By Felipe on November 08th, 2019. Posted under: 2019
As states hostile to abortion continue to increase regulations and place heavier burdens on patients trying to access abortion care, the services abortion funds provide are becoming even more important. Abortion funds seek to remove barriers to abortion access by providing funding and logistical support to people seeking abortions. Funds give individuals money to pay for abortion procedures, travel/lodging, childcare, and/or whatever else the person needs to access care.
The MSFC chapter at Wake Forest School of Medicine was proud to partner with the Carolina Abortion Fund (CAF) last month to host a seminar and volunteer training for medical and law 
students. CAF operates a confidential, toll-free hotline to provide financial, logistical, and emotional support to callers in North and South Carolina seeking abortion care. Though it’s important for us to learn the clinical aspects of abortion care, we recognize many patients in our state face numerous barriers to abortion access, and it is important we understand those barriers as well. We know if patients cannot afford abortions, lack transportation to and from the appointment, and/or don’t know where to seek safe abortion, the care and training we provide is not as useful. Partnering with CAF gave students an opportunity to learn what barriers patients face in accessing abortion, and how we can mitigate these barriers.
The weeknight session lasted about three hours and included dinner, which we paid for using our Student Activism Funding. We had great medical student turnout, and we also invited law students from the If/When/How chapter at Wake Forest University School of Law. If/When/How is a national organization for law students dedicated to growing the reproductive justice movement. We often invite law students to our events to expose them to the medical side of abortion care, as we think hearing from abortion providers and learning about the barriers they face to care for their patients gives them a deeper perspective. We also love attending their events to hear more about reproductive health from a legal perspective. We highly encourage other chapters to work with law students at their schools.
During the session, CAF discussed their history and vision, and provided an overview of programming, volunteer opportunities, and how we can get involved. CAF relies on volunteers to do helpline casework, fundraising, and transportation support, among other forms of support. Our session also included an interactive values clarification exercise, a reproductive justice/birth justice primer, information on queering reproductive health, and tips for providing support for someone through their abortion. Finally, CAF gave us some background on the general legal landscape of abortion access in North Carolina and in the United States. Moving forward, there are many members of our chapter who are interested in volunteering with CAF and who will be seeking further training in doing helpline casework.
We strongly encourage other MSFC chapters to reach out to their local abortion funds to find out more about what they offer and consider hosting an event with them. As future providers, we are glad to know abortion funds exist to help our patients pay for abortions, as well as provide logistical support like transportation, childcare, translation and abortion doula services. Our experience with CAF was invaluable, and we hope other MSFC chapters can collaborate with their local abortion fund!
By Felipe on September 10th, 2019. Posted under: 2019
I saw my first D&C as a pre-med college student, who had been newly introduced to the possibilities of ob/gyn. Despite being pro-choice, this experience deeply affected me and made me question my limits in the abortion debate. It also made me realize that being pro-choice does not necessarily translate into becoming an abortion provider, and I wondered how else I could advocate as a physician. Years later, as a second year medical student at UC Davis SOM, I attended the 2018 MSFC Conference on Family Planning, hoping to gain perspective from current and future abortion providers to better understand my own stance and where I fit in the movement.
Sharing a hotel room with three other medical students from across the country gave me invaluable insight to the state of abortion and reproductive health beyond the conference walls. California, Iowa, Illinois, Connecticut, Massachusetts—each student brought a wealth of knowledge about their hometown experiences as women and how they differ from their patients’. It is amazing to recognize that even among the progressive classmates at my own school, a stigma exists that prevents open, unapologetic discussion of reproductive needs. At this conference, in the safety of our shared hotel room, we were able to break the silence in a way that’ll change how we approach our future patients. Medication side effects, health fears, LGBTQ-oriented care, communication shortcomings – as medical students we are especially equipped to advocate for our own reproductive health, but our stories revealed that we are still subject to an imperfect system that hurts our patients even more.
Outside of these anecdotes, we were also able to compare the medical school curricula. Echoing a panelist’s anatomy experience several decades ago, one of my roommates said that her medical school spent a day and a half on men’s reproductive physiology, while women’s reproduction received half a day of instruction. As lucky as I felt to receive more balanced reproductive education at my institution, I stopped short when my roommate asked, “where are the histology slides of the clitoris? Why aren’t we talking about female pleasure?” In these small ways, I became re-sensitized to the often paternalistic shortcomings to truly inclusive reproductive education.
