Analysis Abortion

Next Generation Access: Medical Students Fill A Void

On The Issues Magazine

Medical Students for Choice were and are still literally putting their futures and lives on the line by taking on the medical establishment as well as the anti-abortion zealots to bring forward new generations of abortion providers.

Originally written by by Mary Lou Greenberg for On The Issues Magazine.

For all our coverage of the 29th Anniversary of Roe v. Wade, click here.

I remember the first time I heard about Medical Students for Choice. I don’t remember the exact date but I remember the atmosphere. Anti-abortion fanatics had been targeting abortion providers for years by firebombing clinics, harassing and stalking doctors and their families, blockading medical facilities and assaulting women who came to them. And anti-abortion violence had just escalated horribly with the coldly-calculated murder of Dr. David Gunn outside the Pensacola, Florida abortion clinic where he worked.

It was 1993, and although dedicated women and men had been defending abortion clinics across the country, the reality was that 84 percent of U.S. counties had no known abortion provider. So when reproductive justice activists heard that young medical students had formed a new organization, Medical Students for Choice, we were elated. These students were literally putting their futures and lives on the line by taking on the medical establishment as well as the anti-abortion zealots to bring forward new generations of abortion providers. It was one of the few bright spots in a dangerous and daunting landscape.

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And it still is.

Medical Students for Choice (MSFC) now has 148 chapters, including several in other countries, with a network of over 10,000 medical students. The organization’s executive director, Lois V. Backus, MPH (Master of Public Health), said in an interview that while much remains to be done, more Ob-Gyn residents are getting some level of training today. Chapters of Medical Students for Choice – its slogan is “Creating Tomorrow’s Abortion Providers and Pro-Choice Physicians Today” — fill in the gaps in medical school curricula with their own training and educational events, and continue to advocate for more comprehensive training within the formal training at medical schools.

At the same time, accessing abortion is even more difficult today than it was when MSFC began, with a staggering number of new state restrictions and even more counties — 87 percent — without abortion providers. The harassment and assaults on providers and clinics continues — just two years ago, Dr. George Tiller, the foremost provider of later abortions, was murdered in the lobby of his church in Wichita. It needs to be emphasized over and over again: Without providers, there can be no choice.

The number of abortion providers today continues to decrease, although the decline appears to be slowing, according to Backus. From 1995-2000, the number of abortion providers declined by 11 percent; from 2000-2005, the latest figures available, the number of providers went down by “only” two percent. This is still not acceptable to Medical Students For Choice, but the “tide is starting to turn,” said Backus.

Papaya Workshops Build Skills

When the organization was founded in the mid1990s “some medical students began realizing that as the number of older abortion providers retired from practice or passed away, the new generations of physicians weren’t being trained in what is one of the simplest and most common medical procedures,” said Backus. One of the first national projects of Medical Students for Choice was to petition the Accrediting Council for Graduate Medical Education (ACGME) to require that all Ob-Gyn programs make learning about abortion available to all Ob-Gyn residents – only about 12 percent did so in 1994.

New standards passed in 1995, and latest statistics indicate that 50 to 70 percent of residency programs make this training available as part of the curriculum –“a big improvement,” said Backus. But “still a long way to go,” she concedes. “Family planning and abortion deserve to be significant elements of the curriculum, taught along with pregnancy and related topics,” said Backus.

Two-thirds of medical schools have some curriculum elements related to abortion, Backus said, but “most of this is limited to a discussion of ethics in the context of medical ethics, as opposed to MSFC’s goal that every physician has some understanding of abortion as a medical need.” Typically, the curriculum element is less than 30 minutes. “While there is a lot to learn and not a lot of time in medical school,” Backus continued, “erectile dysfunction medication, for example, gets up to three hours, as compared to one hour on topics related to conception.”

To fill in gaps in the curriculum, chapters conduct about seven educational events for students every year, many of them workshops on abortion techniques. One is training in vacuum aspiration, a simple procedure where the content of the uterus is suctioned out, demonstrated by an experienced physician who uses papayas as surrogate uteruses. Medical Students for Choice provides and ships the equipment for these trainings, and last year there were more than 25 “papaya workshops.” “It’s fair to say,” Backus commented, “that more education comes out of those events than out of the very slow progress made in changing the curriculum.”

The “conservative culture” of medical schools in general is an obstacle for students seeking training in abortion services, said Backus. “When medical schools force people to work an average of 80 hours per week in an intense work environment, they want people who will say ‘yes sir’ and not cause any problems,” said Backus.

As a result, medical students can feel vulnerable, she said. For example, when third year students apply to residency programs, they need to secure a letter from the dean of their medical school assessing their capability for future medical school training. Some students tell Backus that they are concerned they will get “a bad dean’s letter” because of their MSFC activism. One MSFC activist said a dean’s letter called her a “troublemaker,” and she felt that she failed to make a match with the residency program because of it. “Our students are incredibly smart and courageous,” said Backus.

Wearing the White Coat

Tracey Wilkinson, a pediatrician in the Northeast, came across Medical Students for Choice “as a fluke,” she said, “and then it shaped my career.” In 2002 she attended a conference and learned about the barriers to all reproductive health care. “I felt suddenly impassioned about the issue, ” she said, and started an MSFC chapter at Vanderbilt University Medical Center in Nashville, Tennessee, in her words, the “buckle of the Bible Belt,” with” three churches on four corners of many intersections.”

