Abortion in Medical Schools in Canada – An Elective Subject

Pamela Pizarro

Medical students in Canada are not receiving the training that they need to become abortion providers. Many medical schools do not include the subject in their curriculum, so students wishing to learn the procedure must take it upon themselves to become trained providers.

The lack of trained abortion providers in Canada is huge problem and is keeping women in our country from accessing adequate sexual and reproductive health services. Trained medical staff is already in high demand around the country, meaning that abortion providers are hard to come by in some areas. One of the causes of lack of providers is the fact that new doctors are not being trained on the procedure. When you consider that up to 40% of women will have an abortion during their life time, it is astonishing that the abortion procedure is not required to be taught in any medical school curricula. In fact in a study conducted by Medical Students for Choice, 40% of 50 schools that they surveyed “do not teach any aspect of abortion in the pre-clinical years.”

So what is deterring young doctors from providing abortion services? One of the main obstacles is the fear and intimidation that anti-choice groups inflict upon doctors that do provide the procedure. In the past abortion providers have been targets of physical attacks and death threats. Abortion in Canada is still susceptible to stigma in Canada and many physicians feel the need to keep their services private for their own safety and the safety of their family.

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Another major factor is that medical schools are simply not covering the subject in their lectures. Students that are interested in knowing and learning about the procedure must take it upon themselves to seek out an existing abortion provider that will teach them and supervise while they learn the procedure. Medical students need to witness and be involved in 50 abortion procedures shadowing a physician who is already a provider before they are allowed to perform the procedure themselves. I once heard a young female doctor speak at an event that I attended and she detailed how students in her class feel that abortion is no longer an issue that needs to be fought for. They are under the same belief as are many other Canadians, that a women’s right to an abortion in our country is a guarantee. This is simply not true! Without properly trained doctors, compassionate medical staff, and adequate facilities, women in Canada are not able to access the abortion services that they need.

Culture & Conversation Media

Filmmaker Tracy Droz Tragos Centers Abortion Stories in New Documentary

Renee Bracey Sherman

The film arrives at a time when personal stories are center stage in the national conversation about abortion, including in the most recent Supreme Court decision, and rightly so. The people who actually have and provide abortions should be driving the narrative, not misinformation and political rhetoric.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

A new film by producer and director Tracy Droz Tragos, Abortion: Stories Women Tell, profiles several Missouri residents who are forced to drive across the Mississippi River into Illinois for abortion care.

The 93-minute film features interviews with over 20 women who have had or are having abortions, most of whom are Missouri residents traveling to the Hope Clinic in Granite City, Illinois, which is located about 15 minutes from downtown St. Louis.

Like Mississippi, North Dakota, South Dakota, and Wyoming, Missouri has only one abortion clinic in the entire state.

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The women share their experiences, painting a more nuanced picture that shows why one in three women of reproductive age often seek abortion care in the United States.

The film arrives at a time when personal stories are center stage in the national conversation about abortion, including in the most recent U.S. Supreme Court decision, and rightly so. The people who actually have and provide abortions should be driving the narrative, not misinformation and political rhetoric. But while I commend recent efforts by filmmakers like Droz Tragos and others to center abortion stories in their projects, these creators still have far to go when it comes to presenting a truly diverse cadre of storytellers if they really want to shift the conversation around abortion and break down reproductive stigma.

In the wake of Texas’ omnibus anti-abortion law, which was at the heart of the Whole Woman’s Health v. Hellerstedt Supreme Court case, Droz Tragos, a Missouri native, said in a press statement she felt compelled to document how her home state has been eroding access to reproductive health care. In total, Droz Tragos interviewed 81 people with a spectrum of experiences to show viewers a fuller picture of the barriersincluding legislation and stigmathat affect people seeking abortion care.

Similar to HBO documentaries about abortion that have come before it—including 12th & Delaware and Abortion: Desperate ChoicesAbortion: Stories Women Tell involves short interviews with women who are having and have had abortions, conversations with the staff of the Hope Clinic about why they do the work they do, interviews with local anti-choice organizers, and footage of anti-choice protesters shouting at patients, along with beautiful shots of the Midwest landscape and the Mississippi River as patients make road trips to appointments. There are scenes of clinic escorts holding their ground as anti-choice protesters yell Bible passages and obscenities at them. One older clinic escort carries a copy of Living in the Crosshairs as a protester follows her to her car, shouting. The escort later shares her abortion story.

One of the main storytellers, Amie, is a white 30-year-old divorced mother of two living in Boonville, Missouri. She travels over 100 miles each way to the Hope Clinic, and the film chronicles her experience in getting an abortion and follow-up care. Almost two-thirds of people seeking abortions, like Amie, are already a parent. Amie says that the economic challenges of raising her other children make continuing the pregnancy nearly impossible. She describes being physically unable to carry a baby and work her 70 to 90 hours a week. Like many of the storytellers in the film, Amie talks about the internalized stigma she’s feeling, the lack of support she has from loved ones, and the fear of family members finding out. She’s resilient and determined; a powerful voice.

