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“They were there because they were pregnant. Which is a really apolitical thing”—Medical student discussions of politics in abortion care in the United States

  • Author Footnotes
    1 Present address, Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, United States.
    Katherine Rivlin
    Correspondence
    Corresponding author.
    Footnotes
    1 Present address, Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, United States.
    Affiliations
    Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH, United States
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  • Author Footnotes
    2 Present address, Cerner Enviza: An Oracle Company, University of Maryland-College Park, 2195 Morrill Hall, 7313 Preinkert Dr., College Park, MD 20742, United States.
    Alexandra Kissling
    Footnotes
    2 Present address, Cerner Enviza: An Oracle Company, University of Maryland-College Park, 2195 Morrill Hall, 7313 Preinkert Dr., College Park, MD 20742, United States.
    Affiliations
    Department of Sociology, Ohio State University, Columbus, OH, United States
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  • Author Footnotes
    3 Present address, Kaiser Permanente, 1600 Owens Street, SF, CA 94158, United States.
    Maryl G. Sackeim
    Footnotes
    3 Present address, Kaiser Permanente, 1600 Owens Street, SF, CA 94158, United States.
    Affiliations
    Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, United States
    Search for articles by this author
  • Author Footnotes
    1 Present address, Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, United States.
    2 Present address, Cerner Enviza: An Oracle Company, University of Maryland-College Park, 2195 Morrill Hall, 7313 Preinkert Dr., College Park, MD 20742, United States.
    3 Present address, Kaiser Permanente, 1600 Owens Street, SF, CA 94158, United States.

      Abstract

      Objectives

      State abortion policies can vary widely. Geographic location and political climate could influence a medical student's abortion education experience. We compared how medical students training in one permissive and one restrictive state discussed politics in abortion care.

      Study design

      From 2018 to 2019, we interviewed US medical students during their Obstetrics and Gynecology rotation from two Midwestern academic centers with differing state abortion policies—one in Ohio (restrictive) and one in Illinois (permissive). In-depth interviews occurred following an abortion shadowing experience and included questions about politics in abortion care. We sorted data using flexible coding, with index codes around “politics,” followed by specific analytic coding. We compared codes by medical school using NVIVO software.

      Results

      We interviewed 28 students (50% in Ohio). Students in Ohio discussed specific barriers to patient care and how politics infringed upon the quality of medical care, describing abortion as stigmatized care. Students in Illinois described abortion as high-quality medical care, delivered without the infringement of restrictive laws. Students at both schools described their medical school climates as supportive to abortion, yet in Ohio, students described exposure to more diverse abortion views than Illinois students. Ohio students also described engaging in abortion advocacy work, while Illinois students felt more politically disconnected.

      Conclusions

      Even as clinical training opportunities decline, restrictive states may hold unique advocacy opportunities. Educators should tailor abortion curricula to address state level differences, as disparities in abortion access and student learning opportunities widen.

      Implications

      Students training in permissive states see abortion as routine health care, occurring without political interference. Students in restrictive states see abortion as hindered by politics and stigmatized, which may encourage advocacy. Educators should tailor curricula to address state level differences as disparities in abortion access and student learning opportunities widen.

      Keywords

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