Aside from these private conversations, I also gained a lot from the conference sessions. Building Resilience in Providers of Color was one of the most powerful discussions I attended at this conference. Compared to the main conference hall and 6 different discussion sessions, this room was the first where I was blown away by the predominance of tan and brown faces. The contrast was a visual testament to the lack of diversity in our country’s future abortion providers, a striking issue when we think about minority health outcomes like maternal mortality. In this discussion we began to contextualize Reproductive Justice for providers and patients beyond abortion. One of the black Family Planning fellows shared a story where an ob/gyn colleague asked her, “if black women’s lives are already so hard, why are they still having babies?” The room seemed to react in unison: surprise, hurt, anger. How could an ob/gyn, someone uniquely attuned to women’s needs and the inequalities of reproductive health, make such a comment? How could she so casually dismiss institutional racism by blaming the women she is supposed to serve? It is easy to imagine that we have made great strides in reproductive health, but stories like these are crucial reminders that intersectionality and equity still have so much further to go.
Hearing these perspectives and sharing these experiences with like-minded future providers reinforces my conviction that abortion services are a necessary component of quality reproductive care. It is reassuring to know that there are powerful people who are fighting the good fight in legislation, in curriculum, and in the clinics themselves. As a student, I think it’s important to spread the dialogue within my community as controversial as it may be. A pregnancy can carry immense value to some patients and physicians or it can carry no weight at all; as I struggled to understand my own feelings around abortion, it was reassuring to recognize that I wasn’t alone among the current and future providers. I walked away from this conference with a deep respect for abortion providers and the inspiration to do more. I am profoundly grateful for the opportunity to attend the MSFC Family Planning conference and hope I can use the activities, thought experiments, conviction, and newfound colleagues to become the provider that I want to be.
*Please note that my opinions are my own and do not necessarily reflect those of my institution
By Felipe on August 12th, 2019. Posted under: 2019
As abortion becomes more restricted in the United States, medication abortion has become critical in the fight for abortion access. Medication abortion, or the “abortion pill”, is a combination of two drugs, Mifepristone and Misoprostol. It is a popular and safe option for many, accounting for around half of all abortions before nine weeks of pregnancy.
Before Roe v. Wade, illegal abortions outside the healthcare system were often extremely risky—which is why the coat hanger became an iconic symbol of unsafe abortion in the United States. Luckily, this is no longer accurate. Medication abortion now offers a safe alternative for people who self-manage their abortions. It’s essential knowledge for any medical student around the world – whether you live in a country where abortion is illegal, or one where it’s more accessible, your advocacy for medication abortion will make a difference.
Here are 10 reasons all medical students (whether they plan to provide abortions or not) should make sure they know about medication abortion:
- 1 So you can provide it! There is a shortage of abortion providers in the United States, and around the globe. 90% of counties in the US lack an abortion provider.
- 2 It’s not hard to master the skill. Prescribing medication abortion is just like prescribing any other medication.
- 3 Most abortions happen in the first ten weeks of a pregnancy, so increasing the availability of medication abortion providers has a big impact on the number of options available to patients.
- 4 Many patients prefer a medication abortion over a procedure abortion, including patients that may need to hide an abortion from an abuser (medication abortion looks like a miscarriage), people with trauma who can’t tolerate a pelvic exam, or someone in a country where abortion is illegal.
- 5 Medication abortion can be provided through telemedicine, making it a great resource for people in rural or underserved communities.
- 6 “Regardless of whether you provide medication abortion, you can still advocate for it to be offered at your practice and/or in your community, challenge myths (such as the “abortion pill reversal” myth), and support patients who have had medication abortions.”
- 7 Self-managed abortion with pills is common. You can support patients who self-manage by providing them with accurate information.
- 8 You can fight the stigma against abortion and self-managed abortion in your practice or healthcare system.