The film also follows Kathy, an anti-choice activist from Bloomfield, Missouri, who says she was “almost aborted,” and that she found her calling in the anti-choice movement when she noticed “Anne” in the middle of the name “Planned Parenthood.” Anne is Kathy’s middle name.

“OK Lord, are you telling me that I need to get in the middle of this?” she recalls thinking.

The filmmakers interview the staff of the Hope Clinic, including Dr. Erin King, a pregnant abortion provider who moved from Chicago to Granite City to provide care and who deals with the all-too-common protesting of her home and workplace. They speak to Barb, a talkative nurse who had an abortion 40 years earlier because her nursing school wouldn’t have let her finish her degree while she was pregnant. And Chi Chi, a security guard at the Hope Clinic who is shown talking back to the protesters judging patients as they walk into the clinic, also shares her abortion story later in the film. These stories remind us that people who have abortions are on the frontlines of this work, fighting to defend access to care.

To address the full spectrum of pregnancy experiences, the film also features the stories of a few who, for various reasons, placed their children for adoption or continued to parent. While the filmmakers interview Alexis, a pregnant Black high school student whose mother died when she was 8 years old, classmates can be heard in the distance tormenting her, asking if she’s on the MTV reality show 16 and Pregnant. She’s visibly distraught and crying, illustrating the “damned if you do, damned if you don’t” conundrum women of color experiencing unintended pregnancy often face.

Te’Aundra, another young Black woman, shares her story of becoming pregnant just as she received a college basketball scholarship. She was forced to turn down the scholarship and sought an adoption, but the adoption agency refused to help her since the child’s father wouldn’t agree to it. She says she would have had an abortion if she could start over again.

While anti-choice rhetoric has conflated adoption as the automatic abortion alternative, research has shown that most seeking adoption are personally debating between adoption and parenting. This is illustrated in Janet’s story, a woman with a drug addiction who was raising one child with her partner, but wasn’t able to raise a second, so she sought an adoption. These stories are examples of the many societal systems failing those who choose adoption or students raising families, in addition to those fighting barriers to abortion access.

At times, the film feels repetitive and disjointed, but the stories are powerful. The range of experiences and reasons for having an abortion (or seeking adoption) bring to life the data points too often ignored by politicians and the media: everything from economic instability and fetal health, to domestic violence and desire to finish an education. The majority of abortion stories featured were shared by those who already had children. Their stories had a recurring theme of loneliness and lack of support from their loved ones and friends at a time when they needed it. Research has shown that 66 percent of people who have abortions tend to only tell 1.24 people about their experience, leaving them keeping a secret for fear of judgment and shame.

While many cite financial issues when paying for abortions or as the reason for not continuing the pregnancy, the film doesn’t go in depth about how the patients come to pay for their abortions—which is something my employer, the National Network for Abortion Funds (NNAF), directly addresses—or the systemic issues that created their financial situations.

However, it brings to light the hypocrisy of our nation, where the invisible hand of our society’s lack of respect for pregnant people and working parents can force people to make pregnancy decisions based on economic situations rather than a desire to be pregnant or parent.

“I’m not just doing this for me” is a common phrase when citing having an abortion for existing or future children.

Overall, the film is moving simply because abortion stories are moving, especially for audiences who don’t have the opportunity to have someone share their abortion story with them personally. I have been sharing my abortion story for five years and hearing someone share their story with me always feels like a gift. I heard parts of my own story in those shared; however, I felt underrepresented in this film that took place partly in my home state of Illinois. While people of color are present in the film in different capacities, a racial analysis around the issues covered in the film is non-existent.

Race is a huge factor when it comes to access to contraception and reproductive health care; over 60 percent of people who have abortions are people of color. Yet, it took 40 minutes for a person of color to share an abortion story. It seemed that five people of color’s abortion stories were shown out of the over 20 stories, but without actual demographic data, I cannot confirm how all the film’s storytellers identify racially. (HBO was not able to provide the demographic data of the storytellers featured in the film by press time.)

It’s true that racism mixed with sexism and abortion stigma make it more difficult for people of color to speak openly about their abortion stories, but continued lack of visual representation perpetuates that cycle. At a time when abortion storytellers themselves, like those of NNAF’s We Testify program, are trying to make more visible a multitude of identities based on race, sexuality, immigration status, ability, and economic status, it’s difficult to give a ringing endorsement of a film that minimizes our stories and relegates us to the second half of a film, or in the cases of some of these identities, nowhere at all. When will we become the central characters that reality and data show that we are?

In July, at the progressive conference Netroots Nation, the film was screened followed by an all-white panel discussion. I remember feeling frustrated at the time, both because of the lack of people of color on the panel and because I had planned on seeing the film before learning about a march led by activists from Hands Up United and the Organization for Black Struggle. There was a moment in which I felt like I had to choose between my Blackness and my abortion experience. I chose my Black womanhood and marched with local activists, who under the Black Lives Matter banner have centered intersectionality. My hope is that soon I won’t have to make these decisions in the fight for abortion rights; a fight where people of color are the backbone whether we’re featured prominently in films or not.

