By Felipe on April 27th, 2022. Posted under: Blog Post, Featured Article
This session on providing safe abortion in rural and low-resource settings explores service delivery bottlenecks and discusses ways to expand access to safe abortion by highlighting innovative success stories enabling this access.
Francis Makiya is a medical doctor currently working as the District Medical Officer for Mwanza District in Malawi. He has interests in strengthening health systems, health rights, and policy advocacy. He is a board member of the International Network for the Reduction of Abortion Discrimination and Stigma (inroads). He has been volunteering with the Coalition for the Prevention of Unsafe Abortion (COPUA) in Malawi for the past eight years advocating for change to reform restrictive abortion laws. He served as the founding chairperson for Medical Students for Choice (MSFC) – Malawi chapter.
Francis Makiya, District Medical Officer for Mwanza District, Malawi
In Malawi, abortion is legally restricted. There is only one medical school with around 700 medical doctors working in government serving 19 million people. Maternal mortality is high at 439 deaths by 100,000 live births, and abortion-related death is among the top 5 causes of maternal death. Misoprostol is available; however, accessing a prescription is a challenge and requires secret referral systems where private clinics and NGOs conceal the actual reason for the prescription.
Providing safe abortion remains a challenge in rural and low-resource settings like Sub-Saharan Africa, where less than 97% of abortions performed are unsafe. Rural and low resource settings are typically poverty-stricken and have poor health systems and weak governing institutions. Individual, community, and systemic factors often limit access to safe abortion.
Advocacy in rural and low-resource settings requires influencing local leaders and decision-makers and building an environment conducive to enabling people to exercise their rights by changing laws and policies. Collaborating and networking with grassroots movements and local and regional organizations is crucial to accessing technology and networks. The Harm Reduction model is a valuable tool to reach underserved rural communities and reduce public health risks as seen through telemedicine examples include HowToUseAbortionPill, Women on Web, Hesperian Health Guides, Aunty Jane Hotline (0800-721530), and the Ipas Health Link.
By Felipe on March 15th, 2022. Posted under: Blog Post, Featured Article
As in 2020, in 2021 the COVID-19 restrictions continued to negatively impact MSFC’s capacity to administer the Abortion Training Funding Programs—the Reproductive Health Externship (RHE) for medical students and the Training to Competence Externship (TCE) for residents. Despite many disruptions caused by travel restrictions and other safety considerations, a total of 41 medical students participated in the RHE and 13 residents completed the TCE program. This volume of participation is on par with 2020.
These 54 participants came from 41 schools and training programs, and were able to schedule their externship placement at one of the 28 host facilities that accepted participants this year.
Here is what some of the participants said after completing their training experience:
I really loved this experience a lot. The patients and providers were very nice and focused on training me. They asked me about my goals on the first day and focused on meeting them throughout the training. I worked a lot on my hands on skills, and I always felt like I was needed around the clinic. The patients were great, and I had a very amazing experience – definitely my best rotation in general. I felt very inspired to continue this type of training and work in my future career.2021 RHE Participant
It was an incredible experience. I got more hands on opportunities in 2 weeks than I had in 2 months of medical school. The doctors were amazing and since it was a small family practice, I felt more like a team member than a student hovering in the corner.2021 RHE Participant
[The RHE] It is a unique experience that most students are not exposed to during their medical school training. There is so much to learn from not only the medical aspect but also from the team work amongst doctors, social workers and other healthcare professionals that is essential in providing safe and competent patient care.2021 RHE Participant
Program Impact
To evaluate the outcomes of these programs we ask applicants to complete a survey before and after their training, here are some of the highlights from 2021’s evaluation.
Program participants were asked to indicate how knowledgeable they felt about key abortion provision and reproductive health topics, on both the pre- and post-externship surveys. Results show an increase towards “very knowledgeable” on all categories:
Intention to Provide Abortion Services
Another topic we explored among our participants was their intention to provide medical and/or surgical abortion services in their future practice. Although this was already high on the pre-externship survey, we see a slight increase on intention to provide on the post-survey results.
