By Felipe on March 18th, 2025. Posted under: 2025, Blog Post, Featured Article
On Wednesday, November 13, 2024, MSFC Student Organizing held an International Student Leader virtual event. It was an opportunity for student leaders from around the world to share their experiences, ask for advice, and provide context about what it is like to pursue and advocate for abortion training in their region. They reflected upon how MSFC has informed their work.
MSFC operates globally and has a robust network of current and future abortion providers, which allows us to come together to illuminate what providing that care looks like, what barriers exist to doing so, and how to best advocate for healthcare access and reproductive justice around the world.
During the event, we heard from several medical students leading chapters outside of the United States. We wanted to share some of their insights here for those unable to attend.
A student leader from Makerere University in Uganda spoke about what access to abortion care looks like in Uganda:
“Access to comprehensive abortion care is highly restrictive in Uganda and other low socio-economic countries due to unfavorable legal frameworks, cultural and religious landscape. Because of this, comprehensive abortion care and post-abortion care are not exclusively taught in medical schools. Medical Students for Choice has given us students from such abortion restrictive environments knowledge and skills to provide compassionate and non-judgmental care to individuals seeking reproductive health services; and skills to advocate for policy changes that prioritize the health, dignity and rights of all individuals. This has been through seminars, regional conferences, webinars, projects and reproductive health externship programs. I can now comfortably extend comprehensive abortion care, post-abortion care, and family planning services to girls and women needing them.”
This student also opened up about their experience attending the externship program hosted by the Dynamic Doctors Uganda program:
“Dynamic Doctors Uganda hosts medical students from across Africa with funding from Medical Students for Choice for hands-on training at health facilities in rural areas. This externship provides students with invaluable hands-on experience and an in-depth understanding of clinical care and counselling in sexual reproductive health and gives them a chance to refine their clinical skills from rural settings where they will practice from when they qualify in areas of reproductive health in comprehensive abortion care, post-abortion care and contraception. I had the pleasure to be an extern for this wonderful Externship Program at Jinja Regional Referral Hospital in July 2023. This MSFC/DDU RHE Externship Program was such an invaluable experience to understand the health disparities in rural settings from a global health perspective while delving into something that I am extremely passionate about sexual reproductive health and rights.”
At the event, we also heard from a student leader at the University of Duisburg-Essen who presented an overview of their work and the landscape of providing abortion care in Germany. This student shared that the chapter has hosted pub quizzes, lectures, and hands-on workshops. They have organized demonstrations, attended rallies, and coordinated with Doctors for Choice, ProFamilia in Action, Bündnis für sexuelle, and Selbstbestimmung. From these experiences, the chapter reports having developed networking and leadership skills and engaged in interdisciplinary exchange with other medical students and with a midwife community. They have grown in their ability to communicate with the press and give interviews. They have also organized effective campaigns to decriminalize abortion and formed a reliable network of like-minded people from a range of different fields and career stages.
The chapter also shared that their engagement with MSFC has increased political involvement and advocacy among medical students and has inspired many of them to pursue OB-GYN as a career path.
One of the University of Duisburg-Essen chapter members is researching influencing factors on abortion provision in Germany and credits MSFC’s network in facilitating the research required for her doctoral thesis.
Photos provided by the University of Duisburg-Essen
A student leader attending Dalhousie University in Canada provided additional context about their advocacy through MSFC. They focus on teaching students about topics they’ll encounter in any field of practice and getting students more knowledgeable and comfortable in providing a variety of services. They brought in a local abortion provider to share about prescribing abortion medication. This provider discussed indications, required testing, follow-up care, side effects and complications, and counselling patients. They also hosted a local pharmacist to discuss dispensing medication abortion pills, and the kinds of questions patients ask in those interactions. The event concluded with a hands-on session using MSFC MVA kits. The chapter also hosted a urologist to discuss vasectomies as a reproductive healthcare option, a contraceptive information session, and an IUD insertion workshop. They see their role as supporting future abortion care providers and advocating for reproductive justice in New Brunswick.
Finally, we heard from a student leader based in Cotonou, Benin, at the Faculty of Health Sciences, who described chapter activities and an overview of healthcare access in West Africa.
All of the student leaders expressed that MSFC has allowed them to organize, advocate for, and train to provide abortion care in their respective regions. Despite varying social, political, and economic barriers to providing reproductive healthcare globally, these student leaders related to one another through their commitment to fighting for reproductive justice and learning to provide the best care possible in their community.
MSFC HQ has a regular virtual events series and hosts events like these, which help us connect and learn about various topics related to abortion, family planning, and reproductive justice. We hope to see you at the next one!
By Felipe on February 25th, 2025. Posted under: 2025, Featured Article
In 1994, Black women coined the term “reproductive justice” as a way to fold their lived experiences and intersections of identity into a framework for justice, not just abortion access. Without Black women, there would be no Reproductive Justice movement, no lens through which to examine the deep connections between reproductive rights and broader systems of oppression.
Reproductive Justice history is Black history. As we honor Black History Month, we must recognize the Black activists and organizations that have built and continue to shape the reproductive justice movement today.
As stated by SisterSong, the reproductive justice movement has 4 foundational pillars:
- The human right to own our bodies and control our future.
