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“It Allows You to Challenge Your Beliefs”: Examining Medical Students’ Reactions to First Trimester Abortion

      Abstract

      Background

      Abortion is a common medical procedure, integral to women's health, and a core educational topic for medical students. Medical schools often rely on brief clinical exposure to abortion during the obstetrics and gynecology clerkship to provide this learning. Abortion is also a highly politicized and stigmatized procedure. Given this potential conflict, we examine medical student reactions to their observation of abortion care.

      Study Design

      Medical students in their second and third years at an academic medical center who observed in a first trimester abortion clinic completed open-ended, written questionnaires. Questionnaires explored student reactions to participating in the abortion clinic. We used applied thematic analysis to code and qualitatively analyze 78 questionnaires.

      Results

      We identified the following five themes: (1) students found participating in abortion care deeply worthwhile, (2) some were challenged by their reactions, particularly when reactions conflicted with prior beliefs, (3) some demonstrated empathy for the patient, but (4) some expressed judgment of both the patient and the abortion provider, and (5) students reported a desire for curricular change around abortion education, requesting more time for reflection, and some felt that their abortion observation might better prepare them to serve future patients.

      Conclusions

      Observing in an abortion clinic is a valued experience that allows students to challenge their existing beliefs and may build empathy. Educators should provide students with adequate time for preparation and reflection around this topic and address areas of misunderstanding that may perpetuate abortion stigma. These findings may inform medical student curriculum changes around abortion.
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      Biography

      Katherine Rivlin, MD, MS, is an Assistant Professor of Obstetrics and Gynecology at the Ohio State University Wexner Medical Center. Her research and clinical interests include reproductive health care, family planning, and medical education.

      Biography

      Erica Sedlander, DrPH, MPH, is a Research Scientist at the Milken Institute School of Public Health at George Washington University. Her work strives to improve women's health by using mixed methods to examine factors that affect behavior change.

      Biography

      Ana Cepin, MD, is an Assistant Professor of Obstetrics & Gynecology at Columbia University Irving Medical Center. She oversees resident and medical student rotations in family planning. She also serves as the medical director of the NY-Presbyterian Family Planning Practice.