Additional Training
On the post-RHE survey, participants were asked, on a scale of 1 through 5—with 1 being not likely and 5 being very likely—, how likely were they to pursue additional abortion training? The average response was 4.7.
By Felipe on December 17th, 2021. Posted under: 2021, Blog Post, Featured Article
Many of the recent abortion restrictions limit access to abortion training and education, making MSFC’s work more essential than ever. MSFC is working to create well-trained, empathetic physicians who can center the patient experience, reduce health inequities, and offer the full range of comprehensive reproductive health. Check out the videos below to learn about how MSFC is working to ensure medical students can access abortion training regardless of the state they go to medical school in; to create more expansive educational opportunities and provide expertise and perspective to all students.
By Felipe on November 16th, 2021. Posted under: 2021, Blog Post, Featured Article
First published in September 8, 2016.
As a first year medical student, I let my doubts get in the way of my education. I was intrigued by the idea of abortion education, but I missed out on Medical Students for Choice’s 2014 Conference on Family Planning (CoFP) because I wasn’t confident enough to make the trip alone. I worried that I would be judged for going and that my safety might be compromised.
That changed after becoming president of my school’s MSFC chapter. I felt compelled to learn more about abortion and family planning. I didn’t want to just say that I supported a woman’s right to choose; I really wanted to understand the issues surrounding reproductive healthcare. Together with my fellow leader, Claire Meikle, we dove head first into the world of Medical Students for Choice.
The author and her co-student leader.
We began the year by attending the 2015 Conference on Family Planning in Philadelphia, PA, and it was such an amazing experience! From the moment we arrived, we were greeted with open arms and were already known by name from our previous MSFC leadership involvement. We heard from amazing speakers from all over the world (we even made our moms attend so we could attend *every*single* breakout session!). We connected with leaders of other chapters and learned some amazing content that we then brought back to improve our own chapter. At the conference, I was able to not only learn more about reproductive health care, but also gain a better understanding of my own beliefs. I was encouraged to push myself out of my comfort zone to continue my abortion education. I took all that I had learned from the conference and all of the questions that I still had and carried them with me to the Abortion Training Institute later that year. Since then, I developed an entire Family Planning course for our school and am currently leading a research project on family planning education for medical students.
No matter how far you are into your medical education, you will gain so much from MSFC’s conference! From the guest speakers to the hands-on training sessions, there is something for everyone. No matter your hesitation, fear not—the CoFP is a safe and welcoming place to start or expand your family planning education. (Plus, it’s a great excuse to travel!)
While I know that medical school can be overwhelming and there’s never enough free time, attending MSFC’s Conference on Family Planning is a valuable experience that is worth the time away from campus.
Are you convinced yet? Ready to register? Sign up here!
By Felipe on November 08th, 2021. Posted under: 2021, Blog Post, Featured Article
Last month, we heard from Kizza Blair, a fifth-year medical student from Gulu University his account of the East African Regional Meeting. “We were trained on legal aspects of reproductive health, the life of an advocate, primary health coverage, healthcare in a resource-limited setting, and dynamics of family planning and safe abortion. Lastly, we had an opportunity to have a hands-on experience with Manual Vacuum Aspiration (MVA) for surgical abortion using melons and pawpaw role-playing for female reproductive organs.”
The student-led planning committee hosted this regional meeting for students from 5 countries to come together and learn from sexual and reproductive health experts from throughout Africa. All participants were asked to complete a survey before the conference, recording their self-assessed knowledge on SRH topics and their attitudes towards abortion and patients seeking abortion. After the completion of the regional meeting, participants filled out another survey. The changes in participants’ knowledge and attitudes were astounding!
Attitudes were measured on a five-point scale (strongly agree to strongly disagree) using the value statements from IPPF’s “How to Educate about Abortion: a Guide.” We asked five questions to measure their attitudes. Responses on the post-meeting survey indicate that through education and conversation about abortion, participants moved toward a more accepting outlook on abortion on all five questions.
The East African Regional Meeting was a great success and we are so proud of the students who organized and administered this program!