- The human right to have children.
- The human right not to have children.
- The human right to parent the children we have in safe and sustainable communities.
Black-Led Organizations
We are grateful for the ongoing efforts Black-led organizations are doing to improve reproductive healthcare and outcomes for Black birthing people while ensuring that Black communities have the resources and support needed to thrive at every stage of life, including but not limited to:
- SisterSong is the largest national multi-ethnic reproductive justice collective. They aim to amplify the voices of Indigenous women and women of color to win access to abortion and reproductive rights.
- Black Mamas Matter Alliance serves as a national entity working to advance black maternal health, rights, and justice, and uplifts the work of locally based, black women-led maternal health initiatives and organizations.
- New Voices for Reproductive Justice is an unapologetically Black and queer-led movement organization, dedicated to advancing reproductive justice.
- The AFIYA Center serves Black women and girls by transforming their relationship with their sexual and reproductive health in Texas.
- National Black Midwives Alliance aims to increase the number of Black midwives and access to Black midwives so that there are more providers who can impact perinatal health disparities.
- Birth in Color offers community based doula training. Through community events, workshops, and policy efforts, it is working to redefine what maternal health means for families of color.
- Southern Birth Justice Network strives to make midwifery and doula care accessible to all birthing people, especially POC and LGBTQ+ communities. They offer Birth Justice Doula certifications that focus on building skills in full spectrum perinatal support, health and power disparities and advocacy.
Maternal Mortality and Reproductive Care
Students entering the healthcare field have a role to play in addressing the inequities that Black patients face when seeking reproductive care. According to the Centers for Disease Control and Prevention (CDC), Black women are three times more likely to die from pregnancy-related causes than white women. MSFC provides Event Resources for hosting a discussion on maternal mortality where medical students can discuss both how access to safe, legal abortion is linked to a decline in the maternal mortality ratio (MMR), and how worldwide disparities create drastically different outcomes for patients of different nationalities; as well as patients of different economic, racial, and ethnic backgrounds.
Through training, workshops, and advocacy, MSFC supports medical students committed to fighting these barriers in patient care. We encourage our supporters to learn from and uplift the Black-led organizations that are driving change in reproductive healthcare. Here’s how you can help:
- Support Black-Led Organizations: Stay current with groups like SisterSong, Black Mamas Matter Alliance, and others leading this work and efforts made in reproductive health.
- Advocate for Policy Change: Support policies addressing racial disparities in maternal and reproductive health care.
- If you are a medical student, get involved in MSFC’s efforts to ensure future physicians are trained to provide comprehensive reproductive care.
With access to reproductive health care under constant attack, one of the most powerful things we can do is help ourselves and our community with how to advocate effectively.
Our community’s commitment to reproductive freedom can be never taken away. We are here to support the next generation of providers with the knowledge and skills to deliver compassionate, patient-centered care that acknowledges the systemic factors at play.
By Felipe on February 11th, 2025. Posted under: 2024, Blog Post, Featured Article
Around the world, pregnant individuals face barriers to accessing safe, compassionate care, and providers encounter more challenges in ensuring reproductive rights are protected. Yet, in the face of adversity, members at Medical Students for Choice (MSFC) continue to make a lasting impact.
Two of our board members share their insights on the progress made in reproductive health and education, the significance of hands-on training, and the importance of supporting future healthcare professionals. Their perspectives highlight the hope and momentum in our community:
Jennifer Zhang, President-Elect
University of British Columbia
“As a Canadian medical student, I am grateful that in Canada, abortion remains legal and an available medical procedure. W hile environmental and systems barriers exist in accessing abortion, it is important that here we can practice without risks of provider or patient criminalization However, hands-on learning is rare, and didactic teaching is also limited. In the US, uncertainty surrounds the future of abortion care. At MSFC, we continue to support and champion the reproductive justice movement.
This year, MSFC’s in-person Conference on Family Planning (CoFP) was a unique space where folks could share experiences and learnings on abortion care and reproductive justice, which is much needed for current and aspiring providers practicing in all levels of restrictions. Providing hands-on practice opportunities and collaborative sessions that are rarely found in medical curriculums, the CoFP is something I am very grateful for and leaves me invigorated for the coming year.”
Dr. Hadiza P B Thompson
University of Nigeria Teaching Hospital, Enugu, Nigeria
“As we enter a new year, I want to reflect on the immense strides made in reproductive health and justice, both in the US and across the globe. What we did last year was nothing short of inspiring! It is a work grounded in compassion, resilience, and a commitment to every person’s right to access comprehensive reproductive care regardless of where they live or the barriers they face. I am deeply grateful for the in-person trainings that continue helping medical students and professionals with the tools, knowledge, and courage needed to effect change. These training sessions are spaces of advocacy and learning, where every action brings us one step closer to a world where reproductive rights are human rights.
MSFC is shaping the future of reproductive health and justice, not just in the U.S. but in Africa. In places where access to abortion care is limited, where sexual and reproductive health education is sparse, and where systemic barriers continue to prevent many people from receiving the care they need, we are making an indelible mark. This work is especially crucial in Africa, where both cultural and political challenges often exacerbate reproductive health disparities. Through training and advocacy, MSFC is creating a new generation of healthcare professionals who are ready to provide care, committed to challenging the status quo, and advocate for reproductive justice at every turn. Looking ahead, I am filled with hope. The strides we’ve made, though significant, are only the beginning. What we are doing together–whether through education, resources, or policy change–is laying the foundation for a future where reproductive justice is a reality for all.
