many hospitals now claim they cannot afford to provide abortions even if they wanted to.”
Ultimately, segregating abortion from the rest of medical care has made it an incredibly easy target. Because the vast majority of abortion care is performed at freestanding clinics, abortion opponents can easily focus their efforts on those clinics and force them to shut down — a much easier feat than forcing a hospital to cease its medical practice. It also makes it easier for the anti-choice community to demand that abortion providers are held to higher standards than the medical professionals in other fields. Successful attacks on abortion providers are forcing clinics across the country to close their doors — and now some states, like Mississippi and North Dakota, have just one abortion clinic left.
It’s not that doctors don’t want to learn how to perform abortions, or that hospitals are opposed to providing abortion care. Most OB-GYNs do want to learn about the full spectrum of reproductive care, and most public hospitals have no problem with abortion itself. It’s simply that political pressure has steered the medical community away from it — some states ban abortion training at publicly-funded medical institutions, and some public hospitals have come under the control of private companies that are opposed to abortion. Now, it’s hard for doctors to have the opportunity to work with women who need abortions whatsoever. Medical professionals often have to choose between being an abortion doctor or being a practicing OB-GYN, since so many hospitals don’t offer the procedure.
That lack of integration within the broader medical community, as well as the pervasive societal stigma regarding abortion that results in intimidation and harassment against providers, has contributed to a serious shortage of abortion doctors in the country. Along with the increasing numbers of clinics being forced to close, that’s a dangerous combination. Many women are losing access to reproductive care even while Roe still stands.
The group of doctors who signed onto the new letter hope to change that by encouraging hospitals to reintegrate abortion care with the rest of their medical services.
This isn’t the first time that medical professionals have spoken up in favor of reproductive rights. The American College of Obstetrics and Gynecologists has officially come out against state-level abortion restrictions that flout medical practice and interfere with the doctor-patient relationship. And earlier this year, 100 OB-GYNs joined forces to publish a different letter in the American Journal of Obstetrics and Gynecology warning that reproductive rights are in “grave danger” as anti-choice policies are pulling states back to a time before Roe.