Vachon Danielle, Hildebrand Marisa C, Averbach Sarah, Turk Jema, Steinauer Jody, Mody Sheila K
Division of Complex Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, CA, United States.
Division of Complex Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, CA, United States.
Contraception. 2025 Apr;144:110808. doi: 10.1016/j.contraception.2024.110808. Epub 2024 Dec 30.
The Ryan Program collaborates with obstetrics and gynecology (OBGYN) residency programs in the United States (U.S.) to ensure that abortion and contraception care are incorporated into resident curriculum as required. We sought to understand the impact of the Dobbs v. Jackson decision on OBGYN residency abortion training programs from the perspective of Ryan directors and to understand barriers and facilitators to maintaining abortion training in OBGYN residency programs post-Dobbs.
We conducted qualitative, semi-structured in-depth interviews with Ryan program directors at U.S. academic medical centers. We coded the data iteratively and analyzed the data thematically.
From January to April 2023, we conducted 24 interviews, representing 21% (n = 23) of eligible U.S. Ryan directors. Participants were evenly distributed across four geographic regions of the U.S.; 50% (n = 12) of participants were from programs in abortion-restrictive settings. Two themes emerged: (1) Ryan directors experienced stressors related to the administration of Ryan programs post-Dobbs, including perceived difficulty satisfying requirements for abortion training in restrictive states, burnout, and increased financial needs to support training partnerships. (2) Directors face challenges in recruitment and clinical care post-Dobbs.
Increased state restrictions on abortion place logistical and financial burdens on OBGYN abortion training programs. Dobbs impacted training experiences across the U.S. and made it more difficult for many OBGYN residencies to provide abortion training.
The research findings will inform strategies for improving the delivery of abortion education post-Dobbs. We anticipate findings will enhance procedures to establish and maintain partnerships post-Dobbs and identify areas where philanthropy and advocacy can be effectively utilized.
瑞安项目与美国的妇产科住院医师培训项目合作，以确保堕胎和避孕护理按要求纳入住院医师课程。我们试图从瑞安项目负责人的角度了解多布斯诉杰克逊案的裁决对妇产科住院医师堕胎培训项目的影响，并了解在多布斯案之后维持妇产科住院医师培训项目中堕胎培训的障碍和促进因素。
我们在美国学术医疗中心对瑞安项目负责人进行了定性的、半结构化的深入访谈。我们对数据进行了迭代编码，并进行了主题分析。
2023年1月至4月，我们进行了24次访谈，占美国合格瑞安项目负责人的21%（n = 23）。参与者均匀分布在美国的四个地理区域；50%（n = 12）的参与者来自堕胎限制环境中的项目。出现了两个主题：（1）多布斯案之后，瑞安项目负责人在管理瑞安项目方面面临压力源，包括在限制堕胎的州满足堕胎培训要求的难度增加、倦怠以及支持培训伙伴关系所需的资金增加。（2）多布斯案之后，负责人在招聘和临床护理方面面临挑战。
各州对堕胎的限制增加给妇产科堕胎培训项目带来了后勤和经济负担。多布斯案影响了美国各地的培训经历，使许多妇产科住院医师项目更难提供堕胎培训。
研究结果将为改善多布斯案之后堕胎教育的提供策略提供信息。我们预计研究结果将加强多布斯案之后建立和维持伙伴关系的程序，并确定慈善事业和宣传可以有效利用的领域。