- 9 Medication abortion has saved an untold number of lives throughout the world for people with no access to surgical abortion. This simple medication has dramatically reduced the maternal mortality rate in countries where surgical abortion is inaccessible or illegal. Rarely are there easier ways to save so many lives.
- 10 Medication abortion should be routine healthcare every medical professional knows about!
Our members learn about medication abortion at the Conference on Family Planning, at our Abortion Training Institutes, and during their Reproductive Health Externship. We also offer resources for students to host their own medication abortion events on their campus. We encourage all our members to do all they can to spread the word about the power of medication abortion, and create a generation of doctors that understands how essential medication abortion and self-managed abortion already are, both in the US and around the world.
By Felipe on June 11th, 2019. Posted under: 2019
Reaching Young Doctors from Around the World Through Student Activism
Paul Mulyamboga is a 4th year medical student and MSFC chapter leader at St Augustine International University in Kampala, Uganda. The chapter recently advocated for abortion education to be included in the curriculum, changes that were unprecedented at any medical schools in Uganda. After months of advocacy, culminating in a two-week student-run pilot program in April, university officials voted to include medication abortion education in all years of study. The changes will be implemented this summer.
The Medical Students for Choice chapter of St. Augustine International University (SAIU) was started in November 2017, with an aim of increasing medical students’ access to safe medical abortion education and skills through trainings, awareness talks and community outreach campaigns. We have seen great success through a number of projects, including curriculum reform.
Unsafe abortion is a major health concern in Uganda. However, abortion is illegal in Uganda and thus is not accessible to the general population except when the pregnant person’s life is threatened. In 2010, the Ministry of Health estimated that 8% of maternal deaths were due to unsafe abortion. And in 2013, 93,300 women were treated for complications (Guttmacher).
Paul Mulyamboga, MSFC chapter leader at St Augustine International University in Kampala, Uganda.
Despite the burden unsafe abortion places on both society and pregnant women, medical students in Uganda are not being taught the necessary skills to manage patients who have had unsafe abortions, nor are we taught safe medical abortion. As we are an international university with over half of students hailing from other countries including Australia, Tanzania, India, Nigeria, and more, we need to pass on information to them regardless of Ugandan law. Additionally, the foreign students would benefit from taking this knowledge back to their countries, where they will be practicing in different settings and abortion may be legal. I wanted to see to it that all medical students in our university finish their 5th year with practical skills to manage and provide safe abortion. This desire drove me to write a proposal for curriculum change and request the university to allow us to present it to the university senate.
Being a very sensitive issue in terms of cultural and religious values both in the university and the community, and the fact that abortion is illegal in Uganda, it would not be an easy task to accomplish; we faced enormous opposition from pro-life groups and from some conservative administrators. Because SAIU has Catholic roots (the owners are Catholic although the school is not officially Catholic and includes students and instructors from diverse religions), it was difficult to convince the different authorities to accept the cause of the above reforms that we had presented. Being a multi-linguistic university with all religions accommodated, we argued that the SAIU is not a strictly Catholic school.
In addition, SAIU lawyers argued that since abortion is illegal in Uganda, it’s not right for the university to teach abortion skills. In reply, we argued that in the Ugandan Constitution, we have the right to speech and to information. And as long as we are not committing a crime in doing it, access to information and teaching abortion is completely not a crime. The administration was ultimately open to this idea.
We faced opposition from the student body as well. Some students were completely against abortion education and through their pro-life groups staged rallies against us on different occasions. But we met their resistance with peaceful gathering, showing the support we had from many students for this education. Many of us students supporting the reforms were isolated socially and always criticized by those who were against the idea of reforms involving medical abortion. We overcame this isolation and criticism and supported each other by meeting frequently.
In order to demonstrate to the administrators how the curriculum reform would be implemented in the following academic year, we created a 2 week pilot training in the form of training in each year of study. It was a student-led initiative to help show the administrators how our reforms would be done and how the university should plan for them. With funding from MSFC, we held ten lectures over two weeks, taught by supportive instructors. This included lectures on contraception, medication abortion, and legal and policy considerations. In order to demonstrate the effectiveness of the pilot program, we designed a survey for participants. 70% of those who took the course thought that the proposed reforms would be very useful, and 55% said they would plan to incorporate abortion services into their future practice.
