Ask The Expert: Ben Brown ’08 MD’12
The Supreme Court decision to overturn Roe v. Wade has many medical educators worried about how trainees in states that have banned or will ban abortion will be able to learn the procedure. Nearly 45 percent of ob/gyn residency programs—which must offer abortion training to be accredited—are in those 26 states. Benjamin Brown ’08 MD’12, the Mimi Pichey Assistant Professor of Obstetrics and Gynecology, says these restrictions will have serious consequences for patient care, the provider-patient relationship, and health care access, especially for marginalized populations.
Abortion is a critical component of comprehensive health care. The surgical procedure that we would provide when somebody has a first-trimester miscarriage and when someone needs a first-trimester procedural abortion is the same. And that’s true often for second-trimester pregnancy loss as well as second-trimester abortion. Providers need to develop this skill set in order to care for folks who are coming to care for a variety of reasons. In restrictive settings, patients will face barriers to access for induced abortion, for miscarriage management, for ectopic pregnancy management.
Laws that interfere in our ability to provide patient-centered care are tremendously harmful to that provider-patient relationship because they may prevent health care workers from providing scientifically sound, ethically correct care because of the values of a legislator or a judge. When restrictions interfere in that decision-making process, the resultant delays and denials of care may harm the patient. And the folks most likely to be burdened by those denials of care will be folks who’ve historically been excluded from health care spaces due to oppressions like racism, trans- and homophobia, and xenophobia.
We don’t know for sure what everything is going to look like in the next one to five to 10 years. I do think that we are going to see more trainees needing out-of-state rotations in order to train to competency in ob/gyn, family medicine, internal medicine. It takes a lot of money and privilege to be able to pursue medical school and residency. So we also need to focus on making sure that people can access comprehensive training to enter the profession that they want to be in, to be able to be of service in sexual and reproductive health.