Exploring How Targeted Regulations of Abortion Providers Affect Training and Practice Location [4A

Abstract

INTRODUCTION: Targeted Regulations of Abortion Providers (TRAP laws) create variable abortion accessibility by state. We explored how TRAP laws affect where physicians choose to receive family planning training and practice. METHODS: We conducted semi-structured telephone interviews with 25 physicians who provide abortion care across the United States and asked them about their experiences providing care in the recent political climate. Using an iterative qualitative coding process, we detected themes around how political climate and state laws around abortion affected personal preference in location of family planning training and practice. RESULTS: State laws surrounding abortion provision often influenced where providers chose to receive family planning training and practice. Reasons for choosing to train in liberal areas with few TRAP laws include a higher patient load and more opportunity to gain procedural skills. Some providers chose to train in restrictive areas for experience in navigating state laws that limit abortion access. When choosing location of practice, those that chose a hostile environment cited a greater need for abortion providers in restrictive areas. Those who practice in liberal areas often had personal reasons, including safety concern for themselves and their families as well as a desire to work in an environment where state laws do not force providers into practicing substandard care. CONCLUSION: Understanding how state TRAP laws affect location of training and practice of abortion providers creates an opportunity to further analyze what training, supports, and resources can be provided to encourage physicians to practice in underserved areas with restrictive abortion policies.