To you reading this, know that you are part of something monumental. Your impact, whether through your actions or your support of MSFC and organizations like it, is shaping a future where reproductive health and rights are accessible to everyone, everywhere. As we enter this new year, let’s hold onto our mission, knowing that each day we are bringing hope to the hearts of those who need it most and restoring their dignity and autonomy.
Thank you for being part of this transformative journey. We will continue to achieve feats and move closer to a world where all reproductive health choices are freely accessible.”
This work would not be possible without the dedication of our supporters, members, and allies. Our MSFC community is shaping the future of reproductive health where education and hands-on training are the necessary tools for change.
By Felipe on November 06th, 2024. Posted under: 2024, Blog Post, Featured Article
Medical Students for Choice (MSFC) is dedicated to supporting students worldwide to advocate for reproductive freedom, access to contraception, and safe abortion education. Through local chapter events, these student-led initiatives have sparked meaningful conversations, provided hands-on training, and reached communities needing accurate and accessible health information. Below are the recent activities of MSFC chapters in Africa, detailing how each chapter has approached education, advocacy, and community engagement to positively impact in their regions.
FSS COTONOU UNIVERSITY – BENIN
During the first half of 2024, FSS Cotonou organized a webinar on the importance of contraception, during which they addressed numerous uncertainties that their fellow students had on the topic. Subsequently, they conducted an initiation activity for new members on Sexual and Reproductive Health. In addition to this, they carried out various information campaigns, notably on International Women’s Rights Day and International Menstrual Hygiene Day.
GULU UNIVERSITY – UGANDA
In collaboration with the student body of Gulu University in Uganda, the MSFC Gulu chapter organized a march through Gulu. Accompanied by a band, medical students wore their clinical coats to advocate for accessible medical abortion services, aiming to reduce the mortality rates and post-abortion complications faced by individuals, who are unable or unprepared to continue pregnancies for personal reasons. Due to the inaccessibility of abortion services, many are forced to resort to unsafe, self-administered methods, such as the use of herbs.
In their efforts to bring about positive change, the group also sought to reach the entire community. They utilized Radio Pacis as a platform to educate the public on various family planning methods, including where these services can be accessed, how they work, their uses, and potential side effects. This initiative had a significant impact as there was an increased turnover of community members accessing the family planning services compared to before.
MSFC Gulu Chapter members at Radio Pacis, a community-based radio station in Arua, Uganda.
MAKERERE UNIVERSITY – UGANDA
In Uganda, the MSFC-MAK Chapter organized a two-day Sexual and Reproductive Health (SRH) Day Fair in collaboration with various partners at the College of Business Administration and Management Studies (COBAMS). The event provided students with opportunities to showcase innovations in sexual and reproductive health and access services such as condoms, safe male circumcision, contraceptive services, menstrual hygiene services, HIV/AIDS and STI testing and screening, pregnancy testing, reproductive health education, emergency contraception, and more.
The fair also included activities aimed at reducing unsafe abortions among university students. There was a collaborative evaluation meeting with Makerere University Hospital and partnering clinics, preliminary debates for the SRH Inter-University Dialogue, a menstrual campaign, and the national launch of the “Community Check Now” HIV testing services in Uganda.
Flyer for the Sexual and Reproductive Health Day Fair organized by the MSFC Makerere Chapter
MBARARA UNIVERSITY OF SCIENCE AND TECHNOLOGY – UGANDA
The MSFC chapter organized a sexual and reproductive health event in collaboration with Reproductive Health Uganda, students, and the Mbarara Medical Students Association. The event attracted 87 students and provided services such as SRH education, guidance and counseling, safe abortion education, family planning information, condom distribution (56 boxes distributed), and HIV testing and counseling (22 individuals tested). A key goal was also to raise the visibility of Medical Students for Choice within Mbarara University.
In addition to the event, they conducted outreach in university halls, distributing flyers and posters about Medical Students for Choice, family planning, safe abortion, and women’s rights. These materials were posted on notice boards in various hostels, allowing students who may not attend SRH events to access vital information and reach more students.
SOROTI UNIVERSITY – UGANDA
The chapter hosted hands-on training in surgical abortion, utilizing models and Manual Vacuum Aspirator (MVA) sets. First-time participants gained foundational knowledge in the use of MVA as a vital tool in abortion training, in addition to learning other methods such as dilatation and curettage.
In collaboration with university religious groups, the chapter also organized a one-day workshop on engaging traditional and religious leaders in sexual and reproductive health and rights activism. Recognizing that religious leaders hold significant influence, the workshop allowed participants to explore what different faiths say about sexual and reproductive health and rights (SHRH).
Additionally, the chapter conducted a capacity-building session on self-care and personal resilience in SRHR activism, addressing common obstacles and how to navigate them in any context.
UNIVERSITY OF NGOZI – BURUNDI
During the semester, the chapter organized three key events advocating for reproductive justice for all.
