“They were there because they were pregnant. Which is a really apolitical thing”—Medical student discussions of politics in abortion care in the United States

Abstract

ObjectivesState abortion policies can vary widely. Geographic location and political climate could influence a medical student's abortion education experience. We compared how medical students training in one permissive and one restrictive state discussed politics in abortion care. Study designFrom 2018 to 2019, we interviewed US medical students during their Obstetrics and Gynecology rotation from two Midwestern academic centers with differing state abortion policies—one in Ohio (restrictive) and one in Illinois (permissive). In-depth interviews occurred following an abortion shadowing experience and included questions about politics in abortion care. We sorted data using flexible coding, with index codes around “politics,” followed by specific analytic coding. We compared codes by medical school using NVIVO software. ResultsWe interviewed 28 students (50% in Ohio). Students in Ohio discussed specific barriers to patient care and how politics infringed upon the quality of medical care, describing abortion as stigmatized care. Students in Illinois described abortion as high-quality medical care, delivered without the infringement of restrictive laws. Students at both schools described their medical school climates as supportive to abortion, yet in Ohio, students described exposure to more diverse abortion views than Illinois students. Ohio students also described engaging in abortion advocacy work, while Illinois students felt more politically disconnected. ConclusionsEven as clinical training opportunities decline, restrictive states may hold unique advocacy opportunities. Educators should tailor abortion curricula to address state level differences, as disparities in abortion access and student learning opportunities widen. ImplicationsStudents training in permissive states see abortion as routine health care, occurring without political interference. Students in restrictive states see abortion as hindered by politics and stigmatized, which may encourage advocacy. Educators should tailor curricula to address state level differences as disparities in abortion access and student learning opportunities widen.