The National Right to Life Committee: its founding, its history, and the emergence of the pro-life movement prior to Roe v. Wade

During the mid-1960s a few Catholic journals and individuals advised that a more active role should be taken in defeating abortion reform. In 1967 the National Conference of Catholic Bishops selected James Thomas McHugh, administrator of the United States Catholic Conference’s Family Life Bureau, to guide its National Right to Life Committee (NRLC). Several pro-life organizations, including Minnesota Citizens Concerned for Life, emerged and affiliated with the NRLC national office. To appeal to a more broad-based, nonsectarian movement, key Minnesota leaders proposed an organizational model that would separate the NRLC from its founder. In early 1973 McHugh and his executive assistant, Michael Taylor, proposed a different plan, facilitating the NRLC’s move to independence.

Abortion training at multiple sites: an unexpected curriculum for teaching systems-based practice

BACKGROUND

In 1999, the Accreditation Council for Graduate Medical Education endorsed systems-based practice as one of six general competencies.

PURPOSE

The objective is to explore the paradigm of teaching residents systems-based practice during a women's health rotation that included abortion training in multiple settings.

METHODS

During a routine women's health rotation, residents from two urban family medicine residency programs received early abortion training at a high-volume abortion clinic and their continuity clinic. Thirty-min semistructured interviews were conducted with all 26 residents who rotated between July 2005 and August 2006. Transcripts were analyzed using thematic codes.

RESULTS

Through exposure to different healthcare delivery systems, residents learned about systems-based practice, including understanding the failure of the larger system to meet patients' reproductive healthcare needs, differences between two systems, and potential systems barriers they might face as providers.

CONCLUSIONS

Abortion training in multiple settings may serve as a paradigm for teaching systems-based practice during other rotations that include training in multiple sites.

[The abortion from bioethics: autonomy of woman and physician?]

In this reflection on abortion, we will analyze from the bioethics viewpoint the concept of autonomy, in accordance with the liberal individual model and personal ambitions to be applied to the woman's and the doctor's decision making and the society in general. Now that the abortion liberalization is being proposed in Spain through a law that intends to substitute the decriminalization of certain assumptions that have been in effect since 1985, it is necessary to analyze in deep the ethical aspects beyond the legal and social approaches. Bioethics and Law must join together, since both have the same aim: the promotion of human life respect and its basic rights; safeguard -as long as possible-, the values within an interpersonal relationship that lead to fulfill a woman's life having an unwanted pregnancy, as well as that of the fetus and the doctor; and always trying to protect the rights of those who are the weakest: the woman and the fetus, without disregarding everyone's duties with them.

Abortion in late Imperial China: routine birth control or crisis intervention?

In late imperial China, a number of purported methods of abortion were known; but who actually attempted abortion and under what circumstances? Some historians have suggested that abortion was used for routine birth control, which presupposes that known methods were safe, reliable, and readily available. This paper challenges the qualitative evidence on which those historians have relied, and presents new evidence from Qing legal sources and modern medical reports to argue that traditional methods of abortion (the most common being abortifacient drugs) were dangerous, unreliable, and often cost a great deal of money. Therefore, abortion in practice was an emergency intervention in a crisis: either a medical crisis, in which pregnancy threatened a woman's health, or a social crisis, in which pregnancy threatened to expose a woman's extramarital sexual relations. Moreover, abortion was not necessarily available even to women who wanted one.

Politics, religion and gender equality in contemporary Mexico: women's sexuality and reproductive rights in a contested secular state

This article explores the complexities of the interaction between politics, religion and gender equality in contemporary Mexico, by analysing recent developments in public debate, legal changes and implementation of government policies in two areas: 1) the inclusion of emergency contraception in public health services in 2004; and 2) the decriminalisation of abortion in Mexico City in 2008, which was followed by a massive campaign to re-criminalise abortion in the federal states. Three main findings emerge from our analysis: first, that women's sexual and reproductive autonomy has become an issue of intense public debate that is being addressed by both state-public policy and society; second, that the gradual democratisation of the Mexican political system and society is forcing the Catholic Church to play by the rules of democracy; and third, that the character and nature of the Mexican (secular) state has become an arena of intense struggle within which traditional political boundaries and ideologies are being reconfigured.

