The rise of anti-abortion-rights OB-GYNs

In April, Arizona Gov. Jan Brewer signed a bill that makes it illegal for state colleges to fund medical residency programs that offer abortion training with state or federal money, including money paid by students as part of tuition or fees.

But what began as a rare seed in a nationwide garden of abortion-defunding measures has blossomed into a national movement to reduce the number of medical professionals who are trained to provide abortions. Last week, the U.S. House of Representatives passed a measure that would ban health centers from using federal funds for comprehensive medical training that includes instruction of abortion procedures.

In the past two decades, there has been a recognizable dearth in the number of obstetrician-gynecologists who perform abortions and in the number of hospitals where they are provided. In a July 2010 New York Times Magazine story, Emily Bazelon wrote of the recent rise in abortions performed at clinics versus in hospitals -– as more and more physicians began dropping out of the practice due to increased stigma accompanied by a slew of abortionist murders that began with the killing of Dr. David Gunn in March 1993. According to Bazelon, in 1973, hospitals made up 80 percent of the country’s abortion facilities, but by 1981, the procedure began shifting to clinics. In 1996, 90 percent of the abortions in the U.S. were performed at clinics.

For a more recent assessment of providers, according to the Guttmacher Institute, there were 1,793 abortion providers in 2008, and 87 percent of all U.S. counties (where 35 percent of women in America live) lacked an abortion provider. Guttmacher says that, currently, 95 percent of providers offer abortion at eight weeks from the last menstrual period; 64 percent offer some second-trimester abortion services; 23 percent offer abortion after 20 weeks; 11 percent of all abortion providers offer abortions at 24 weeks.

To address these shortages, Dr. Jody Steinauer — now a gynecologist and OB-GYN professor at the University of California at San Francisco — in the early 1990s founded Medical Students of Choice (MSC), a nonprofit organization based in Philadelphia with a current network of more than 10,000 medical students and residents at more than 130 medical schools throughout the U.S. and Canada. MSC’s main functions are to ensure that medical schools and residency programs include abortion training as part of their reproductive health services curricula.

With the help of heavy financial support from the Susan Thompson Buffett Foundation (Warren Buffett’s association with the group was unknown for many years), MSC has been successful in its mission, and most residency programs offer abortion observation and training, at least as optional courses or electives.

Voice for a budding movement

Then last year came the birth of another national medical-student network, this one based in Arlington, Va., with a focus on creating a culture among medical students that questions the validity of abortion as good medicine.

Medical Students for Life of America (MSFLA) was founded in April 2010 as an arm of a larger anti-abortion-rights group founded in 1987 as American Collegians for Life and renamed Students for Life of America (SFLA) in 2006.

For the past five years, Students for Life of America, led by Executive Director Kristan Hawkins, has toured college campuses across the country helping to start up student groups that advocate against abortion. Politicians with anti-abortion-rights agendas such as Reps. Chris Smith (R-N.J.), who authored the “No Taxpayer Funding for Abortion” bill, and Mike Pence (R-Ind.), who authored the failed amendment to defund Planned Parenthood at the federal level, have spoken at SFLA conferences and webcasts. Their board president is Leonard Leo, who is also the executive vice president of The Federalist Society for Law and Public Policy Studies, an organization of conservative lawyers. SFLA spokesperson Mary Powers said the organization’s network comprises more than 600 student groups in nearly every state: Fifty groups started up in the fall of 2010 and 30 in the spring of 2011. Powers said that individual student groups usually receive funding from their universities and private donors, which she would not reveal to TAI.

At a Students for Life conference held in Maryland in January, Hawkins told an audience of more than 2,000 university students that abortion will be abolished in their lifetime. But MSFLA national coordinator Dominque Monlezun is less blunt about Medical Students for Life’s mission, which he said is less political and more about fostering “constructive and healthy dialogue about improving patient care.”

“The majority of medical schools [post-]Roe v. Wade hinder fair and equal dialogue,” Monlezun told The American Independent. “More and more students [seek] fair arenas, something that medical students for life treasures. We want to be here for the good of fellow men.”

On April 30, Medical Students for Life hosted its first-ever national web conference, sponsored by the Family Research Council, which included presentations from various physicians and researchers who cited studies documenting evidence of long-term psychological and physiological damage purportedly caused by abortion and/or hormonal contraception.

Monlezun said that 32 medical-student groups have formed on as many college campuses. A few weeks ago, he led a national bioethics symposium, touring more than 23 medical schools in 15 states in 14 days. However, Monlezun is phasing out of his paid role as national director of MSFLA as he gets further into his medical training. He is currently in medical school pursuing a dual degree in an M.D. program and a master’s of public health/global health systems management, but he did not reveal his school to TAI for fear of retribution from his professors or future employers.

‘Value of life is increasingly lost on the medical student’

In most medical schools, Monlezun said the issue of abortion and other “bioethics” matters does not even come up in lectures until the third year, and even then, these issues are skirted, “to the detriment of patients.”

The evidence Monlezun has of discrimination against students with anti-abortion-rights views is anecdotal, gathered from visiting schools and talking to students. On the recent bioethics tour, Monlezun said he spoke with a student who said she felt “intellectually raped” every day of her OB-GYN rotation because she felt there would be repercussions for refusing to partake in abortion training. Another student told Monlezun that he couldn’t get into a residency program because an attending physician had written a letter in his file referring to him as a “radical pro-lifer” and a “future clinic bomber” for suggesting adoption in the event of a “crisis pregnancy.”

