Today one of our episodes was shared on the CREOGs over Coffee, an amazing educational podcast for OB-Gyn residents. They cover many, many topics across the subspecialty. Check out their podcast here:
We’re also sharing an abortion care curriculum featuring episodes, reading recommendations, videos, and question guides. Enjoy and happy learning!
OUTLAWED BUT LEARNING
Learn about abortion by listening to podcast episodes produced by physicians about the science and stories of abortion bans in the US. Episodes are paired with readings, videos, and a question guide.
Module 1: Learn the basics about abortion:
Goals and Objectives:
· Learn about the epidemiology of abortion in the US.
· Describe the methodology of the turnaway study and understand the impacts on patients’ lives and health when they are denied abortion access.
· Learn about the techniques for 1st trimester abortion.
· Understand relative safety of abortion compared to childbirth.
Listen to ‘Abortion School” episode.
Read about the Turnaway Study
Pick one of the papers from the Turnaway study to read from the annotated bibliography
Innovating education video: 1st trimester abortion
Deeper Dive: Read the Turnaway Study book
Question Guide:
· What surprised you about abortion numbers in the US? What types of misinformation are perpetuated about abortion dangers/safety?
· What were the main findings of the Turnaway Study? What makes this study design unique?
· Explain the steps of a first trimester abortion in lay terms. What are the main risks of the procedure? Compare the risks of abortion and pregnancy.
Module 2: Medication Abortion:
Goals and Objectives:
Understand how the two medications (mifepristone and misoprostol) work
Learn about REMS requirements
Learn about self-managed abortion
Listen to ‘Spoonful of science’ and ‘Meet the abortion pill revolution’ episodes
Deeper Dive: Read ‘Just pills: The extraordinary story of a revolution in abortion care’ by Rebecca Kelliher
Question Guide:
The pandemic helped people gain better access to telehealth opportunities. How did this impact the provision of telehealth abortion?
How do REMS requirements impact care?
Describe how mifepristone and misoprostol work? Why do you think rates of medication abortion use in the US have increased?
Module 3: Understand the impacts of bans on people’s lives and livelihoods:
Goals and Objectives:
Understand the impacts of abortion bans on access and who receives care
Connect how distance from a clinic affects who is able to obtain care
Listen to ‘Abortion on the moon’ episode
Read Caitlin Myer’s paper Measuring the Burden: The Effect of Travel Distance on Abortions and Births
Spend some time with the abortion travel dashboard
Discussion Questions:
How does distance impact access to care? At what distance cuts off most people from care (Caitlin says you might as well be traveling to the moon)?
Why are abortion numbers going up in the US after Dobbs?
How is care impacted where you live? What is your distance to the closest abortion facility?
Module 4: Outlawed and RJ:
Goals and Objectives
Learn about the principles of reproductive justice
Contrast the RJ and reproductive rights movements
Listen to episodes - ‘Abortion Hollers’ and ‘What we are talking about when we talk about abortion’
Link to Renee Bracey Sherman op-Ed in The NY Times.
Read this article by Dorothy Roberts called: Reproductive Justice, not just rights
Deeper Dive: Read Renee Bracey Sherman’s book: Liberating Abortion.Question Guide:
How do abortion bans disproportionately impact people of color?
Explain the tenets of reproductive justice? Explain why it’s more than just abortion access?
Compare the RJ movement to the reproductive rights movement?
Module 5: Law and abortion:
Goals and Objectives
Understand how the law has impacted access to abortion in the US
Learn about the landmark cases impacting access to care
Listen to ‘Roe v Everyone’ and ‘After Dobbs: A conversation with Carole Joffe and Davide Cohen’
Spend some time with Guttmacher’s interactive policy map to see how laws vary based on geography.
Deeper Dive: Read After Dobbs by David Cohen and Carole Joffe.
Question Guide:
How did Dobbs overturn Roe v. Wade?
What other legal cases have impacted care provision and TRAP laws?
What are some upcoming legal cases that have the potential to impact care?
How do shield laws protect Telehealth providers?
Module 6: Bioethics and Abortion:
Goals and Objectives:
· Learn more about the ethical principles that relate to the provision of abortion care
· Understand the ethics of fetal personhood laws
Listen to episode: ‘Are women people?’
Katie Watson Article: Dark Alley Ethics in NEJM
Deeper Dive: Read Katie’s book Scarlet A: The ethics, law, and politics of ordinary abortion
Question guide:
Abortion after birth is a common myth that is perpetuated about later abortion care. How does Katie address this sticky question in her discussion?
Abortion providers in ban states are sometimes fearful of providing care unless maternal health risks are clear. How does the article ‘Dark Alley ethics’ give us ways to continue to provide care in the gray areas?
How do abortion bans impact other parts of care (including IVF)?
Discuss how fetal personhood laws impact reproductive health care and care outside of OB-Gyn.
Module 7: Pregnancy Criminalization:
Goals and Objectives:
· Learn about disparities in pregnancy-related criminalization in the US
· Understand the connection between providers reporting patients and pregnancy related arrests.
· Describe the ethical principles at play when patients are reported to the police.
Listen to ‘The Pregnancy Police State’
Read ACOG Committee Statement Self-Managed Abortion
Read NEJM article: ‘Supporting, not reporting – Emergency department ethics in a post-Roe era’
Read SFP Clinical Guidance around Self-Managed Abortion
Deeper Dive: Watch Pregnancy Justice Webinar: ‘Policing Pregnancy: Pregnancy Criminalization in first 2 years post-Dobbs’.
Question guide:
1. A patient presents to the clinic and reports using medications acquired online to end her pregnancy. She wants to make sure that all the tissue has passed. Based on her LMP you are worried that she might have been past the gestational age for your state’s abortion ban. How might you document your interaction with the patient? Are you required to report?
2. What are areas where physicians are mandatory reporters? How is abortion care different? How does HIPAA protect patient information?
3. Describe the disparities in which patients are criminalized for pregnancy-related crimes? Who is turning patients in to authorities?
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