By Felipe on October 25th, 2021. Posted under: 2021, Blog Post, Featured Article
Medical Students for Choice wrapped up another successful Abortion Training Institute (ATI) season earlier this fall. These virtual ATIs allow highly motivated students to learn many aspects of abortion in an intense, small group learning environment. Students learn about the clinical aspects of first-trimester abortions, examine their own biases and values, and hear from abortion providers about their experiences, challenges, and motivations. Fifty students from 46 schools were accepted. Each student received a training kit in the mail to participate in an Manual Vacuum Aspiration (MVA) workshop to gain facility and familiarity with the equipment.
Reproductive health is a vital part of medicine (and life), no matter what specialty you go into. Unfortunately, most medical school education is still very limited on reproductive health, despite how often it is encountered in practice, which leads to confusion and misinformation, even amongst health care professionals. These classes have been phenomenal in bridging that gap.ATI Participant
Students walk away from the ATIs feeling more knowledgeable about abortion-related topics. Based on the results of pre-ATI and post-ATI tests, students reported being significantly more knowledgeable around the techniques of first-trimester procedural and medical abortion, identifying products of conception, and legal restrictions in the U.S.
When looking at the proportion of students who rated themselves a 4 or 5 on a 1-5 knowledge scale (1 being not competent and 5 being very competent), all changes in knowledge were statistically significant with a p-value of <.0001.
Even among this highly self-selected group of participants, the ATI clarified and solidified these students’ intention to provide abortions in their future careers. For students that indicated future provision was unlikely, their desire to enter a specialty further removed from reproductive health care was the main reason given.
We asked participants to indicate how much of an impact the factors would have on their ability to provide abortions. Below are the percentages of respondents who indicated factors would have a high impact. As you can see, anti-choice legislation was the factor students believed would have the highest impact on their careers.
For me, a big part of medicine is social justice. Becoming an abortion provider is an incredible way I can fulfill that mission. MSFC is helping me reach that goal by providing clinical training, tools, and resources not included in my curriculum.ATI Participant
By Felipe on October 18th, 2021. Posted under: 2021, Blog Post
In 2021, MSFC continued to experience a wave of interest, with new chapters popping up in new areas across the world. We asked two student leaders some questions to gain their insight into why they decided to start a chapter at their university. Here’s what they had to say:
What made you want to start an MSFC chapter at your university?
There was a gap in access to reproductive health services and information including abortion care. There was no student-driven kind of arrangement available to enhance mentorship, leadership, and service provision for reproductive health, including abortion. So, when I was informed by the late student leader Rossette about MSFC and what it does, I fell in love with the idea and wanted to engage in MSFC in my time as a medical student to apply reproductive health knowledge in my practice. Most importantly, it looked like a grand opportunity for me to exercise my potentials in leadership, organization, and networking here at home and abroad.Henry, Student Leader, MSFC Chapter in Soroti, Uganda
I attended the Reproductive Justice Leadership Program offered by AMSA last semester; it was an enlightening experience. I couldn’t believe that my education had been lacking so much that the stigma around Family Planning, being in control of our bodies no matter our race or gender, is being dictated by people who aren’t educated on what each community needs and is biased towards what they believe. I wanted to bring MSFC to my university and region so that we could start the conversation so that we could become more open-minded to any future patient’s needs.Olivia, Student Leader, American University of the Caribbean
Why is it important that sexual and reproductive health (SRH) advocacy and education be brought to your campus (or region)?
My university is a community with over 90% of its students in their reproductive age. This implies a necessity for access to reproductive health information, education, and services. Although many university students are not minors, I mean they have their beliefs and rights. So, it is important that they are empowered to be able to come up with informed decisions on aspects such as abortion, Family planning, and belonging to LGBT community or not.Henry, MSFC Chapter in Soroti, Uganda
It’s important to have this level of advocacy and education in my region because a lot of us want to learn, but we don’t have access to the resources, and a lot of hospitals don’t offer the training provided by MSFC. Even if the training is never used, it’s important to have it so that we can guide our future patients to what is best for them, even if that is outside of our personal comfort zone. I think that this should be a part of our school curriculum so that we are able to help any patient we have.Olivia, American University of the Caribbean
How does being an MSFC student leader align with your future plans (Career, Interests, or other)?