- On February 13th, medical students gathered to discuss how they can engage in comprehensive family planning, including abortion, by breaking the stigma surrounding these services. The event was attended by 50 students (27 girls and 23 boys).
- On March 5th, the chapter, which included 25 students, celebrated International Women’s Day. This event focused on empowering girls to stand up for their rights, including abortion rights.
- On May 28th, in honor of Menstrual Hygiene Day, 55 students met to discuss how menstruation can be normalized and how to avoid stigmatizing girls during their periods. The event emphasized supporting girls throughout their monthly physiological journey.
Medical students in MSFC chapters have been at the forefront of reproductive health advocacy, striving to create safer, more informed communities. By addressing topics such as family planning, menstrual hygiene, and safe abortion practices, these students are empowering their peers and local communities to make informed decisions about their reproductive health.
By Felipe on October 08th, 2024. Posted under: 2024, Blog Post, Featured Article
We’re thrilled to share the journey of the Medical Students for Choice (MSFC) chapter in Riga, Latvia, the first of its kind in the Baltics. Our chapter, based at Riga Stradins University (RSU), one of Latvia’s largest medical schools, was inspired by the 2022 FIAPAC conference held at RSU. This event, organized by the International Federation of Abortion and Contraception Professionals, connected us with reproductive rights activists worldwide and set the stage for our mission to advocate for reproductive rights.
Our current team—Isabell von Waitz, Patricia Steuber, Hanna Kreuzer, Féline Kuhn, and Linda Schulz—came together with a common goal: to empower choice in reproductive healthcare. United in our commitment, we’ve organized various educational activities, including film evenings, open discussions, and lectures. A highlight was a session with Theresa Nisslmüller, a member of Doctors for Choice and an OBGYN, who shared invaluable insights into reproductive rights in Germany. We’ve also conducted two Papaya Workshops, also known as a Manual Vacuum Aspiration (MVA) Workshop. An MVA is a safe and easy method of providing early surgical abortion. A papaya is used as the model and students use the MVA procedure to remove papaya pulp and seeds from the papaya which simulates suctioning the products of conception from the uterus. This was possible through support from MSFC HQ and our mentors, Dr. Olga Plisko and Dr. Anita Ungure, and resources from German MSFC chapters. The latest workshop featured Marcela Trocha, a veteran reproductive rights activist from Poznan, drawing over 50 enthusiastic medical students.
Impressions from the first Papaya Workshop. (Photo: Aleksandrs Oborins)
In addition to workshops, we hosted a lecture on Transgender Healthcare, emphasizing the diverse needs and choices within healthcare. Our book club discussion on “Ejaculate Responsibly” by Gabrielle Blair broadened our perspective on reproductive health by highlighting the often overlooked role of male fertility in contraception.
Our motivation is deeply rooted in the belief in free choice and bodily autonomy. The 2022 overturning of Roe v. Wade intensified the urgency of the pro-choice movement globally. In Europe, rising far-right ideologies threaten reproductive rights, making our advocacy for gender equality and social justice more critical than ever. Through our work, we aim to increase the availability of abortion providers and ensure comprehensive reproductive healthcare training for medical students, an often neglected area in medical education.
One of our most rewarding moments was the overwhelming response to our first Papaya Workshop in the Baltics. The students’ enthusiasm has inspired us to consider making these workshops a regular part of our activities. Our mentors, who led the workshop for the first time, have been strong advocates for integrating such practical training into the medical curriculum.
First Papaya Workshop in the Baltics with mentors Dr. Olga Plisko and Dr. Anita Ungure (Photo: Aleksandrs Oborins)
Our journey has included challenges. One of the biggest hurdles was creating a collaborative space between international students and students from the OBGYN association. Securing Manual Vacuum Aspirators (MVAs) for our workshops was another challenge, initially solved by borrowing kits from German MSFC chapters, leading to a cross-border collaboration. Recently, through the generous support of Doctors for Choice Germany, we’ve become proud owners of our MVAs, enabling us to continue our Papaya Workshops independently.
These experiences have taught us the importance of reaching out and building connections with like-minded organizations and individuals. Collaboration and careful planning have allowed us to overcome obstacles and lay the foundation for sustained and impactful advocacy. Looking ahead, securing consistent funding will be essential as we continue to expand our workshops and other activities.
From left to right: Diāna Grasmane (Human Rights activist), Arturs Zaremba (Clinical Psychologist) and Dr. Una Gailiša (Endocrinologist) speaking at the Transgender Healthcare Lecture.
Our goal is to destigmatize abortion, dispel myths, and promote safer practices in reproductive healthcare, ultimately strengthening the doctor-patient relationship and fostering greater trust in healthcare settings.
For any student considering starting an MSFC chapter at their medical school, our advice is simple: take the plunge. Connect with like-minded individuals and feminist organizations. The MSFC network is strong and supportive, and if there isn’t a chapter in your country, neighboring ones can offer guidance. Build connections, find supportive physicians, and start with accessible activities like movie screenings. Together, we can advance reproductive healthcare rights and make a meaningful difference in the lives of patients and healthcare providers.
