As some states pass abortion bans following the U.S. Supreme Court’s decision to overturn Roe v. Wade, Stanford University Medicine is increasing access to a complex abortion care and family planning curriculum for medical students and residents.

The complex family planning training program aims to expand training in an area that already lacked adequate available services, said Dr. Erica Cahill, associate director of the Stanford University medicine program for the fellowship. Complex family planning includes birth control options; unwanted and abnormal pregnancies; contraception for women with complex medical conditions; difficult insertion and removal of IUD/implant; and abortion care.

“At all levels, we’re trying to increase our ability to have more learners from restrictive states,” Cahill said.

Depending on the year, up to 12 students train in a four-week rotation. Stanford medical students get priority and visiting students are admitted if there is no Stanford student interested in an opening, she said. The program attracts a lot of out-of-state students, but it has for a long time, Cahill said.

Government restrictions on abortion aren’t the only reasons students attend, she said.

“We’ve had students come in even from non-restrictive states that just have a program run by a religious hospital, or something where they’re not able to get abortion education…but I would say more commonly, that comes from restrictive states,” she says. “We’ve had more and more, over the last year, more and more people reaching out to us from programs in Texas, that’s for sure.”

Not having enough medical personnel trained in abortion and complex family planning is “a huge threat to pregnant women’s health and women’s health, and has been for a long time,” Cahill said.

“The scope of abortion care training was already very limited and restricted, so I would say we are continuing to expand,” she said. “Even though it looks like a huge new influx, it has been a huge problem in the field of obstetrics and gynecology and other fields as well. These are essential skills that are common and this is not not uncommon.Caring for people with complications in early pregnancy is something that happens every day in OB-GYN, and so not having the skills or the tools or the knowledge is terrible for a provider and it’s not not because people don’t want it mostly I’m not able to access this training,” she said.

The decision to have a baby — or not — is complicated and weighs on many factors in life, she said. There are also many complications beyond a person’s control that lead to the need for an abortion during pregnancy, she said.

“There are a lot of challenges in interpreting these rules as to whether or not we can provide standard treatment of care for miscarriage; standard treatment of care for ectopic pregnancy; standard treatment of care for molar pregnancy – like all these things that are maybe on a first trimester pregnancy care spectrum – that are all linked in medicine. You can’t separate them from each other,” he said. she stated.

Cahill also sees a setback to the Supreme Court’s decision on abortion that offers a glimmer of hope.

“What we’re seeing is this huge engagement from other specialties,” she said. “At Stanford, our colleagues in emergency medicine, our colleagues in family medicine, our pediatricians, our anesthesiologists are all thinking more about how they can help support abortion care and pregnancy care in different ways. .

“And I think we’re seeing that across the country, because people won’t be able to get standard care for complications of miscarriage, abortion, or pregnancy from their OB-GYN because of these terrible restrictions. They’re going to get that care in the emergency room, they’ll have to go to the emergency room, so our colleagues in emergency medicine are adapting quickly and trying to learn quickly how to adapt so that they can continue to keep people safe when they see complications that would normally be avoided by the routine standard of OB-GYN care.”

Cahill said it’s the kind of interesting place medicine is heading because of abortion regulations.

“We have emergency medicine residents contacting us; we have family medicine residents contacting us and general surgeons,” she said. “So I think that’s a bit of hope in this time of darkness; that there’s so many people who – it hasn’t been in their field because it may have been in the field of the Obstetrics, Gynecology and Reproductive Health – and now everyone is thinking, ‘How could I, in my role, help too? How could I be best prepared? How can I have the most knowledge and skills to provide the best patient care?” And I think we’re seeing that across the country. So that’s really exciting.”

Cahill said it’s important to note that abortion is safe and legal in California, and there are also many places where people have access to non-surgical medical abortion by pill.

“We were really lucky that the American Board of American College of OB-GYN and the ACGME (Accreditation Council for Graduate Medical Education), which is our group that develops these kinds of training standards, were really supportive. and nimble to adapt to whatever they can to support ongoing training to provide the best care,” she said.