Being in the room: reflections on pregnancy options counseling during abortion training

BACKGROUND AND OBJECTIVES

The Residency Review Committee requires that family medicine residents learn options counseling for women with unintended pregnancies. This qualitative study identifies important domains for future formal evaluations of pregnancy options counseling by exploring the relevant benefits reported by residents who underwent routine abortion training. To our knowledge, this is the first study of abortion training in family medicine to include an in-depth examination of its benefits in areas that may be important for pregnancy options counseling.

METHODS

Residents from two urban family medicine residency programs received training in first-trimester aspiration abortion at a high-volume abortion clinic during a routine women's health rotation. Thirty-minute semi-structured interviews were conducted with all 28 residents who rotated between July 2005 and November 2006. A coding scheme was developed and applied to transcripts for analysis.

RESULTS

Through exposure to routine abortion training, residents reported improved knowledge, attitudes, and skills that are likely to be important for providing open and informed pregnancy options counseling. These include an understanding of the context of women's lives when they seek abortion care, familiarity with the procedure, and improved self-reported pregnancy options counseling skills.

CONCLUSIONS

Our findings suggest that exposure to abortion training benefits residents in areas that may be important for providing effective pregnancy options counseling. In addition, residents' reflections on their involvement with patients during the abortion process highlight key domains for future formal evaluations of accurate and nonjudgmental options counseling for unintended pregnancy.

Between the town and the mountain: abortion and the politics of life in Edith Wharton's "Summer"

In the early twentieth century, American laws focused on women's reproductive capacities and were coalescing into the ethical and moral frameworks that subtend American reproductive politics today. Edith Wharton published her 1917 novel, Summer, at a time when anti-abortion sentiment was widespread in American culture. Through a reading of Summer, the article provides a theoretical and historical framework for understanding this new American obsession with the judicial regulation of women's reproductive options. In particular, I situate the novel's presentation of abortion within the tension between the carefully defined laws of North Dormer, the town in which the majority of the story takes place, and the lawlessness of the Mountain, a place that looms throughout the story as the protagonist's birthplace and a location of utmost abjection. The novel's profound insight is that power does not function unilaterally and individually but through and on the population. Furthermore, Wharton leaps ahead by recognizing that life is not simply that which lives but that which is recognized and embraced by the law. This realization, one that Wharton must have come to terms with through her painful work with World War I refugees, shapes Charity's character and her understanding not only of how reproduction is regulated but also of how living within this regulation and control generates the norm and offers the only possibility for a liveable and legible life.

Using case scenarios and role plays to explore issues of human sexuality

INTRODUCTION

Doctors and medical students should know what to ask patients, should do so in a sensitive and caring manner and convey a supportive, non-judgmental attitude to their patients, especially with regard to sexual and reproductive issues. The Manipal College of Medical Sciences (MCOMS), Pokhara, Nepal admits students from Nepal, India, Sri Lanka and other countries to the undergraduate medical (MBBS) course. In the MBBS curriculum sexual and reproductive issues are not adequately covered.

METHODS

The Department of Medical Education at MCOMS organized a voluntary Medical Humanities module and conducted a session on social issues in the use of medications. Issues regarding sexual and reproductive health were explored using case scenarios and role plays.

RESULTS AND CONCLUSIONS

This manuscript describes selected case scenarios and various sexuality-related issues covered. The students and the faculty members were of the opinion that sexual and reproductive issues are a grey area in the curriculum. The case scenarios appeared to be successful in sensitizing students and faculty members about certain issues of sexuality. Participants felt the skills acquired would be useful in their future practice. Based on this experience, the module will be modified and strengthened, along with the evaluation process.

