Abortion

Restrictions on abortion and lack of broad access to abortion services are unique for a legal medical procedure. The controversy over abortion and associated violence and harassment of patients and providers have resulted in a limited number of active abortion providers, especially in rural areas of the United States. In 1996 out of all U.S. counties only 14 percent had practicing providers, and the number appeared to be declining. Nearly one-third (32%) of women aged fifteen to forty-four were living in counties without local abortion services.

The majority of medical residents specializing in obstetrics and gynecology are not required to perform first-trimester induced abortions as part of their training. In 1995 only 12 percent of obstetrics and gynecology residency programs routinely offered abortion training, though nearly half (46%) reported provision of routine training in 1998 subsequent to new guidelines from the Accreditation Council for Graduate Medical Education. Family practice residents have limited experience with either contraception or abortion. The approval in 2000 by the Food and Drug Administration of pharmaceutical agents to induce abortion medically rather than surgically could increase the number of providers. At the time of approval, however, both women and doctors indicated the importance of maintaining a range of abortion choices, since preferences are influenced by many practical, physiological, and psychological factors.