Because the American medical profession ostracized the abortion business from mainstream health care, a new breed of abortionists now have strategic plans to re-infiltrate medical schools and providers.
-- From "The New Abortion Providers" by Emily Bazelon, New York Times 7/12/10
As mainstream medicine backed away [from abortion services soon after Roe v. Wade], feminist activists stepped in. They set up stand-alone clinics to care for women in their moments of crisis. In many ways, the clinics were a rebel-sister success story.
But the clinics also truly came to stand alone. In 1973, hospitals made up 80 percent of the country’s abortion facilities. By 1981, however, clinics outnumbered hospitals, and 15 years later, 90 percent of the abortions in the U.S. were performed at clinics. The American Medical Association did not maintain standards of care for the procedure. Hospitals didn’t shelter them in their wings. Being a pro-choice doctor came to mean referring your patients to a clinic rather than doing abortions in your own office.
This was never the feminist plan. . . . As abortion moved to the margins of medical practice, it also disappeared from residency programs that produced new doctors. In 1995, the number of OB-GYN residencies offering abortion training fell to a low of 12 percent.
“Under pressure and stigma, more doctors shun abortion,” wrote David Grimes, a leading researcher and abortion provider of 38 years, in a widely cited 1992 medical journal article called “Clinicians Who Provide Abortions: The Thinning Ranks.” In a 1992 survey of OB-GYNs, 59 percent of those age 65 and older said that they performed abortions, compared with 28 percent of those age 50 and younger. The National Abortion Federation started warning about “the graying of the abortion provider.” In the decade after Roe, the number of sites providing abortion across the country almost doubled from about 1,500 to more than 2,900, according to the Guttmacher Institute. But by 2000 the number shrank back to about 1,800 — a decline of 37 percent from 1982.
There’s another side of the story, however — a deliberate and concerted counteroffensive that has gone largely unremarked. Over the last decade, abortion-rights advocates have quietly worked to reverse the marginalization encouraged by [pro-life] activists like Randall Terry. Abortion-rights proponents are fighting back on precisely the same turf that Terry demarcated: the place of abortion within mainstream medicine. This abortion-rights campaign, led by physicians themselves, is trying to recast doctors, changing them from a weak link of abortion to a strong one. Its leaders have built residency programs and fellowships at university hospitals, with the hope that, eventually, more and more doctors will use their training to bring abortion into their practices. The bold idea at the heart of this effort is to integrate abortion so that it’s a seamless part of health care for women — embraced rather than shunned.
This is the future. Or rather, one possible future. There’s a long way to go from here to there. Between 2000 and 2005, the last year that statistics are available, the number of abortion facilities in the U.S. dropped 2 percent — a smaller dip than those in the preceding five-year periods, but a decline nonetheless. “The ’90s were about getting abortion back into residency training and medical schools,” says Jody Steinauer, an OB-GYN professor at the University of California at San Francisco, the hub of the abortion-rights countermovement in medicine. “Now it’s about getting abortion into our practices.”
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