Most obstetrics and gynecology residents in Louisiana train at an abortion clinic in Shreveport. Now, it’s unclear where they’ll get that surgical instruction when most abortions likely become illegal in Louisiana and the clinic is closed.
“We’re looking to create another opportunity for this training somewhere, anytime or anywhere,” said Nicole Freehill, clinical residency program director for OB-GYN at LSU Health Sciences Center in New York. Orleans.
Even if doctors never intend to perform elective abortions, they still need the training provided at the clinic because they may have to perform the procedure in an emergency situation, where a pregnancy may cause death. OB-GYNs also use the same surgical procedures to manage miscarriages if they are life-threatening, Freehill said.
Four of Louisiana’s five OB-GYN residency programs contract with Hope Medical Group for Women, the abortion clinic in Shreveport, clinic administrator Kathaleen Pittman said this week.
Pittman declined to name the four programs that operated at the Shreveport clinic, but Tulane University OB-GYN residents do not train at the facility, according to a university spokesperson.
LSU’s OB-GYN residency programs in New Orleans and Baton Rouge have confirmed they are sending physicians to the clinic. Ochsner Health System, which operates an independent residency program based in New Orleans, and LSU Health Sciences Center in Shreveport did not respond to questions about training their residents at the clinic.
The Accreditation Council for Higher Medical Education currently requires all OB-GYN residency programs nationwide to provide access to abortion education, but the organization is considering adjustments to this rule in light of the recent US Supreme Court ruling overturning the constitutional right to an abortion.
Following the court ruling, an estimated 45% of OB-GYN residents in the United States are now in states like Louisiana, where abortion is likely to be banned or heavily restricted, according to the Bixby Center for Global Reproductive Health.
The accreditation board could allow OB-GYN programs to send out-of-state residents for abortion training instead of providing it as part of their in-house training. For those who cannot travel, residency programs could also turn to simulations that resemble the real-world clinical experience they would otherwise get, according to draft guidelines released by the organization.
LSU Health in New Orleans plans to send its OB-GYN residents — about six people each year — out of state for the training they typically receive at the Shreveport abortion clinic, Freehill said.
The university should cover their travel and housing costs while they worked out of state, said LSU Health spokeswoman Leslie Capo. Because states surrounding Louisiana are also likely to ban abortions, that could mean sending residents as far away as Illinois, Freehill said.
New Orleans teaching hospitals and facilities that typically work with its residents do not see enough cases requiring surgical abortion procedures to provide adequate training opportunities, Freehill said.
University Medical Center and Touro Infirmary in New Orleans, where Freehill works, may only see a handful of people each month who need this type of surgical care for a miscarriage or a pregnancy that has gone wrong. At the Shreveport Abortion Clinic, residents were able to perform these surgical procedures under the eye of an experienced doctor several times a week, Freehill said.
“When they go to Shreveport, they can do multiple procedures in a row. It teaches them so much in a very short time,” she said. “It’s like doing gymnastics or a dance routine.”
Residents who oppose elective abortion have not been forced to perform them, Freehill said. They generally did not go through the procedures at the clinic, but continued to participate in the post-operative care and contraceptive counseling that the clinic also provides.
Freehill said the abortion ban could impact LSU’s ability to attract students to its program. OB-GYN residents come from all over the country to train in Louisiana, but some might be deterred from trying to fit in here if they don’t think they can get the same level of education, she said. declared.
Some Louisiana medical students are already frustrated. Members of a New Orleans chapter of Medical Students for Choice, which supports abortion access, are among those suing the state for its abortion ban. In a legal filing, medical students argued that the state ban will interfere with their medical training.
Dr. Rebekah Gee, former Louisiana health secretary and OB-GYN, said she’s concerned that fully trained residents and doctors will want to practice in Louisiana if there’s a threat of criminal sanctions hanging over her. them.
Orleans Parish Civil District Court is currently blocking the state abortion ban with a temporary restraining order, but it could be lifted as soon as July 8. When it goes into effect, the ban contains criminal penalties, including fines and jail time, for people who perform illegal abortions, including doctors.
The ban includes some general exceptions where abortion would be legal, such as to treat a life-threatening pregnancy. Gee said the circumstances of a legal abortion are not spelled out clearly enough in the law. Doctors fear facing criminal charges for manipulating a miscarriage or performing a medically necessary abortion, she said.
“What if a woman presents with a miscarriage and is bleeding profusely? How to know if she is bleeding enough [to justify an abortion-like procedure]? Will the resident and the attending physician be comfortable treating her given the criminal penalties? Gee said. “Will people want to come here to train if they can go to jail?”
In Louisiana, people are already more likely to die of pregnancy or childbirth than in almost any other region of the country. So the prospect of limiting the medical training needed to treat life-threatening pregnancies and miscarriages is concerning, Freehill said. If doctors aren’t comfortable with certain procedures — or are afraid to administer them — it could exacerbate the state’s already high rate of pregnancy and childbirth deaths, she said.