New book and study on obstacles to providing abortion

Dr. Lori Freedman, ANSIRH Medical SociologistI recently published a new book, Willing and Unable: Doctors’ Constraints in Abortion Care, which explores the social world where abortion politics and mainstream medicine collide. I interviewed physicians of obstetrics and gynecology around the United States to find out why physicians rarely integrate abortion into their medical practice. While abortion stigma, violence, and political contention provide some explanation, my findings demonstrate that willing physicians are further encumbered by a variety of barriers within their practice environments.

The 40 in-depth interviews present a challenge to a commonly held assumption that physicians decide whether or not to provide abortion based on personal ideology. Instead, the majority of physicians I interviewed described formal and informal policies imposed by their private group practices, employers and hospitals, as well as the strain that providing abortions might put on relationships with superiors and coworkers. Restrictions on abortion provision sometimes were made explicit when new physicians interviewed for a job, but sometimes became apparent only after they had joined a practice or institution.

cover of Willing and Unable: Doctors’ Constraints in Abortion Care<The book builds on a study on the same topic that I co-authored with Uta Landy, Philip Darney and Jody Steinauer, “Obstacles to the Integration of Abortion Into Obstetrics and Gynecology Practice,” published in Guttmacher’s September 2010 issue of Perspectives on Sexual and Reproductive Health. The study was also featured in a June 1, 2010 article by Carol King that ran in Ms. blog, in a June 13 interview with Amanda Marcotte of RHrealitycheck.org (the interview runs from minutes 7-19), and in a piece by Emily Bazelon on Slate, following up on her article “The New Abortion Providers,” which was the lead article earlier in July in the New York Times Sunday Magazine.

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