“When I stated organizing,” she said, I was “intrigued and nervous about the response I would get. I went to a student organization fair with MSFC materials and was really surprised when I got 75 sign-ups out of 400 students there.” Why did she get so many? “I think there had been a void — a lot of people had probably been pro-choice, but there hadn’t been an opportunity to express it.” Vanderbilt, she noted, also has a reputation for diversity. “It was 100 miles an hour after that,” Wilkinson said.

In Tennessee, knowing that religion was important on a campus rife with prayer groups and Christian societies active at the medical school, the new MSFC chapter founded by Wilkerson reached out with the message that “being pro-choice and having religious beliefs were not mutually exclusive.” They brought pro-choice clergy, including a protestant priest and a rabbi, to speak at lunchtime lectures.

The national umbrella group run by Backus tries to ensure that student activists have everything they need – from funds drawn from private donations to the national organization, a nonprofit, to support when they are frustrated or scared, equipment for trainings and connection with mentors from the pro-choice community who will support them. “Medical education is still a very formalized, non-feminist environment,” Backus said. “One of the most powerful things about MSFC is that it provides a strong feminist environment for both men and women in medical school. The community we provide for people is as powerful a change-maker as the education work we do.”

Since graduating, Wilkinson has brought her commitment for ensuring women’s reproductive choice to her specialty, pediatrics. “My real passion is preventing unplanned pregnancies…I remember the first time I met teen moms on the labor and delivery floor in the hospital. Girls are having sex at earlier ages, and I thought about the missed opportunities to prevent unwanted teenage pregnancies. I feel strongly that pediatricians could do more to prevent unplanned pregnancies among adolescents. Emergency contraception and unplanned pregnancies should be general pediatric topics,” said Wilkerson. “Pediatricians should be on the front lines of this question,” she added, not just Ob-Gyns.

She also has one powerful image that carries her forward. In 2004, while in medical school, Wilkinson and several other Vanderbilt med students attended the March for Women’s Lives in Washington, D.C., wearing their white medical coats and carrying signs. Wilkerson’s read, “I am tomorrow’s abortion provider.” She recalls that “out of nowhere, people started applauding us. It was one of the most memorable moments in my medical training.”

Mary Lou Greenberg is an activist and contributing writer to Revolution newspaper. For Mary Lou’s author profile, click here.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (R-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

News Abortion

Parental Notification Law Struck Down in Alaska

Michelle D. Anderson

"The reality is that some young women face desperate circumstances and potentially violent consequences if they are forced to bring their parents into their reproductive health decisions," said Janet Crepps, senior counsel at the Center for Reproductive Rights. "This law would have deprived these vulnerable women of their constitutional rights and put them at risk of serious harm."

The Alaska Supreme Court has struck down a state law requiring physicians to give the parents, guardians, or custodians of teenage minors a two-day notice before performing an abortion.

The court ruled that the parental notification law, which applies to teenagers younger than 18, violated the Alaska Constitution’s equal protection guarantee and could not be enforced.

The ruling stems from an Anchorage Superior Court decision that involved the case of Planned Parenthood of the Great Northwest and the Hawaiian Islands and physicians Dr. Jan Whitefield and Dr. Susan Lemagie against the State of Alaska and the notification law’s sponsors.

In the lower court ruling, a judge denied Planned Parenthood’s requested preliminary injunction against the law as a whole and went on to uphold the majority of the notification law.

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Planned Parenthood and the physicians had appealed that superior court ruling and asked for a reversal on both equal protection and privacy grounds.

Meanwhile, the State of Alaska and the notification law’s sponsors appealed the court’s decision to strike some of its provisions and the court’s ruling.

The notification law came about after an initiative approved by voters in August 2010. The law applied to “unemancipated, unmarried minors” younger than 18 seeking to terminate a pregnancy and only makes exceptions in documented cases of abuse and medical emergencies, such as one in which the pregnant person’s life is in danger.

Justice Daniel E. Winfree wrote in the majority opinion that the anti-choice law created “considerable tension between a minor’s fundamental privacy right to reproductive choice and how the State may advance its compelling interests.”

He said the law was discriminatory and that it could unjustifiably burden “the fundamental privacy rights only of minors seeking pregnancy termination, rather than [equally] to all pregnant minors.”

Chief Justice Craig Stowers dissented, arguing that the majority’s opinion “unjustifiably” departed from the Alaska Supreme Court’s prior approval of parental notification.

Stowers said the opinion “misapplies our equal protection case law by comparing two groups that are not similarly situated, and fails to consider how other states have handled similar questions related to parental notification laws.”

Center for Reproductive Rights (CRR) officials praised the court’s ruling, saying that Alaska’s vulnerable teenagers will now be relieved of additional burdensome hurdles in accessing abortion care. Attorneys from the American Civil Liberties Union, CRR, and Planned Parenthood represented plaintiffs in the case.

Janet Crepps, senior counsel at CRR, said in a statement that the “decision provides important protection to the safety and well-being of young women who need to end a pregnancy.”

“The reality is that some young women face desperate circumstances and potentially violent consequences if they are forced to bring their parents into their reproductive health decisions. This law would have deprived these vulnerable women of their constitutional rights and put them at risk of serious harm,” Crepps said.

CRR officials also noted that most young women seeking abortion care involve a parent, but some do not because they live an abusive or unsafe home.

The American Medical Association, the American College of Obstetricians and Gynecologists, and the Society for Adolescent Medicine have said minors’ access to confidential reproductive health services should be protected, according to CRR.