"Neither Side Really Knows… What an Abortion Is Like": A Qualitative Analysis of Medical Students' Experiences With Second-Trimester Procedural Abortions.

Objectives: Medical students value abortion education; however, there has been little study regarding participation in second-trimester procedures, which are less common yet receive significant societal attention. We aimed to explore medical students' perceptions of participation in second-trimester procedural abortions to optimize this educational experience.

Study design: We conducted qualitative semi-structured interviews with third- and fourth-year medical students who voluntarily participated in second-trimester dilation and evacuation cases. We coded interviews inductively and performed thematic content analysis until thematic saturation was reached.

Participants: We interviewed 25 medical students, including 16 third-year and nine fourth-year students. Most participants were female (64%) and white (58%) and had no prior abortion care experience (80%).

Results: Four major themes emerged: 1) students felt unprepared for second-trimester procedural abortions and were unable to find adequate educational resources for preparation; 2) students experienced complex emotional reactions to the procedures, often finding the experience more challenging than expected; 3) students observed implicit expectations and biases in the learning environment; and 4) students highly valued their involvement in abortion procedures, noting that participation was important for their future practice and allowed acquisition of essential clinical skills.

Conclusions: Medical students value the educational opportunity to participate in second-trimester procedural abortions; however, most feel unprepared for the technical and emotional aspects, despite utilizing available educational resources. To maximize educational experience and psychological safety, educators should develop specialized training resources. This could strengthen physician knowledge and comfort with abortion care in the future, ultimately improving patient care.