When we talk about the stigma associated with abortion, the conversation is often about the experiences of women who choose the procedure. Sometimes we talk about abortion providers, specifically the harassment and violence they endure to courageously provide women with medical care. But what about the harassment abortion providers receive from within the medical community?
I recently interviewed a friend of mine who performs abortions and other routine reproductive health care. Her words speak for themselves.
Me: Tell me about your experience as an abortion provider within the medical community.
Doctor: Although the majority of physicians favor legal, safe abortion, some tend to think of it as a shameful kind of care to provide. In general, status within the medical community has to do with faculty appointments and research grants. People who provide abortion are frequently excluded from faculty positions at academic universities for political reasons (even at a non-religiously affiliated university, all it takes is one anti-choice department member to keep someone out for good).
It’s hard to be somewhat of an outcast in one’s own community. It’s hard to see the president of the American College of OB/GYN make statements about his personal distaste for abortion, and to see your entire sub-area of expertise nearly entirely excluded from conference programs. It’s hard to know that some of your colleagues disrespect you for what you do and think your job is “dirty” somehow, and while they’re glad you do it, they’re glad they don’t have to.
How might being an abortion provider impact a doctor’s future?
In terms of research grants, most academic researchers get their funding from the US government through the National Institute of Health. Federal funding is often what helps academic departments distinguish themselves nationally, and what helps individual doctors gain status within their departments. Someone who studies abortion will not have access to this kind of funding, which can lead to further academic marginalization. The implications of academic marginalization are significant. There is less ability to advance in one’s career, both in terms of taking on more senior positions and serving in administrative roles in health systems and within professional societies.
There’s also a perception that in terms of skill performing abortions is less difficult than some other surgeries, so people who choose to provide abortions are somehow less capable than those who choose to do, for instance, complicated gyn-onc surgeries. This similarly can lead to marginalization and limited career options.
This isn’t unique to abortion provision; within medicine, people think primary care doctors aren’t as “smart” as specialists, for instance. But within the gyn specialty this added stigma against abortion providers is just one more nail in the coffin.
How does this play out day to day in the clinic?
I wouldn’t say I personally get treated differently, but I happen to work in a very supportive environment. I have plenty of colleagues who encounter roadblock after roadblock in their attempts to provide abortion care at their respective facilities, even to the point of being called names by others within their specialty. This is especially difficult for later abortions, I think. Abortion specialists often get called to see women at 20 or more weeks gestation who are suddenly facing a devastating diagnosis and need an abortion quickly. In those moments the maternal-fetal-medicine specialists are glad their abortion-providing colleagues are there, but still often don’t recognize the crucial role they play.
Medicine is a vast field. We will never know everything and we frequently need to consult our colleagues, even colleagues within our own field. We’ll have complications and patients will need to be admitted to the hospital or at least seen by another specialist occasionally (as we know, it’s quite rare, but it does happen). Doctors often are thinking about the worst case scenario, and to whom they can reach out when they need help. If the answer to that is nobody, then the idea of providing those procedures can be petrifying. If the accepting doctors at the hospital are unhappy with the care the transferring provider gave to the patient (for whatever reason, including unhappiness with the very fact that an abortion was done), they are going to treat that transferring provider, and possibly the patient, like crap. Feeling ostracized from your own medical community, on which you really depend, is incredibly painful, both personally and professionally.
For information on supporting abortion providers within the medical community, see:
— Medical Students for Choice
— Physicians for Reproductive Choice & Health
— Nursing Students for Choice
— National Abortion Federation
— Carol Joffe’s books, Doctors of Conscience and Dispatches from the Abortion Wars (see this interview with Joffe for a taste of the book)
— Roe v. Wade at 30: What Are the Prospects for Abortion Provision?