I am a medic, and my life will be medicine as I want to pursue being a medical specialist in Obstetrics and Gynecology and public health. I realized being an MSFC leader puts me at the forefront of all the activities which are a reflection the experience needed in those fields.Henry, MSFC Chapter in Soroti, Uganda
My future plans include being a trauma surgeon or disaster medicine ER physician. So, while I might never encounter a patient that needs guidance about sexual and reproductive health or an emergency abortion, I don’t want to limit my education on something that may benefit the one patient out of a hundred. I want to be able to provide the best care I can to any patient that I encounter and make them feel heard and understood.Olivia, American University of the Caribbean
If you or someone you know is interested in starting an MSFC chapter at your school, visit our Get Involved webpage for more information.
By Felipe on October 11th, 2021. Posted under: Blog Post
With in-person events ramping up this fall, the University of Utah SOM MSFC leaders wanted to keep Medical Students for Choice and reproductive health topics at the forefront of our classmates’ minds. We also wanted to raise additional funding to use to help us put on events throughout the year, as well as to send members to the MSFC conference. To accomplish both of these goals, we decided to host a fundraiser at a local brewery to give students and healthcare professionals an opportunity to socialize and relax while also learning more about joining and/or supporting MSFC.
Salt Lake City is home to a variety of microbreweries, and we felt hosting our event at one would be an effective way to both support a local business while providing an interesting event for our classmates to attend. The brewery agreed to donate 20% of their sales from the evening to our cause. We made the event more appealing by also emailing local businesses to collect raffle donations (MSFC has sample letters here you can use to ask for in-kind donations). Their enthusiasm for our cause was refreshing and several businesses donated amazing prizes, including $100 equipment rentals, enormous gift baskets, and unique artwork. To boost our direct donations, we asked people to pay $2 per raffle ticket to increase their chance of winning a prize. We also asked for direct, private donations to our MSFC account for people that couldn’t attend. To boost attendance, we used Facebook, Instagram, and class time to promote the event to the entire UUSOM student body (use MSFC’s design resources to create social media posts).
University of Utah SOM MSFC Chapter leaders at the fundraiser table.
The turnout for the event helped us realize how many amazing healthcare professionals in Utah understand the need to protect organizations that promote reproductive justice. We estimate that over 100 medical students, physicians, and nurses attended the event leading to over 100 in person donations and several private donations. Because of the great turnout, we were able to raise almost $3,000 for our chapter! We’ve already used some of the money to organize a patient abortion panel featuring one of our MSFC leaders, which 60 students attended. This month, we have plans to host several IUD insertion workshops, sponsor a rural reproductive health talk, and discuss racial disparities surrounding reproductive health. People who attend our events have been discussing the impact learning about abortions has had on them and how that changes their perspective on reproductive rights. We already feel we are making progress to help our community.
I encourage other MSFC chapters to investigate unique ways to fundraise money and promote MSFC’s mission. For some quick advice:
- Set a target dollar amount that you are trying to raise. This helps you figure out how much needs to go into planning the event—a smaller goal will likely require less work than a larger one. Our target goal was $1,500.
- If you choose to hold your fundraiser at a local restaurant/brewery/etc., let the owners of the business make most of the decisions regarding timing of the fundraiser. I gave them a range of dates that worked for us, and they decided on a time. 4-7 PM on a Saturday worked well. They know when their business is busy and when sales will be high.
- Incorporate multiple streams of income into the fundraiser. The brewery donated 20% of the sales from the night to our group. This was only about $600. Most of our donations came from the raffle and private donors.
Good luck and get out there!
By Felipe on October 04th, 2021. Posted under: 2021, Blog Post
Medical students from different parts of gathered for a regional meeting to harness their abortion service delivery and advocacy skills.