Second Papaya Workshop with mentor Dr. Olga Plisko. (Photo: Aleksandrs Oborins)
By Felipe on August 21st, 2024. Posted under: 2024, Blog Post, Featured Article, News and Views
The fall semester begins! Now is the time to welcome new members, revitalize our chapters, and deepen our commitment to reproductive health education. Whether you are an Experienced Student Leader (ESL) or new to Medical Students for Choice (MSFC), the upcoming months promise a variety of opportunities for learning, advocacy, and growth.
Welcoming New Members
A new semester brings new faces, fresh perspectives, and boundless enthusiasm. At MSFC, we are thrilled to welcome new members passionate about reproductive rights and health. Joining MSFC means becoming part of a community dedicated to education, advocacy, and support.
For those new to our chapters, there are many ways to get involved:
- Many chapters host events and clinical training sessions at the start of the semester. These are great opportunities to meet current members, learn about our mission, and find out how you can contribute. MSFC provides Event Resources for personalized event planning help with chapter events and workshops.
- We offer various training sessions and workshops equip you with the knowledge and skills to advocate for reproductive health. Our workshops are interactive and engaging; providing a platform for students to ask questions, participate in discussions, and learn from experts in the field.
- Get started in participating in local advocacy efforts, engaging in campus outreach, or contributing to curriculum reform. There are numerous ways to make your voice heard as a future abortion provider.
Arkansas MSFC welcoming first-year medical students during the Interest Group Fair
Enhancing Our MSFC Chapters
Existing members play a crucial role in helping our chapters thrive. Your experience and knowledge are invaluable in mentoring new members and leading initiatives.
Here are a few ways you can help strengthen our chapters:
- Experienced Student Leaders offer mentorship to new members by sharing their experiences, providing guidance, and helping them navigate their involvement in MSFC.
- You may consider becoming an MSFC Chapter Leader at your campus. Your leadership can significantly impact in your medical journey and curriculum.
- We also work with other reproductive health organizations and groups to broaden our reach and amplify our message. Collaborative efforts can lead to innovative projects and stronger advocacy networks.
Family Planning and Reproductive Health Education
This semester, we are committed to engaging more students in workshops to advance their skills in reproductive health care. These workshops are designed to provide comprehensive, evidence-based information on a range of topics, from contraception and abortion care to advocacy and policy.
Don’t forget to register for the 2024 Conference on Family Planning – Bridging Divides, Sparking Connections: The Power of Community! This year’s conference will be held in Denver, Colorado on Saturday, December 7 – Sunday, December 8, 2024. Registration opens on August 26 and closes on October 28, 2024. MSFC welcomes our members, alum, and colleagues to join us as we meet in person to engage with the pro-choice community and spark new connections to bridge divides in reproductive health, equity, and justice through medical student education, training, and advocacy.
How to Get Involved with MSFC
Contact Your Local Chapter: Find out about events and meetings happening on your campus. Email our Student Organizing team and we will help you get connected to an existing chapter or start one at your medical school.
Follow Us on Social Media: Follow what future doctors are doing to protect and expand abortion access. And stay updated with our latest news and events.
Visit our Website: Explore resources, upcoming events, and more information about MSFC.
We look forward to a productive and inspiring semester ahead. Welcome to the new semester with Medical Students for Choice!
By Felipe on February 13th, 2024. Posted under: 2024, Featured Article, News and Views
Last week, MSFC members Danna Ghafir and Natalie Givens joined medical and undergraduate students across the country to participate in a virtual roundtable discussion with the United States Secretary of Health and Human Services, Xavier Becerra. The roundtable on reproductive health and justice was organized to commemorate the 51st anniversary of the Roe v. Wade decision and offer an opportunity for student advocates to share their experiences and ask the Secretary questions.
Danna and Natalie are medical students in restrictive states Texas and Georgia. Their experiences with a lack of access to abortion training were amplified by similar stories from the medical students who attended the roundtable. Danna shared that in Texas, abortion education has been highly variable between medical schools. As an Experienced Student Leader for Texas chapters, Danna engages with chapter leaders across the state to understand the status of abortion education at their schools. Some medical schools offer lectures dedicated to abortion and complex contraception, the existence of which is often the result of student-driven curriculum reform efforts made possible with the support of MSFC resources. Meanwhile, other schools have little to no mention of abortion care in their didactic curricula, and these students rely on external learning opportunities, like MSFC’s virtual lectures and the Reproductive Health Externship program offering training in other states.
Natalie shared with the Secretary her experience as a medical student in Georgia, where abortion is banned after detection of embryonic cardiac activity, which usually occurs around 6 weeks gestational age. Her school gave a lecture on abortion care during her didactic years. To get more experience, Natalie recently asked to shadow an abortion provider who helped at an MSFC event. The provider declined, saying that because of the current Georgia law, abortion patients have much more fear, and having a medical student shadowing in the room could erode the patient’s trust in such a vulnerable situation. Medical students from restrictive states shared stories similar to Natalie’s, expressing their concern that states with restrictive abortion laws have, on average, higher maternal mortality rates and fewer maternity care providers1, yet medical students are disincentivized to pursue OB-GYN residency training in these states due to potential limitations in their education.