In the future, I hope to see implementation of the reforms regardless of change of administration. We hope the university will embrace all the changes especially those involving the practical skills. We also pray that all universities in the country can embrace the changes and start including safe abortion education in all their curricula.
Some of the Students of the MSFC chapter of St. Augustine International University (SAIU)
By Felipe on June 03rd, 2019. Posted under: 2019
In the US, recently passed abortion bans in 9 states have finally awakened the national press and the general public to the dire threat facing legal abortion. For those of us who have struggled for decades to provide safe abortions in an increasingly restrictive legal environment, these recent developments came as no surprise, but a huge amount of regret. An enormous amount of passion and hard work has gone into the nationwide effort to prevent this from happening…but here we are.
As we look toward the day when the conservative majority in the US Supreme Court overturns legal abortion in the US, Medical Students for Choice has given a great deal of thought to whether, and in what ways, providers of abortion will matter within our healthcare system. As we work to encourage and support new providers, how will this dramatically changed legal environment affect our work and the future work of our committed young members?
Over the past decade, MSFC has learned a great deal from our members in Africa, most of whom are advocating for abortion training and expanded education in family planning in low resource settings where abortion is either highly restricted or illegal. Our passionate members in countries like Rwanda, Uganda, and Malawi have worked courageously to bring opportunities to their schools that enable their fellow students to develop skills and knowledge in abortion techniques while at the same time working within their communities to liberalize abortion laws and expand access to safe care. Empowering medical professionals with a commitment to enhancing reproductive safety and giving them concrete skills that directly improves care for pregnant persons saves lives following an unsafe abortion while simultaneously making it more likely that they will have the medical help they need to prevent pregnancies.
As we see “abortion deserts” expand in the US, US medical students will have a similar challenge. Our partners in the Reproductive Rights movement can’t do it all – today there are 20 week abortion bans already in effect in some states and almost continual efforts to pass bans earlier in gestation. The ACLU, the Center for Reproductive Rights, and many other legal advocacy organizations work to counter all these restrictions, but of course, they can’t win them all. Where we lose access, we need good, committed, and skilled medical professionals to ensure that those harmed by these restrictions will have the best medical care that our medical system can provide. Lives depend on it.
By Felipe on March 21st, 2019. Posted under: 2019
The appointment of Judge Kavanaugh to the United States Supreme Court last fall means that the balance of the court is now prepared to restrict abortion access and potentially overturn Roe v Wade. However, we are ready—MSFC chapters across the US have been fighting to provide abortion access under difficult circumstances for 25 years.
In October, Executive Director Lois Backus wrote about how we are adapting to a changing political climate to support our chapters in states where abortion could become illegal with additional resources. More recently, we talked to MSFC student leaders around the country to find out how they are responding to and preparing for changes in abortion law in a post-Roe country. Here’s what they had to say:
If abortion is illegal or heavily restricted in your state, how will that impact your future career choices? How will your role as a pro-choice physician change?
“I want to specialize in Family Planning and that will continue to be my goal regardless of the legality of abortion. Will I be willing to risk my medical license and freedom to provide this service to my patients if it is illegal in my state? I really don’t know, but it is something I think about.”
— Michigan
“Pro-choice physicians practicing in this state will no longer be able to practice evidence-based medicine and offer their patients access to full-spectrum reproductive health care. Instead, they will need to focus on harm reduction around abortion care—preventing morbidity and mortality that will inevitably follow…”
—Alabama
“If abortion access in AZ were further restricted or outright banned, I would definitely consider changing where I practice medicine… If abortion were illegal, I believe my role as a pro-choice physician would be to advocate for overturning that decision while also educating patients about long term contraceptive methods and safe sex practices.”
— Arizona
“If certain states completely restrict abortion services, I am less likely to practice there.”
— Wisconsin
“I will not be able to provide the best care for each of my patients. Optimistically, this is going to make me more of a fighter – and fight until medical education to patients about choice is accurate.”
— Michigan
In the next two years, abortion may become illegal or severely restricted in your state. How will this impact the priorities of your chapter?