Medical Students for Choice (MSFC) is a non-profit student-led organization that has tirelessly, through the numerous grassroots chapters worldwide, extended not only equipment and materials necessary for safe abortion training but also created a safe space where young people like me with a dream of becoming pro-physicians can go ahead achieve it. For over two decades, MSFC has been dedicated to generating a pool of safe abortion service providers and advocates worldwide, and amazing work has been done in the marginalized parts of the world, particularly sub-Saharan Africa, where I come from. My country of origin is Uganda. I’m currently in my final year pursuing a bachelor’s degree in medicine and surgery at Gulu University, where I happen to serve as the chapter leader of the MSFC Gulu chapter. I attended the East African regional meeting on the 4th of September 2021, where the majority of chapters from East and central parts of Africa were represented both physically and online. Students at the conference came from Uganda, Tanzania, Somalia, Democratic Republic of Congo, Rwanda, and Burundi. In this regional meeting, we were trained on legal aspects of reproductive health, the life of an advocate, primary health coverage, healthcare in a resource-limited setting, and dynamics of family planning and safe abortion. Lastly, we had an opportunity to have a hands-on experience with Manual Vacuum Aspiration (MVA) for surgical abortion using melons and pawpaw role-playing for female reproductive organs.
What did I learn from this regional gathering as a future pro-physician in Africa?
First and foremost, I learnt how to confidently use an MVA to initiate termination of a pregnancy or complete an underway process (Comprehensive Post Abortion Care), a lifesaving skill that the majority of our universities have denied us through our medical school training. Secondly, I learnt how to strongly advocate for curriculum reform in my university and advocate for safe abortion care to be adopted in the constitution as part of healthcare because, truth be told, it is. Events like this as so pivotal in our careers as service providers, Did my life change?! Definitely it did!
By Felipe on September 24th, 2021. Posted under: Blog Post
Health care professionals share personal accounts, correct misconceptions about abortion advanced by Mississippi’s 15-week ban
On September 20, 2021, on behalf of a diverse group of health care professionals, leading medical organizations filed an amicus brief in the U.S. Supreme Court case, Dobbs v. Jackson Women’s Health Organization. The case, brought by the Center for Reproductive Rights on behalf of Jackson Women’s Health Organization — the last abortion provider in Mississippi — challenges a blatantly unconstitutional ban on abortion care after 15 weeks of pregnancy that seeks to overturn nearly 50 years of precedent since Roe v. Wade. The Supreme Court recently announced it will hear oral arguments in the case on December 1, 2021.
The groups are Abortion Care Network, Bixby Center for Global Reproductive Health, Medical Students for Choice, National Abortion Federation, Physicians for Reproductive Health, and Planned Parenthood Federation of America. Orrick, Herrington & Sutcliffe LLP is serving as pro-bono counsel.
The brief corrects misconceptions about abortion and includes first-hand accounts from trained, expert health care professionals who provide abortion — including physicians, clinic administrators, and medical students — on the devastating consequences abortion bans and restrictions have on patients across the country, including today in Texas. The brief was filed on the 20th day that Texas’s S.B. 8 — the radical “sue thy neighbor” law that has made abortion virtually inaccessible in the state — has been in effect.
Excerpts from health care providers featured in the brief are below.
Bhavik Kumar, M.D., M.P.H., Texas; Planned Parenthood provider“When Texas banned abortion in the spring of 2020, claiming falsely that abortion was a non-essential service, our clinic was forced to shut down four different times. I remember one patient who came to our clinic four times—we had to turn her away twice because of court orders that were issued while she was in our waiting room. I had patients who had to travel, in the middle of a pandemic, to as far as Chicago or Colorado, to access the care that we could have provided right here. And I had other patients who didn’t have the means or ability to travel out of state.”
Amna Dermish, M.D., Texas; Planned Parenthood provider“Just today, I had to turn away several patients who were too far along to obtain an abortion in Texas, including a patient who was less than six weeks pregnant. One curled up into a fetal position and started bawling hysterically. The others reacted more calmly but with no less devastation. I’m already dreading tomorrow, where I will yet again be forced to inflict pain on my patients as I deny them the care they need.”
