One of the most well-respected OB-GYN programs in the country could be forced to stop teaching its students how to perform abortions, if the North Carolina legislature ends up approving a piece of legislation that was introduced this month.
Tucked deep in HB 465, an anti-abortion bill that would restrict the procedure in several different ways, is an obscure provision that stipulates that “no department at the medical school at East Carolina University or the University of North Carolina at Chapel Hill shall permit an employee to perform or supervise the performance of an abortion as part of the employee’s official duties.”
According to the GOP lawmakers who proposed the bill, this particular section of HB 465 will help ensure that taxpayer dollars don’t go toward abortion services. Because East Carolina University (ECU) and the University of North Carolina (UNC) are state schools, abortion opponents don’t want any of their instruction time to be spent on the procedure. But this complicated effort to separate taxpayer money from abortion services could have huge implications for the medical field.
“It takes several steps to get to the point of the regulation,” Elizabeth Nash, the senior states issues associate at the Guttmacher Institute, a think tank that closely tracks abortion-related legislation, told ThinkProgress. “It takes you a couple steps to understand that this would eliminate — or, at the very least, drastically reduce — the abortion training programs that are in place.”
That would have particularly big consequences for UNC, which is ranked as one of the country’s top five OB-GYN residency programs. UNC’s medical school is currently home to a Ryan Program — a national initiative intended to address the growing shortage of abortion providers by providing more opportunities for doctors to be trained in pregnancy termination. Residents can also pursue a separate family planning fellowship that includes opportunities for abortion training and research. If HB 465 is enacted into law, both of those programs could be placed into jeopardy.
“It raises a very serious issue: Who’s going to be training the OB-GYNs at UNC to do abortions, if faculty can’t do them?” Dr. David Grimes, a retired abortion doctor and researcher who completed his own residency at UNC, told ThinkProgress.
The experts at UNC have been pioneering medical advances in abortion care for decades. Back in 1970, researchers at UNC published perhaps the first reliable study estimating the prevalence of illegal abortion procedures in the United States. In the years since, the institution has continued to provide, teach, and research abortion.
Grimes, who later returned to Chapel Hill to serve as a faculty member, called the proposed legislation to restrict abortion training “outrageous” and an “unwarranted intrusion” into doctors’ professional lives. “Some religious groups are also opposed to blood transfusions. So should the state legislature in North Carolina pass a law that would close down the blood bank at the university hospital?” he said.
Indeed, the proposal in North Carolina goes against the consensus in the medical field. The accreditation bodies for OB-GYN programs stipulate that abortion training must be included in residency education, except among religiously-affiliated schools with moral objections to the procedure.
And comprehensive reproductive health training for future OB-GYNs can hardly afford to be further limited. Thanks to the political opposition to abortion, the procedure has already been effectively isolated from the rest of women’s health care. The vast majority of hospitals have shied away from pregnancy terminations, worried about sparking protests from anti-choice groups that target any professional institutions that enter into partnerships with abortion providers. So doctors getting trained in obstetrics often face significant barriers to learning more about abortion — particularly if they’re completing their residency in a Catholic-affiliated hospital, where abortion services are totally banned. That makes it difficult for reproductive health providers to offer their patients the full range of services related to pregnancy.
It also threatens to influence the care that women may receive in emergency situations. Pregnancies sometimes go wrong, and the so-called “miscarriage management” that takes place in a hospital often isn’t any different than abortion in a practical sense. But if doctors haven’t been trained in that area, where does that leave women who need immediate medical attention?
“We hear abortion opponents argue that they want to protect women’s health. The last thing in the world you want to do, then, is restrict opportunities to provide training for safe abortion,” Nash pointed out.
According to the Guttmacher Institute’s records, only a handful of very conservative states — the states that often serve as testing grounds for extreme abortion restrictions — have previously attempted to prevent medical schools from providing their students with any training about pregnancy terminations.
In 2011, Arizona enacted a similar law that has since forced some of the state’s Planned Parenthood clinics to stop offering abortion services because they can’t find enough qualified doctors to hire. Texas and Kansas have also passed laws going after medical schools; under an omnibus anti-abortion law enacted in 2013, for instance, instructors at the University of Kansas Medical School are only allowed to teach their students about abortion is they do it after business hours and off campus.
In North Carolina, the abortion training restriction is accompanied by somewhat of a more mainstream anti-choice provision: An extended abortion waiting period that would require patients to wait 72 hours before ending a pregnancy. Nash believes that gives HB 465 a better chance of passing this session, particularly since North Carolina’s legislature has recently proven itself eager to enact abortion restrictions.
GOP legislators in the state are also currently attempting to restrict other types of education about reproductive rights. A separate bill introduced last week, HB 596, would prohibit public schools from including any information about emergency contraception in their sex ed classes.
Planned Parenthood South Atlantic has come out against the legislation, releasing a statement declaring that “these bills have nothing to do with patient safety, and are just attempts by politicians to insert their own political agendas into medical care.”