The spectrum of educational opportunities around abortion care in US medical schools is broad and unstandardized. Currently, the Liaison Committee on Medical Education (LCME) does not include any requirements for abortion education or training in their curriculum standards. According to their website, “The LCME is recognized by the U.S. Department of Education and WFME as the notable authority for the accreditation of medical education programs leading to the MD degree.” When asked if the Department of Health and Human Services is collaborating with the Department of Education to standardize abortion education and training in medical schools nationwide, the Secretary responded that they do not currently collaborate with the DoE on this matter, but that they recognize the concerns students brought up regarding this issue. A collaborative effort between the two regulatory bodies could ensure that all medical students have access to the information required to understand evidence-based abortion care practices, and we call on both departments to address this pressing concern.
MSFC has an ongoing petition to the LCME to include abortion training in Undergraduate Medical Education. An excerpt of the petition is below:
As medical students and trainees, we are asking the Liaison Committee on Medical Education (LCME) to include abortion learning objectives and options counseling within the accreditation requirements of each medical school. Currently, the LCME requires that medical school curricula include each organ system, each phase of the human life cycle, continuity of care, and preventive, acute, chronic, rehabilitative, and end-of-life care; however, it does not include any reference to abortion training.
As a medical community and medical education training community, it is the responsibility of the LCME to hold medical schools accountable for providing comprehensive and patient-centered medical education. Healthcare is paramount over any political agenda, and the LCME should be able to defend medical education against policies that endanger the health of our patients.
We were very thankful to be invited to attend the roundtable and have the opportunity to share our experiences with Secretary Becerra and HHS staff members. The discussion ended with Secretary Becerra giving heartfelt thanks to all medical students and undergraduate reproductive health advocates in attendance for their perseverance and vulnerability in sharing their stories.
Reference
Eugene Declercq et al., The U.S. Maternal Health Divide: The Limited Maternal Health Services and Worse Outcomes of States Proposing New Abortion Restrictions (Commonwealth Fund, Dec. 2022).
By Felipe on January 29th, 2024. Posted under: 2024, Featured Article
In the aftermath of the U.S. Supreme Court’s reversal of Roe v. Wade, a ruling that previously established federal protection for patient autonomy in reproductive decision-making, state governments across the nation encountered a pivotal inflection point in reproductive health policy. This juncture signified more than a legal transformation; it represented a fundamental shift in the medical landscape, directly impacting the ability of individuals to exercise their reproductive rights. In the recent 2023 midterm elections, Ohio and Virginia emerged as critical arenas in the discourse on the preservation of reproductive autonomy.
Ohio voters approved Issue 1, an amendment that guarantees individuals’ rights to make their own reproductive decisions, including personal choices on abortion, up until the point of fetal viability (1). Fetal viability refers to the point at which a fetus can survive ex-utero and is defined by Ohio law as 21 weeks and 6 days. The Issue 1 amendment aimed to prevent the reinstatement of SB23, the most recent six-week state abortion ban based on fetal heartbeat detection (2). The direct vote on abortion regulations marked a departure from previous abortion restrictions and a victory for reproductive rights in Ohio.
Similarly, Virginia saw a significant development in the protection of reproductive rights legislation with a political shift establishing a Democratic majority determined to counteract future abortion restrictions. Currently, Virginia’s abortion laws, 18.2-72 and 18.2-73, legalize most abortions until the end of the second trimester, which aligns with the recent amendment proposed in Ohio (3). Recent efforts by Republican legislators have threatened these rights by pushing for a 15-week abortion ban. However, the Democratic sweep during the Virginia midterm ensures the preservation of the current abortion rights within the state.
These recent legislative advancements demonstrate significant implications for practicing providers and research focuses. For providers, the reversal of abortion restrictions restores their full scope of practice and guarantees adequate training in complex abortion care. As reproductive rights continue to evolve, healthcare providers have a responsibility to stay informed on state policy changes and abortion practice guidelines. The implementation of Texas SB8, which prevents providers from offering abortion as an option if a fetal heartbeat is detected, serves as a resounding example of the complexities introduced into the counseling process for healthcare providers. Grappling with insurance and institutional limitations that restrict patient eligibility for hospital-based care, providers are faced with increasing uncertainty on the conditions for which abortion should be considered (4).
In addition to awareness of state-specific legislation, physicians must be committed to advocating for accessible training and comprehensive education on abortion provision. A comprehensive review of abortions in the U.S. concluded that abortions are safe and effective, with rates of complications below 1%, significantly lower than those associated with childbirth (5). Recent studies show that one in five physicians are not confident that abortions are “very or extremely safe,” underscoring gaps in current provider knowledge (6). Ensuring that providers are adequately informed on both legislative and clinical fronts, along with understanding current limitations and opportunities for improved education, is crucial to protecting patient safety and working towards safeguarding provider access to training regardless of the state they go on to practice in.
Research also continues to remain a vital front in evaluating patient safety, psychological impacts, and long-term health outcomes for individuals accessing reproductive care in states with restrictive abortion policies. The shifting legislative landscape, such as recent amendments in Ohio, underscores the growing necessity for such research. Rigorous research guides evidence-based practice standards, and serves as a tool to identify critical gaps in healthcare provision, particularly in the context of complex pregnancies. Another area warranting active research is the impact of abortion costs on patient safety and morbidity. Before the Dobbs decision, three quarters of abortion patients, falling at or below 200% of the federal poverty level, depended on individual state jurisdiction on the use of Medicaid funds for abortion services, given that the Hyde Amendment prohibits federal Medicaid from covering most abortion procedures (7). Considering the role that financial barriers play in the ability to receive abortion care both in and out of state, it is increasingly important to assess the intersection between social determinants of health and the inability to undergo a desired abortion as state laws change.
