Doctors Don’t Want to Perform Abortions

An ultrasound machine sits next to an exam table in an examination room at an abortion provider in South Bend, Ind., on June 19, 2019. (Scott Olson/Getty Images)

Commentary

For nearly half a century—ever since the Supreme Court decided there was a federal constitutional right to get an abortion in Roe v. Wade in 1973—abortion activists have been trying to figure out how to get more physicians to actually perform the procedure. It’s been a tough battle.

A widely publicized survey of OB-GYNs published in 2011 indicated that although 97 percent of respondents said they had been approached by female patients seeking abortions, only 14 percent of them offered the service.

That number has ticked up to 24 percent over the past decade, according to some reports, an indication that the situation hasn’t changed much. Perhaps physicians—who tend to work in large corporate-style practices these days—fear the disapproval of their colleagues. Perhaps they don’t want to deal with pro-life protesters outside their doors. Or perhaps they just plain have moral qualms.

For example, The Washington Post ran a glowing May 10 profile of a doctor, Franz Theard, who runs an abortion clinic in Santa Teresa, New Mexico, just across the Texas line, that helps women skirt a 2021 Texas law banning nearly all abortion after a fetal heartbeat can be detected. But it turns out that Theard doesn’t currently perform abortions after all, at least the surgical kind.

“I mean, imagine crushing something and taking it out. It’s heartbreaking to a certain extent. Honestly, I didn’t like to do it,” he said. He limits his abortion practice these days to handing out pills, which are safe only if administered during the first 10 weeks of pregnancy.

There’s an obvious irony there. The Supreme Court seems to be indicating, via a leaked draft majority opinion, that it will overturn Roe v. Wade before it winds up its term at the end of June, returning the issue of abortion’s legality to the states. The case before the court, Dobbs v. Jackson Women’s Health Organization, involves a Mississippi law barring most abortions after the 15th week of pregnancy. So even on the off chance that some of the justices who signed the draft opinion change their minds and vote to uphold Roe, it seemingly won’t make any difference for cautious or squeamish or conscience-stricken physicians who either limit their abortion practice to the very earliest weeks—or shun it altogether.

The majority of OB-GYNs, as we have seen, fall into that latter category.

Abortion activists’ solution to this dilemma, at least since the 1990s, has been to force more doctors to perform abortions—or, rather, to make it impossible to be certified as an OB-GYN, or maybe even a physician, period—without receiving abortion “training,” which means participating hands-on in abortions. This drastic inversion of the Hippocratic Oath, in which doctors once pledged never to perform the procedure, would mean that every specialist you consulted about safely delivering your baby would also be willing to cut that baby out of your body if that’s what you wanted instead. It’s called, in the words of a recent New Yorker article on the subject, a “patient-centered approach to health care” that makes the individual doctor’s moral qualms irrelevant.

This approach has worked out better in theory than in practice—at least so far. In 1995 the Accreditation Council for Graduate Medical Education (ACGME) started requiring all medical residency programs—the multi-year specialized training at hospitals after graduating from medical school—in obstetrics and gynecology to learn how to perform “induced abortion.” After strong protests from Catholic and other religiously affiliated hospitals and medical programs, Congress in 1996 passed a law forbidding discrimination in federal funding to institutions that decline to comply with the ACGME rule. Subsequent federal laws, including, to some extent, Obamacare, have reiterated federal support for conscientious objections.

The result has been a surprising variation in ACGME compliance. A 2018 survey reported in the American Journal of Obstetrics and Gynecology found that 64 percent of residency programs make abortion training a routine part of residents’ schedules (presumably allowing conscientious objections), 31 percent consider it merely optional, and 5 percent (mostly Catholic hospitals) continue not to offer it all. And even in the most ACGME-compliant programs, relatively few residents learn how to perform the late-term dilation-and-evacuation procedures (“crushing something and taking it out”) that even abortion-performing physicians like Theard find repugnant.

So in order to boost the number of abortion providers, abortion advocates have proposed a range of “solutions”: letting non­physicians (nurses, midwives, physician assistants) perform abortions (that’s the situation in 18 liberal-leaning states), and expanding abortion-training mandates to family-practice residencies. The current favorite recommendation, however, seems to be simply screening out doctors who might have qualms about abortion in medical school before they even graduate into residencies. Last year, a coalition of abortion advocates asked the American Medical Association (AMA) to support mandated abortion training for medical students. The AMA rejected the proposal—and several states have laws or pending bills barring such training at public universities. But expect the pressure to continue.

“Pro-life anything has NO PLACE in a medical school,” The New Yorker reported as a typical Twitter attitude toward aspiring doctors who don’t want to perform abortions. With cultural pressure like that, abortion advocates seem to be well along in their goal of assuring that the obstetrician who delivers your baby today spent yesterday terminating the lives of other babies before they could be born.

Views expressed in this article are opinions of the author and do not necessarily reflect the views of The Epoch Times.