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A Texas Showdown: The State vs. Your Care


Yesterday, lawyers for the ACLU and the Center for Reproductive Rights embarked on oral arguments before the Supreme Court for what is being called the most important abortion rights case in decades. In 2013, the Texas House of Representatives passed House Bill 2 which, among many other new restrictive regulations, requires abortion providers to hold admitting privileges at nearby hospitals and imposes ambulatory surgical center requirements for all clinics where abortions are performed. Now, in Whole Woman’s Health v. Hellerstedt the Supreme Court will decide whether HB2 places an undue burden on a woman’s right to terminate a pregnancy. For the women of Texas, the impact of HB2 is clear: women will travel farther to find a clinic and incur higher costs, longer wait periods, and more invasive procedures with no increase in the safety of the procedure. For the record, an abortion performed by a skilled physician has a 0.05%-0.2% risk of major complications.

What remains less clear, and certainly less talked about, is the impact HB2 will have on the medical students in Texas. Training and education in abortion care is already difficult to obtain for medical students, particularly in the Lone Star State.

Across the US we know that two-thirds of medical schools spend less than 30 minutes of class time on all aspects of abortion throughout the four year medical education. This means that for future doctors who want (and need) to be prepared to meet the reproductive needs of their patients they must seek training outside of their medical program. Most often this comes in the form of receiving training at a local clinic. What will this look like in Texas if HB2 is allowed to go into effect? It’s impossible to know with any certainty, but if current numbers are any indication, training in Texas could grind to a virtual halt.

Each year Texas graduates roughly 1,700 medical students, and 58% of those graduates remain in Texas for residency. With only 10 clinics providing abortions, and each abortion provider needing to retain admitting privileges with a nearby hospital, even if only a fraction of medical students or residents seek out training, the feasibility of training to competence becomes nearly impossible. And without opportunities for future physicians to learn, Texas could easily become a state without any abortion care in a few short years.

A Supreme Court decision which does not explicitly strike down HB2 not only harms today’s women, but places future generations of women at risk as well.

HB2, previously upheld by the 5th Circuit Court of Appeals, will go into effect in the event of a 5-3 decision in favor of Hellerstedt or in the event of a 4-4 decision with the current even number of justices. For the sake of women everywhere and the medical students, residents, and physicians dedicated to providing abortion care, we hope medical knowledge and not political grandstanding prevail in the coming months. However, regardless of the outcome, Medical Students for Choice will remain steadfast in our mission to create tomorrow’s abortion providers and pro-choice physicians. Today, more than ever, it is important for us all to remember that without providers, there is no choice.

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"This is such a unique opportunity to gain clinical exposure in a classically underrepresented area of medical school curricula, and I am certain that I would not have received such a robust abortion education in medical school without the RHE."

Reproductive Health Externship Participant

"I left the ATI with a strengthened resolve to get abortion training during residency in order to provide them as a PCP, and now am looking ONLY at residency programs that will allow me to get training. Moreover, talking with residents and providers left me with concrete knowledge of how to find training experiences."

Abortion Training Institute Participant