Benefits of a learner-centred abortion curriculum for family medicine residents

BACKGROUND AND METHODOLOGY

Despite the high prevalence of unplanned pregnancy and abortion in the USA, abortion education in medical schools and residencies is extremely limited. Regardless of their personal views, family physicians will care for many women who have abortions. This article describes the implementation and evaluation of a learner-centred abortion curriculum in a family medicine residency. Residents were surveyed at baseline to assess openness to abortion education. An abortion curriculum was developed and implemented as a routine component of training. Three to four half-day training sessions were tailored to individual residents, with varying levels of participation in providing abortion depending on learners' personal beliefs. Residents completed written surveys before and after participation in the curriculum.

RESULTS

The pre-implementation survey had a 90% response rate and showed that routine participation in an abortion curriculum was acceptable to 69% of respondents. The curriculum was implemented and evaluated from 2003 to 2006. All 39 residents participated and 28 (72%) completed both pre- and post-rotation surveys. Comparisons between pre- and post-rotation surveys demonstrated statistically significant improvements in abortion-related knowledge and self-reported comfort with abortion-related skills and significantly more favourable attitudes about abortion training.

DISCUSSION AND CONCLUSIONS

Residents were better prepared to care for women with unwanted pregnancies after routine participation in an abortion curriculum. For controversial topics such as abortion, a learner-centred curriculum ensures adequate education for all residents. Future research should assess how routine abortion education affects patient care and whether it results in an increased number of family physicians who provide abortion.

Predictors of abortion provision among practicing obstetrician-gynecologists: a national survey

OBJECTIVE

The objective of the study was to identify the factors that predict whether physicians include pregnancy termination in their practices.

STUDY DESIGN

We surveyed all 5055 obstetrician-gynecologists who became board certified between 1998 and 2001 about personal characteristics, career plans, intention to provide abortions before residency, residency training, and current abortion practice.

RESULTS

Of 2149 respondents (43%), 22% had provided elective abortion in the past year. In multivariate analysis controlling for preresidency intentions, personal beliefs, and other variables, the following were independently associated with current abortion provision: completing a residency program with abortion training (odds ratio [OR], 1.6; confidence interval [CI], 1.1-2.3; P = .007) and performing a greater number of abortions during residency (>25 abortions: OR, 2.8; CI, 1.9-4.1; P < .001). Factors negatively associated with working in a practice (OR, 0.4; CI, 0.2-0.6; P < .001) or hospital (OR, 0.4; CI, 0.3-0.6; P < .001) that prohibits abortion.

CONCLUSION

Regardless of intention to provide abortion before residency, abortion training availability was positively correlated with providing abortion in future practice.

A descriptive analysis of abortion training in family medicine residency programs

BACKGROUND AND OBJECTIVES

Access to abortion services in the United States is declining. While family physicians are well suited to provide this care, limited training in abortion occurs in family medicine residency programs. This study was designed to describe the structure of currently available training and the experience of residents participating in these programs.

METHODS

E-mail questionnaires were sent to key faculty members and third-year residents in nine programs that have required abortion training. These faculty members and a sample of residents also completed semi-structured interviews.

RESULTS

Residency programs varied in the amount of time dedicated to the procedural aspects of abortion training, ranging from 2 to 8 days, and also in non-procedural aspects of training such as values clarification and didactics. Themes that emerged from interviews with residents included the benefit of training with respect to technical skills and continuity of care. In addition, residents valued discussion of the emotional aspects of abortion care and issues relating to performing abortions after graduation from residency.

CONCLUSIONS

While the details of the curricula vary, residents in programs with required abortion training generally felt positively about their experiences and felt that abortion was an appropriate procedure for family physicians to provide. Residents emphasized the importance of both non-procedural and technical aspects of training.

Integrating abortion training into family medicine residency programs

BACKGROUND AND OBJECTIVES

Family physicians provide many office-based procedures in primary care settings. While first-trimester abortion is a procedure appropriate for and performed by family physicians, few residency programs offer routine training in this skill. This study explored the experience of residency programs that have initiated or are in the process of initiating required abortion training.

METHODS

Faculty members responsible for abortion training curricula in identified programs completed questionnaires and semi-structured interviews.

