Osteopathic Medical Students' Concerns About the Future of Abortion Education and Training Post-Roe v. Wade

Abstract

Background In the United States, new regulations on access to abortion and, in some cases, penalization of physicians who provide abortions, have been established on a state-by-state basis. The American College of Obstetricians and Gynecologists recommends that medical schools include abortion training in their curriculum. It is still unknown if the Dobbs decision will limit medical students' abortion training and/or discourage them from pursuing a career in obstetrics. The goal of this study was to investigate the attitudes of medical students toward abortion following the Dobbs decision and their beliefs about its possible effect on future medical education and practice. Methods This cross-sectional, observational study collected data from students enrolled in a Florida, United States osteopathic medical school using an anonymous online questionnaire from February to March 2023. The questionnaire contained 35 items that addressed medical students' attitudes towards a range of potential implications on medical training due to the new abortion restrictions. Hypothesis testing was performed using Spearman's rho correlation and multivariate linear regression to explore the relationship between the predictor variables (concerns about future practice regarding abortion, religiosity, and acceptability of abortion based on gestation age) and the predicted variable (attitudes about abortion). Data were analyzed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 28.0, Armonk, NY). Results In total, 158 participants completed the questionnaire; 91 (57.6%) were women. The mean age was 25.8 (range 21-37 years). Using a stepwise regression analysis, only the variables shown to be statistically associated (per Spearman's rho bivariate correlation) with the predicted variable (abortion attitudes) were entered into the model (i.e., concerns about abortion education and future practice, religiosity, and abortion acceptability based on gestational age). A significant regression equation was found (F(3,134) = 205.750, p < 0.001, R2 = 0.822, R2 adjusted = 0.818). The percentage of variance in the scores accounted for by the model was 82%. Higher levels of feeling that the abortion ban would negatively affect their training and future practice, greater religiosity, and acceptability of abortion at later gestation ages were statistically significant predictors of more positive attitudes toward abortion in this sample of osteopathic medical students. Conclusions The results suggest that the attitudes of medical students toward abortion are related to multiple factors, including concerns about future abortion training, religiosity, and the week of pregnancy acceptable for a woman to have an abortion. Findings also highlight the attitudes of medical students in response to more restrictive abortion legislation, emphasizing their desire for possible curricular enhancements to safeguard their training and education.

Keywords: abortion; curriculum; dobbs decision; medical education and training; reproductive health; women’s health; women’s rights.

Figure 1. Religiosity Frequencies

Participant responses to the item “How important is religion in your life” (i.e., religiosity) are reported by percent.

Figure 2. Acceptability of Abortion Based on Gestational Age

Scoring: “0” weeks indicates abortion is not acceptable at all and "40" weeks indicates acceptability at any gestational age; weeks 1-39 indicate variability based on the exact week of acceptability.

Figure 3. Survey page 1

Items 2, 5, 6, 8, 11, 13, 15, 16, and 17 are reverse scored, whereby 1=strongly agree, 2=agree, 3=slightly agree, 4=slightly disagree, 5=disagree, 6=strongly disagree.

Figure 4. Survey page 2

Items 2, 5, 6, 8, 11, 13, 15, 16, and 17 are reverse scored, whereby 1=strongly agree, 2=agree, 3=slightly agree, 4=slightly disagree, 5=disagree, 6=strongly disagree.

Figure 5. Survey page 3

Figure 6. Survey page 4