“I believe this will make our organization focus on policy and legislation. I also believe we will more actively advocate for students to travel out of state to obtain training.”
— Michigan
“…our chapter will begin to focus more on harm reduction models of care.”
— Alabama
“Abortion is already pretty restricted in Arizona…. the number one priority of our chapter will likely shift from helping to educate students about abortion and how they can become or support providers who perform abortions to making abortion legal and accessible.”
— Arizona
“If abortion does become illegal or severely restricted, our chapter will continue to focus on providing exposure to abortion education as well as abortion laws.”
— New Mexico
If abortion becomes illegal or heavily restricted, what do you hope to see from the medical community?
“OUTRAGE. We hope to see the medical community unite to advocate on behalf of their patients and to advocate for access to safe medical procedures.”
— Wisconsin
“I hope that the medical community continues to fight and speak up, participate further at a legislative and policy level to protect this right… If abortion is made illegal or heavily regulated, I foresee more students being interested in MSFC as this would be one of the few avenues where they can come to meet people with similar interests and have conversations about the political climate and what we can do as students.”
— New Mexico
Whatever happens, we know that students are prepared to fight for their patients’ right to safe, quality abortion care—and we are prepared to support their work, whether that’s in the halls of government, in the classroom, or in the streets!
By Felipe on March 13th, 2019. Posted under: 2019, Blog Post
After the 2017 Conference on Family Planning in Philadelphia, I received an email from one of my Canadian students, Stephanie. In the email she said what an amazing time that she had but how she wished there would be a space for the Canadian students to have a conference all their own. Out of the 419 students who attended our conference that year, 42 of them came from Canada. Although the sessions and the skills workshops are applicable anywhere, all of our providers came in with a U.S. perspective on abortion which is vastly different than in Canada.
In Canada, abortion is not in the criminal code. It is one of the only countries in the world not to. That means all of the TRAP laws, abortion restrictions, and term limit laws that are being passed in droves in the U.S. can’t happen in Canada. However, Canada shares our provider crisis. Most providers are centered in urban centers leaving the rural areas neglected when it comes to abortion care. There is a mandatory ultrasound restriction for providers to prescribe Mifegymiso (the Canadian brand name for the two medications used for medical abortion), severely limiting access considering most clinics do not have ultrasound machines on-site. The lack of providers in rural areas largely affects First Nations women who cannot obtain abortion care, especially since Mifegymiso has only been recently been approved in Canada.
Our Canadian students saw a need for abortion training so they could provide quality care to their patients, no matter where they are located. It took almost a year of planning with the students from Northern Ontario School of Medicine and the University of Ottawa, which hosted the event. Together these students did a tremendous amount of work and preparation: what sessions to have, how to recruit attendees, how to feed everyone, and make it affordable. The end result was a daylong conference that filled up well before the registration deadline.
In the end 60 students registered for the Canadian Symposium on Family Planning, with 10 on the waiting list. On Saturday January 12th, 2019, 60 students attended sessions on values clarification, abortion in Canada, medical and surgical abortions, abortion and mental health, hands-on training workshops, and so much more. The students started the day off with their values clarification session which asked them to dig into how they felt about a variety of topics that happen when providing abortions. They debated, asked questions, and listened to each other; that pattern carried on for the rest of the day. The providers that facilitated the sessions were insightful and truly opened the minds of the students.
Three students brought posters of their research to share with those attending the Symposium. A student from U British Columbia’s Northern Medical Program presented preliminary research about family planning services in northern British Columbia. Another student from U British Columbia presented about “Challenges in Offering STI Screening Among Northern BC Indigenous Communities”. The student from U Toronto presented about the PREVENT project protocol that uses technology to provide contraceptive counselling to those who lack access to contraception. Each of these students has been working on unique ways to understand and address reproductive health disparities in their communities. The Symposium created an opportunity for them to share their research with a group of people equally excited about progressing family planning priorities in Canada.
As the Symposium came to a close and everyone was winding down from their sessions and talking, it was evident that it was a day well spent for all. Providing these opportunities for our chapters is what makes MSFC great because we work to enrich the education and medical school experiences of each of our members. I feel optimistic about the future of abortion in Canada and in the capable hands of these 60 motivated students.