Jonathan D. Scrafford, a third-year medical student at the University of Minnesota Medical School and the president of Medical Students for Human Life (MSHL), one of the groups in the MSFLA network, said he joined the four-year-old group two years ago because he “thought it was important for the future of health care.”

“I think the value of life is increasingly lost on the medical student,” said Scrafford, who thinks he wants to go into pediatrics or obstetrics-gynecology. “So many future patients have respect for human life at all stages, but we think many doctors don’t respect life at all stages.”

Scrafford told TAI he does not think doctors and professors operate from a point of malice by promoting abortion; instead, he thinks the older and younger generations of medical professionals count life at different starting points. MSHL counts life between conception and birth, Scrafford said.

Dr. David A. Grimes, a longtime OB-GYN and epidemiologist, has another theory behind the anti-abortion-rights views of this generation’s medical students: amnesia.

“In the decade I was born -– the 1940s -– 1,000 women died every year from illegal abortions,” Grimes said. “Almost overnight we were able to eliminate that terrible scenario. … Younger Americans are less inclined to be passionate [about this]; it’s a function of age.”

Grimes, 64, is board-certified in preventative medicine in addition to obstetrics-gynecology; he was the chief of the abortion surveillance branch of the Centers for Disease Control and Prevention in Atlanta during the 1980s. He said he is a “pro-life OB-GYN,” evidenced by his decision to provide safe abortions for the past 38 years.

He said anti-abortion-rights advocates use the term “pro-life” incorrectly. “They are pro-fetal life and pro-embryonic life,” Grimes said. “They have a fixation with the fetus. … I, for one, am for women’s health.”

But Scrafford says MSHL’s purpose is to give future OB-GYNs a different perspective they might not otherwise hear, such as embryo adoption, a program wherein frozen embryos are donated. The group invites medical professionals and people who have personal experiences with complicated pregnancies to speak at public lectures.

“The medical community is very pragmatic,” Scrafford said. [They are not inclined] to promote alternatives to abortion. … We understand these topics are not yet mainstream.”

Grimes said a young medical student does not know what it is to treat a woman with a 106-degree fever and a rubber catheter hanging out of her cervix after experiencing an illegal abortion from an untrained doctor. With increased restrictions to abortions and fewer cities where a woman can obtain a legal late abortion, there are increased risks, Grimes said, especially if women have to travel long distances.

Where Grimes thinks anti-abortion-rights doctors mix ideology with their practice of medicine, Dr. John Bruchalski an OB-GYN at the Tepeyac Family Center in Fairfax, Va., believes pro-abortion-rights doctors are equally guilty of mixing politics with medicine.

Bruchalski began his career in the late 1980s, but after two years performing abortions, he experienced what he calls a “conversion.”

“I was ideologically pro-choice,” he said. “Politics are never a great place to start the foundation for your conscience.”

Bruchalski believes the destructive nature of abortions has led to the decline of abortion providers in the last 10 to 15 years. He toured with MSFLA on the recent bioethics tour, talking to future medical professionals about the realities of abortion.

“Even for pro-choice doctors, [abortions are] hard to carry out,” Bruchalski told TAI. “It’s when ideology comes face to face with practice. … We are still using old arguments from the 1960s and 1970s that a woman has a right to her own body. The fetus is becoming more human as it ages. We need to recognize this.”

Toppling the Mubarak of the movement

Vicki Saporta, president of the National Abortion Foundation, does not think anti-abortion legislation and groups like Medicals Students for Life are effectively reducing the number of abortion providers in America.

“While you have a lot new restrictions, that doesn’t necessarily translate into the number of new providers interested offering care,” Saporta said. “I see a growth of pro-choice medical students in residencies.” This growth is partly enabled by the fellowship for abortion-training that Medical Students for Choice offers to aspiring OB-GYNs, she said.

At the same time, Saporta noted that there are still minimal OB-GYN residencies that train students in late-term abortions. Additionally, she said that about half of the abortion-training classes are electives, which makes it difficult for residents to obtain training because they are often too busy with their required courses. Thus, students often have to go out of their way to obtain abortion-training.

Dr. Joseph DeCook, executive director of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), disagrees that abortion training is necessary for the future OB-GYN, who will learn standard procedures of emptying the uterus for natural abortions, such as miscarriages. In his view, it should not be a requirement in residencies to learn how to perform mid-trimester abortions, to learn how to “cut babies into pieces, and pull out the pieces.”

AAPLOG’s website offers a list of programs that are friendly to anti-abortion-rights medical students and residents.

“There’s no point putting your head in the meat grinder,” DeCook told TAI. “There’s always place for life affirming physicians.”

Monlezun conceded that there are fewer OB-GYNS who provide abortions than those that do, but still he’s on a mission to convince medical students that abortion is never in the best interest of the patient. Countering the common argument that abortions are better “safe, rare and legal,” Monlezun disputed that they are safe or rare, citing recent instances of unregulated clinics in Philadelphia and Florida.

“When you and I go into the hair salon, there is a higher standard of care,” he said.

Still early in his medical career, Monlezun views the training world as a regime where students with anti-abortion-rights views are stifled and driven into silence. He compares the movement to the youth-led revolt in Egypt, where students helped topple longtime president Hosni Mubarak. Only their Mubarak is Roe v. Wade.