The film highlights the violent rhetoric anti-choice protesters use to demean those seeking abortions, but doesn’t dissect the deeply racist and abhorrent comments, often hurled at patients of color by older white protesters. These racist and sexist comments are what fuel much of the stigma that allows discriminatory laws, such as those banning so-called race- and sex-selective abortions, to flourish.

As I finished the documentary, I remembered a quote Chelsea, a white Christian woman who chose an abortion when her baby’s skull stopped developing above the eyes, said: “Knowing you’re not alone is the most important thing.”

In her case, her pastor supported her and her husband’s decision and prayed over them at the church. She seemed at peace with her decision to seek abortion because she had the support system she desired. Perhaps upon seeing the film, some will realize that all pregnancy decisions can be quite isolating and lonely, and we should show each other a bit more compassion when making them.

My hope is that the film reaches others who’ve had abortions and reminds them that they aren’t alone, whether they see themselves truly represented or not. That we who choose abortion are normal, loved, and supported. And that’s the main point of the film, isn’t it?

Abortion: Stories Women Tell is available in theaters in select cities and will be available on HBO in 2017.

News Abortion

New Data Shows Drop in Texas Abortion Rates After HB 2

Teddy Wilson

The driving force behind the overall reduction appears to be a dramatic decrease in the number of medication abortions: The number dropped from 16,756 in 2013 to 5,044 in 2014.

The Texas Department of State Health Services (DSHS) released Thursday the state’s abortion statistics for 2014, which show a decrease in the number of abortions in the state compared to the previous year.

The data release comes after the American Civil Liberties Union (ACLU) of Texas claimed that DSHS deliberately delayed releasing the information to hide it from the public. It also follows on the heels of the U.S. Supreme Court’s historic decision striking down two provisions of the state’s omnibus anti-abortion law, HB 2.

The total number of abortions in the state decreased from 63,849 in 2013 to 54,902 in 2014a reduction of 8,947 abortions.

Reproductive rights advocates say the data, which offers a look at the effect of HB 2 in the first full year of its implementation, provides further evidence of the law’s negative impact on access to abortion care.

“We will leave it to statisticians to undertake deeper analyses of this data, but at first glance the numbers demonstrate the devastating effect House Bill 2 had on the women of Texas,” said Trisha Trigilio, staff attorney for ACLU of Texas, in a statement.

The driving force behind the reduction appears to be a substantial decrease in the number of medication abortions: The number decreased from 16,756 in 2013 to 5,044 in 2014.

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HB 2 prohibits anyone other than a physician from dispensing abortion medications. At the time that the bill was signed into law, it also required the physician follow then-outdated FDA protocols. The federal regulations have since changed, increasing the time a pregnant person has to receive a medication abortion, from 49 days to 70 days of gestation.

The statistics also show a slight increase in the number of pregnant persons who traveled out of state to obtain abortion care. The number of abortions that took place “out of state” was 754 in 2014, compared to 681 in 2013.

However, data from other states suggest a much larger increase during that time period. As Rewire previously reported, statistics from Arkansas, Kansas, Oklahoma, and Louisiana appear to indicate at least 1,086 patients traveled to those states from Texas to obtain an abortion in 2014.

The DSHS’ 2014 abortion statistics also show that HB 2 had a disproportionate effect on women of color and women in low-income communities. In 2013, there were 24,063 abortions obtained by Latinas, and in 2014 that number fell to 19,654a decrease of 18.3 percent. Additionally, Black Texans saw a decrease of 7.7 percent, while there was a decrease of 6.7 percent among white Texans.

Trigilio explained in a statement that the statistics reflect the actual intent of proponents of HB 2 and explain why the state agency kept the information “out of the public eye” prior to the Supreme Court decision. (For its part, DSHS said in response to the ACLU’s claims that it had not released the data because it wasn’t final yet.)

“Given the overall drop in abortions—especially in vulnerable communities along the border—as well as the precipitous 70 percent drop in medication abortions, these numbers show that this law never had anything do with women’s health,” said Trigilio.

Heather Busby, executive director of NARAL Pro-Choice Texas, told the Austin American-Statesman that she was not surprised by the data because she has been “hearing firsthand” from people how difficult it is to obtain abortion care in the state.

The statistics are “further validation that the Supreme Court ruled correctly,” Busby said.

Republican Lt. Gov. Dan Patrick said during an interview Thursday on KFYO that the Supreme Court is “corrupt.” Patrick, who was among HB 2’s most strident supporters, argued that the statistics are a positive outcome.

“Our true purpose was to make sure the environments were safe for women, but obviously if you have fewer of abortions that’s something to celebrate,” said Patrick

Lawmakers passed the omnibus abortion bill in 2013 under the pretenses of protecting women’s health and safety. Since the law took effect, there have been multiple reports documenting the detrimental effect it has had on patients’ reproductive health care.

The 2014 abortion statistics also reveal that it continues to be safer to have an abortion than to carry a pregnancy to term in Texas: Between 2008 to 2013, the most recent years for which data is available, there were 691 maternal deaths in Texas, compared to just one death due abortion complications from 2008 to 2014.

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