The growing shortage of physicians performing abortions in the United States prompted a group of doctors and public-health experts Tuesday to call for an overhaul of doctor-training programs and a nationwide push for physicians to include abortion in their practices.
The group, organized by the American College of Obstetricians and Gynecologists and the National Abortion Federation, is making the first concerted effort to bring embattled abortion services and providers into the mainstream of medical training and practice.
"I think many of us, particularly in academia, are not aware of the scope of the problem and its consequences down the road for women," said Dr. David Grimes, a USC professor of obstetrics and gynecology who served as chairman of the group.
While most obstetrician-gynecologists say they support the use of abortion in certain situations, only about one-third perform abortions, polls show. Two-thirds of those do fewer than five a month; only 2% are believed to do more than 25 a month.
Since the mid-1970s, studies indicate there has been a steady decline in the number of physician-training programs offering abortion training. Similarly, there has been a drop in the number of hospitals offering first-trimester abortions.
As a result, the vast majority of the estimated 1.6 million abortions performed each year are done by relatively few physicians, usually in outpatient clinics. Four out of every five counties in the United States have no abortion provider at all, one study found.
"This is a community problem," said Ruth Roemer, a past president of the American Public Health Assn. and an adjunct professor of health law at UCLA. "If we're concerned about the health of women . . . we had better look at the health personnel resources for solving it."
The recommendations were disclosed in Chicago at the annual meeting of the National Abortion Federation, a Washington-based group representing abortion providers as well as individuals and organizations active in abortion rights and reproductive health. The proposal emerged from a symposium held late last year by the abortion federation and the doctors' group that was funded by the Ford Foundation and the George Gund Foundation.
The symposium's 26 participants included prominent professors of obstetrics and gynecology, researchers in reproductive health, public health experts and other specialists in the fields of health care and women's health.