Lori Williams, M.S.N., A.P.R.N., Arkansas; National Abortion Federation board chair“For me, abortion care is natural. It is a calling. It is my passion. People in the abortion community— people who feel just as passionately about their work as I do—have said to me, ‘You’ve chosen such a hard place to provide this care. You could do this in places where it wouldn’t be so stressful and difficult. Why Arkansas?’ But I always knew that I needed to do this work in Arkansas. And I still feel that way.”
Ying Zhang, M.D., Washington“I provide full-spectrum primary care. That includes taking care of babies, children, adults, and older people. And it includes taking care of people who are pregnant and want to be pregnant, and people who are pregnant and don’t want to be pregnant. With that perspective, it’s easy for me to see that abortion care should be a regular part of healthcare. It is care that people need to live their fullest and best lives.”
Ghazaleh Moayedi, D.O., M.P.H., Texas and Oklahoma; Physicians for Reproductive Health board member“The biggest obstacle is a lack of access to abortion clinics. In Texas, there are far more places that deceive people about how far along they are and what their options are than there are facilities providing abortion care.”
DeShawn Taylor, M.D., M.Sc., FACOG., Arizona; owner, founder, and physician at Desert Star Family Planning clinic and Abortion Care Network board member“Abortion saves lives. … The state talks about demeaning the medical profession. But what is the black eye on the profession? It’s not giving that person the procedure she needs and letting her die.”
Colleen McNicholas, D.O., M.S., Missouri, Illinois, and Oklahoma; Planned Parenthood provider “We are already seeing patients six days a week for nine hours a day. If we have to absorb even more patients from other states, that means longer delays. It is ironic that the politicians who are trying to restrict second trimester abortion procedures are the ones who will be responsible for pushing abortion later into gestation, including well into the second trimester.”
Jessica Mecklosky, medical student, Medical Students for Choice board of directors“These patients desperately need accurate information about their reproductive health, from sex education to abortion counselling, and they aren’t getting it.”
Dr. Kristina Tocce, M.D., M.P.H., Colorado; Planned Parenthood provider“In April 2020, after Texas banned abortion, our clinic in Colorado saw a massive increase in patients from Texas. Patients were literally fleeing the state to obtain the care they needed, in some cases driving 12 hours each way. … Many—in particular patients of color and patients I perceived to be undocumented—not only had to get time off work, find a ride, coordinate childcare, and arrange for housing and food while on the road.”
Yashica Robinson, M.D., Alabama; Physicians for Reproductive Health board member“As an abortion provider, I strive for integrity and to maintain the ethics of the profession. That means providing patients the care that they need. Like many abortion providers, that is one of the reasons I fight to provide this care. It is unethical to withhold care that a patient needs, sometimes so desperately. That is especially true with patients who have the fewest financial resources, the least amount of social support, and very little meaningful access to healthcare in general. They are the ones most affected by restrictions on abortion.”
Amy Hagstrom Miller, Texas, Maryland, Virginia, Indiana, and Minnesota; president of Whole Woman’s Health and Whole Woman’s Health Alliance“How people obtain abortions in this country is day and night depending on where they live, even though the abortion procedure and safety outcomes are the same everywhere. In some states, government-imposed barriers make it exceedingly difficult for people to access abortion and delay their care. In states where Medicaid and private insurance do not cover abortion, where patients must make two trips to the abortion facility, and where few clinics remain because of state restrictions, patients are more likely to be pushed into the second trimester. And for some patients, these state-imposed barriers make it impossible for them to access an abortion at all.”
Mugdha Mokashi, medical student, past-president of Medical Students for Choice board of directors “It means that where someone resides will directly impact their ability to live their lives on their own terms. And it will deepen inequities in our society.”
Mona Reis, Florida; founder of Presidential Women’s Center“We are about to put people into crisis—especially people with the least resources. I cannot believe this is still not settled, that women still don’t have access to comprehensive healthcare. To me, it is the most fundamental right we have. Having an abortion can be one of the most important decisions a woman will ever make.”
