Gyuras Is a Research Associate, College of Public Health, the Ohio State University, Ohio, USA.
Division of Social Sciences, Alfred University, Alfred, New York, USA.
Med Educ Online. 2023 Dec;28(1):2145104. doi: 10.1080/10872981.2022.2145104.
The authors explore how abortion regulations in Ohio, an abortion-restrictive state in the USA, impact obstetrician-gynecologists' (OB/GYNs) training in reproductive healthcare and describe what OB/GYNs believe to be the broader impact of Ohio's regulations on skill-building, skills maintenance, and professional retention of reproductive healthcare providers in the state. Authors discuss how their findings foreshadow abortion training limitations in Ohio and other abortion-restrictive states now that abortion regulations have returned to the states.
The authors conducted four semi-structured focus groups and five in-depth interviews between April 2019 and March 2020. Participants included OB/GYNs practicing obstetrics and gynecology in Ohio between 2010 and 2020. Thematic analysis was conducted using Atlas.ti.
Twenty attending physicians and 15 fellows and residents participated in the study. Participants discussed the impact of Ohio's written transfer agreement, gestational-limit, and abortion method and facility bans on training and skill-building opportunities. Participants felt that Ohio's strict abortion regulations 1) limit opportunities to observe and perform abortion procedures during training; 2) require learning the ever-changing legality of abortion provision; 3) limit the number of abortions OB/GYNs can provide, leading to the atrophy of their skills over time; and 4) may prevent prospective medical students and residents from choosing to study in Ohio and may lead to physician attrition from the state.
Prior to the reversal of federal protections for abortion in 2022, OB/GYNs in Ohio and other abortion-hostile states experienced barriers to training in abortion care. In returning abortion regulation to the states, access to training is likely to be increasingly restricted. This research demonstrates how abortion-restrictions hamper physicians' skills needed to care for patients, particularly in emergent situations. This puts patients at risk and places physicians in precarious ethical positions. Expanding protections and reducing restrictions on abortion will ensure OB/GYNs and trainees have the skills necessary to care for patients presenting for reproductive healthcare.
作者探讨了美国俄亥俄州的堕胎法规（美国一个限制堕胎的州）如何影响妇产科医生（OB/GYN）在生殖保健方面的培训，并描述了 OB/GYN 认为俄亥俄州法规对该州生殖保健提供者的技能建设、技能维持和职业保留更广泛的影响。作者讨论了他们的发现如何预示着现在堕胎法规已经回到各州，俄亥俄州和其他限制堕胎的州的堕胎培训限制。
作者于 2019 年 4 月至 2020 年 3 月期间进行了四次半结构化焦点小组和五次深入访谈。参与者包括 2010 年至 2020 年期间在俄亥俄州从事妇产科工作的 OB/GYN。使用 Atlas.ti 进行主题分析。
20 名主治医生和 15 名研究员和住院医师参加了这项研究。参与者讨论了俄亥俄州书面转让协议、妊娠限制以及堕胎方法和设施禁令对培训和技能建设机会的影响。参与者认为，俄亥俄州严格的堕胎法规 1）限制了在培训期间观察和进行堕胎手术的机会；2）要求了解堕胎提供的不断变化的合法性；3）限制了 OB/GYN 可以提供的堕胎数量，随着时间的推移导致他们的技能萎缩；4）可能阻止未来的医学生和住院医师选择在俄亥俄州学习，并可能导致医生从该州流失。
在 2022 年联邦对堕胎的保护被推翻之前，俄亥俄州和其他对堕胎持敌对态度的州的妇产科医生在堕胎护理培训方面面临障碍。随着堕胎法规的回归，培训的机会可能会越来越受到限制。这项研究表明，堕胎限制如何阻碍医生提供患者所需的技能，尤其是在紧急情况下。这使患者处于危险之中，并使医生处于不稳定的伦理地位。扩大对堕胎的保护并减少对堕胎的限制将确保 OB/GYN 和受训者拥有照顾寻求生殖保健患者所需的技能。