RESULTS

Faculty members from nine programs with required training and seven programs interested in initiating this training were included in the study. Factors that assisted in curriculum development included the support of family medicine and obstetrician-gynecologist faculty. Commonly encountered challenges included the need for dedicated resources, inter-specialty conflict, and limited access to training sites.

CONCLUSIONS

Family medicine programs can be successful at developing required abortion training. Collaboration with colleagues inside and outside the family medicine department and with receptive training sites will benefit programs interested in such.

Abortion training in three family medicine programs: resident and patient outcomes

BACKGROUND

Three family medicine residency programs in California integrated abortion training into routine gynecology rotations in academic years 2003-2004 and 2004-2005.

METHODS

Forty-six (88%) of 52 eligible residents participated in the abortion training sessions. Of these 46 residents, 39 (85%) chose to perform abortion procedures, and seven residents elected to provide other aspects of patient care only.

RESULTS

Resident evaluations of the training program were overwhelmingly positive. Moreover, two thirds of the 43 post-training survey respondents reported that the training program increased their interest in providing abortion services, and no resident reported decreased interest. The resident complication rate was 1.0%. In post-procedure surveys completed by 155 patients at two training sites, patients reported a high level of satisfaction with the care they received from the training team.

CONCLUSIONS

These program evaluation results suggest that abortion training can safely be integrated into family medicine residency programs, with a positive reception by both residents and patients.

A family medicine training collaborative in early abortion

OBJECTIVES

This study's objective was to assess participation and perceived benefits of abortion training among residents at programs with integrated early abortion care.

INTERVENTION

We developed a collaborative early abortion training network.

RESULTS

Residents at training sites had high participation (71%) and were more likely to report familiarity and comfort with providing early abortion care than comparison sites. Residents reported benefits to overall training (78%), satisfaction (55%), and plans to provide abortion care (40%).

CONCLUSIONS

This collaborative abortion training program was valued by residents and was associated with greater self-assessed skills and positive attitudes toward providing early abortion care than at comparison sites.

The effect of a simple educational intervention on interest in early abortion training among family medicine residents

OBJECTIVES

We aimed to assess the effect of an educational intervention on the interest in and support for abortion training among family medicine residents.

METHODS

We conducted a cross-sectional survey before and after an educational lecture on medical and surgical abortion in primary care among 89 residents in 10 New Jersey family medicine programs.

RESULTS

Before the lecture, there was more interest in medical abortion training than surgical abortion. Resident interest in surgical abortion and overall support for abortion training increased after the educational intervention (p<.01).

CONCLUSIONS

Efforts to develop educational programs on early abortion care may facilitate the integration of abortion training in family medicine.

Addressing gaps in abortion education: a sexual health elective created by medical students

Medical school curricula frequently contain gaps in the areas of abortion and sexual health. A group of first- and second-year medical students at the authors' institution organized a collaborative, multidisciplinary elective course to address such omissions in the preclinical curriculum. This paper describes the process of creating and implementing the elective. Medical students identified curricular gaps in the areas of abortion, sexual assault, lesbian/gay/bisexual/transgender health, and HIV counseling. Clinical faculty and community-based professionals were invited to address these topics in a weekly lecture series organized by students. The course also included a half-day experience shadowing at a local abortion clinic. Collaboration with several student groups helped broaden student interest in and increase financial support for the elective. Some 37% of all first- and second-year students enrolled in the elective and received institutional credit for the course. Written and verbal evaluations confirmed student satisfaction with the lectures and the clinical experience. Dynamic and well-prepared speakers who presented interesting medical content received the highest ratings from students. Student leaders identified several challenges in implementing the elective. Ultimately the elective proved to be a successful collaboration among students, faculty, and healthcare providers, and resulted in permanent changes in the standard medical school curriculum. Challenges for student-initiated electives include difficulty in finding administrative support, securing funding and ensuring sustainability. This paper aims to make this process accessible and applicable to other students and faculty interested in addressing curricular gaps at their respective medical schools.