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Abortion, Contraception, and Medical Education
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As I write this foreword, I am sitting on an airplane from DC to LA, preparing to give a presentation about our team’s research on the workforce providing abortion and contraception in the United States. While I am thrilled to be sharing our work, I am once again reminded of just how sensitive this topic is. If I open a presentation with the word “abortion” in big letters, will my seatmates raise their eyebrows, or maybe worse? So many of the topics that are near and dear to our hearts can be thorny and difficult, while being critical issues that we must face head on.
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My name is Julia Strasser, DrPH, MPH and I am a researcher and advocate focused on access to abortion, contraception, and the full range of reproductive health services. At George Washington University (GW), I wear two hats: I am an Assistant Research Professor of Health Policy and Management here at the Mullan Institute, and I am the Director of the Jacobs Institute of Women’s Health.
The mission of the Jacobs Institute of Women’s Health is to foster dialogue, facilitate awareness, and create interdisciplinary partnerships on issues that affect women’s health. We have over 50 affiliated faculty members across GW, including from the School of Medicine, School of Nursing, Law School, International Affairs, and others. We engage in federal advocacy efforts and enable connections across research and policy. One year ago, I began my tenure as the Director of the Jacobs Institute. During this time, I have learned so much but also recognize that I have so much still to learn. I continue to be inspired by the work that Social Mission Alliance does as an advocate and a convener, and I am truly honored to be asked to be this month’s guest editor.
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Research Spotlight: Reproductive Health Workforce
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In early 2020, the Mullan Institute undertook the first-ever national-level study of the workforce providing abortion and contraception care in the US. Underlying our work are the principles that:
- Abortion is healthcare.
- Access to all reproductive health services is a critical health equity concern.
- The workforce providing this care can enable– or limit – access.
Over the past 3+ years, we have produced a number of manuscripts, research briefs, and Health Affairs Forefront blogs that explore various aspects of this workforce, such as service & provider changes during Covid-19, translation of policy into practice for direct pharmacist prescribing, and provision of services to Medicaid beneficiaries.
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Our interactive workforce tracker shows the distribution of the workforce providing prescription contraception relative to the population of women of reproductive age. Interested researchers, policy-makers, and students can request a deidentified version of the data.
We are also pleased that our work has been featured in several media outlets and at conferences. You can find us at the upcoming APHA Annual Meeting in Atlanta, giving presentations on November 13 and November 15.
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Our most recent manuscript, published in JAMA Network Open, studied the relationship between residency training for family medicine physicians and provision of reproductive health services to Medicaid beneficiaries. One of our central findings was that training in a Reproductive Health Education in Family Medicine (RHEDI) residency program was associated with significantly higher odds of providing prescription contraception, long-acting contraception, and D&C, a service commonly used for abortion care, management of pregnancy loss, and other conditions.
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Program Spotlight: RHEDI Program
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The mission of the RHEDI program is to integrate high quality, patient-centered abortion and contraception training and services into U.S. family medicine residencies using the Reproductive Justice framework, and to mainstream abortion provision within family medicine. Our team’s research is by no means the first to examine the impact of the RHEDI training experience – a robust body of literature includes:
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Residency Training in the Post-Dobbs Landscape
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While there have been great strides in residency training for family planning and reproductive health services, the Dobbs vs Jackson Women’s Health Organization Supreme Court decision in June 2022 was a huge setback for both access to care and access to medical education. A report from the AAMC Research and Action Institute found larger decreases in the number of 2023 medical school graduates choosing residency programs in states with abortion restrictions than in states without restrictions. Another recent study found that the Dobbs decision affected post-residency practice plans among graduating OBGYN residents.
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Though the Dobbs decision has significantly shifted the landscape for abortion care, leaders in the field are working to provide access to care and education. Recently, the Patient-Centered Abortion Care Education (PACE) curriculum become available, free of charge, to trainees in every state, including ones with abortion bans or restrictions.
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2022 Macy Award Winner Dr. Uda Landy
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In 2022, Dr. Uta Landy received Social Mission Alliance’s Josiah Macy Jr. Foundation Award for Lifetime Achievement. Twenty years ago, Dr. Landy observed that medical training in family planning was inadequate and initiated a Fellowship in Family Planning, which has since grown to train more than 7,000 residents and 400 subspecialists in family planning.
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Nominations for the 2024 Macy Awards for Excellence in Social Mission are open now!
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Submit your recommendation to award a changemaker in health education to be recognized at the 2024 Social Mission Alliance conference in Durham, NC.
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More from Social Mission Alliance
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Recent Publications
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Abstract submissions are open! Submit your work now until December 16.
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Join us April 8-10, 2024 for a chance connect and learn from top health equity experts, share and discuss ground-breaking solutions advancing health equity, and engage in networking opportunities.
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