Navigating the complexities of out-of-state abortion training in the United States Post-Dobbs

Abstract

BACKGROUND

In the United States, the Dobbs v. Jackson Women's Health Organization (Dobbs) decision has implications not just for patient care, but for abortion training. Consequently, training programs in states with abortion bans are developing out-of-state training rotations by partnering with programs in abortion-accessible states. It is unclear what barriers exist for trainees, sending and receiving site faculty as they develop and manage out-of-state training rotations.

OBJECTIVE

This study aims to understand the perspectives of trainees and faculty as they navigate the post-Dobbs landscape and develop out-of-state training relationships.

STUDY DESIGN

This qualitative study interviewed trainees, faculty from states with abortion bans considering sending trainees for abortion training ("Sending Sites") and faculty from states supportive of abortion that are receiving trainees (“Receiving Sites”). Interviews were conducted over Zoom, transcribed, and interview transcripts were analyzed utilizing Nvivo software for thematic qualitative analysis.

RESULTS

We interviewed 9 trainees, 8 sending sites faculty and 5 receiving sites faculty across the country. Faculty in states with abortion bans noted many barriers to establishing an out-of-state rotation including funding and legal support. Receiving sites were worried about integrating outside trainees and making sure they got enough experience without negatively impacting their home trainees’ training. Regardless of rotation length and level of participation, all trainees reported positive experiences with out-of-state training.

CONCLUSION

Despite barriers to developing out-of-state training rotations, trainees value the opportunity to obtain abortion training. Efforts should be made to improve facilitation of out-of-state training opportunities in the post-Dobbs medical landscape.