The legislative developments in Ohio and Virginia mark a significant step forward in preserving reproductive rights. These developments also highlight the transient nature of the current abortion legislative landscape, indicating the urgency to enact federal legislation that codifies the protection of individuals seeking abortion care. Advocacy for nationwide efforts to expand access to abortion care is necessary but must also be supplemented by education among abortion providers and continued research on the downstream effects of the Dobbs decision. Physicians bear the utmost responsibility to safeguard patient outcomes, and engage in legislative discourse and action that ultimately supports a patient’s right to bodily autonomy.
References
(1) Ohio Secretary of State. Issue 1: A Self-Executing Amendment Relating to Abortion and Other Reproductive Decisions. Columbus, OH: Ohio Secretary of State; 2023. Available here.
(2) Ohio General Assembly. Senate Bill 23: Human Rights and Heartbeat Protection Act. 133rd General Assembly, 131st General Assembly Regular Session. Columbus, OH: Ohio Legislature; 2019. Available here.
(3) Virginia General Assembly. Code of Virginia: Article 9. Abortion. Richmond, VA: Commonwealth of Virginia; 2023. Available here.
(4) Arey W, Lerma K, Carpenter E, Moayedi G, Harper L, Beasley A, et al. Abortion access and medically complex pregnancies before and after Texas senate Bill 8. Obstetrics & Gynecology. 2023;141(5):995–1003.
(5) The National Academies of Sciences, Engineering, and Medicine, Committee on Reproductive Health Services. The Safety and Quality of Abortion Care in the United States. Washington (DC); The National Academies Press; 2018. Chapter 2, page 56.
(6) Swan LET, Cutler AS, Lands M, Schmuhl NB, Higgins JA. Physician beliefs about abortion safety and their participation in Abortion Care. Sexual & Reproductive Healthcare. 2023 Dec;38:100916.
(7) Weitz TA, O’Donnell J. The challenges in measurement for abortion access and use in research Post-Dobbs. Women’s Health Issues. 2023 May 22;33(4):323–7.
By Felipe on January 15th, 2024. Posted under: Featured Article
GULU UNIVERSITY chapter in Uganda reached out to the faculty and taught them about safe abortion, its definition, where to get the services, and post-abortion care with the theme, “Childbirth should be your choice not a mistake.” With this, many individuals had a voice and knew they could carry out abortion safely.
MAKERERE UNIVERSITY chapter in Kampala, Uganda, successfully participated in the commemoration of International Safe Abortion Day on September 28th under the theme “Mitigate the unsafe abortions, reduce the abortion Stigma”:
Four active MSFC-MAK Chapter Members reached out to 47 students to talk about abortion stigma, its impact, and how it can be mitigated.
MSFC-MAK Chapter Members attended several online spaces discussing different themes concerning abortion. Most notable was the Twitter Space hosted by Women With A Mission (WWM) in partnership with Global Find for Women. The space was under the theme Unsafe Abortions in Uganda, A public health problem we must deal with. Simon Sserrwanja (A prominent news anchor) moderated the session and had one of our MSFC Almunus, Dr. Kizza Blair, as a Keynote Speaker.
MSFC-MAK hosted a keynote speaker, Mrs. Nambassa Jovia from Dwona Initiatives, to give an address on unsafe abortion and abortion stigma under the Chapter Theme for the Celebrations. Over 150 Medical and non-medical students attended the session.
FSS-COTONOU UNIVERSITY chapter in Cotonou, Benin, conducted an online campaign on their social media on safe abortion in partnership with the International Federation of Gynecology and Obstetrics (FIGO). The training of health workers on safe abortion advocacy through Young Health Workers for Secure abortion networks helps bridge the inequality gaps and provide reliable information on safe abortion.
Their social media profiles:
CHARLES UNIVERSITY chapter in Prague, Czechia, made an Instagram post on their OBGYN account. Students had a presentation about the background of International Safe Abortion Day and planned to show a movie in a public student house about conscious objection concerning abortion.
They also watched videos by the collective KINOKAS, called “wie wir wollen,” which included videos of people sharing individual life stories and how they perceived their abortion, and different perspectives were illuminated.
UNIVERSITÉ DE CONSERVATION DE LA NATURE ET DE DÉVELOPPEMENT DE KASUGHO (UCNDK) chapter in the Democratic Republic of Congo organized an atelier on contraception where they talked about the history of contraception, their culture, and contraception. In the end, they did a debate between our MSFC/UCNDK and student participants on the topic of “stigmatization of men contraception could end in our society?”
HAMBURG UNIVERSITY chapter in Germany helped organize a demonstration together with some other queer feminist organizations (ProFamilia, Efras, Bündnis für sexuelle Selbstbestimmung) and had a speech at the rally about what they do and stand for.
By Felipe on December 04th, 2023. Posted under: Blog Post, Featured Article
I am a Sharon Mathew, 4th year medical student at Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine (NSU-KPCOM). As an aspiring OB/GYN, I aim to use my career to advocate for reproductive healthcare freedom through patient-centered care and community leadership. Serving as a committee member for Unmuted-MSFC since 2021 has allowed me to train in advocacy work as a student.
Championing Gynecological Research in a Post-Roe V. Wade Era
Unmuted is a national subdivision of MSFC that focuses on how the intersections of race, gender, and class affect reproductive healthcare. The research symposium was created to showcase medical students’ research on public health or gynecology. The main objective of the symposium was to create a platform where medical students could highlight their research findings and collaborate with students who might be located in states with restrictions on bodily autonomy. The aim was also to encourage further research and its more “complicated” topics by awarding presenters and creating a platform for students to feel secure and empowered regarding these more controversial topics.
Following the overturning of Roe V. Wade, I and members of our community (AFAB/women/GNC people, etc.) were incredibly disheartened. Witnessing how the monumental defeat affected myself and my future OB/GYN colleagues angered me; I strove to find a way to help empower us to continue pursuing gynecology despite the challenges we may face. This chain of events led me to create a research symposium highlighting gynecological and public health research. I wanted to create an opportunity for the gynecological research of medical students to be celebrated and protected. Creating this safe space for students to showcase their abortion research, helps empower them as future physicians to continue pursuing research in the field and to use their voices to support evidence-based medicine and the rights of their patients.
We were very lucky to have several outstanding presentations!
Timing of Pregnancy Confirmation- 1st place winner; Martinique Ogle
This research surveyed patients at a free-standing abortion clinic in Philadelphia about the gestational age (GA) when they suspected being pregnant vs the GA at which their pregnancy was confirmed. The research concluded that the average GA of pregnancy suspicion was ~4.95 weeks, and most patients (~66.7%) were accurate about their approximate gestational age. This data indicates that patients are able to determine when they are pregnant with relative accuracy, although this is not a perfect method and does not apply to every patient. Even patients can determine that they are pregnant, cannot do so until about 5 weeks GA. This is significant as several restrictions across the nation have been lowered to 6 weeks GA (more colloquially called “heartbeat bills”). It is clear to see how these restrictions directly clash with the timing and lived reality of patients who may not be able to seek medical care before the 6 week mark due to numerous outside factors such as ability to take time off work, child care, transportation, familial support etc. As clinicians, we must use evidence-based research such as this to highlight how these restrictions make it impossible for patients to seek the healthcare they need.
The Effects of Recent Women’s Reproductive Health Legislation Changes on Access to Isotretinoin- Faige Jeidel
This research focuses on how restrictive abortion bans affect AFAB/women who take teratogenic medications such as Accutane. Isotretinoin, more commonly known as Accutane, itself has many regulations and monitoring protocols required for AFAB patients who are of child-bearing age. The aim of this research was to assess how the overturning of Roe V. Wade impacted the use of this medication for both patients and physicians. What was found was that physicians have become increasingly more reluctant to prescribe these medications to their AFAB patients due to abortion restrictions and any potential complications that can arise. The significance of this research lies in the fact that abortion restrictions do not only impact the reproductive healthcare of the affected patients. These restrictions impact the patient’s health across every organ system and advocacy on the part of the physician is required in order to protect the patient’s best interest and autonomy.
Medical Students’ Perspectives on Dobbs v Jackson Women’s Health Organization- Uma Reddy
This research aimed to delineate the shift in perspective of medical students in regards to the overturning of Roe V. Wade. Medical students were surveyed on their geographical region and specialty of choice and how that may have changed due to the overturning. Following the Dobb’s decision, there was a reported 6% decrease in students who reported their specialty to be “Undecided, related to reproductive healthcare.” The impact of this decision not only affects patients seeking care, but also affects the student physicians as they train.
Although not from this paper, research has shown that young doctors are also much less likely to settle in states with restrictive abortion bans, regardless of their specialty. As the crisis of the physician shortage continues to grow, more people will find themselves living in areas without sufficient access to not only gynecological care, but care across other specialties as well.
Empowering Future Advocates
Medical students are enthusiastic leaders who unfortunately cannot stand on their own yet due to the dynamics of being a medical student. Although they are incredibly well informed, the fear of lack of support or retribution from our organizational institutions hinders us from pursuing advocacy despite our desire to do so. In creating events/organizations surrounding abortion care/education, we are able to empower future physicians as students who will feel supported in fighting for evidence-based medicine and for what they believe is right.
As medical students, we are often unintentionally ignored/undermined in clinical settings due to our role. Despite our constant hard work, it is very rare that we are congratulated or highlighted for our accolades. Creating events such as this, where students can showcase their research, be awarded nationally, and collaborate with students/researchers across the nation has proven to be an effective way in garnering engagement and promoting further advancement in these more controversial areas.
One of the aspects that I think the MSFC community should pay more attention to is the call for more research. With every research project’s conclusion, there was a resounding call for further research in these fields. As evidence-based practicing physicians, we should be answering the call for reproductive freedom through investigative research methods. The only way to combat the ambiguity of these complex matters is through neutral data collection/investigation and our dedication to our patient’s rights.
