A Crisis in Providers
A woman’s ability to access abortion and exercise her right to chose is closely link to the number of abortion providers (or lack of providers) in her community. The number of abortion providers nationwide has steadily declined The number of abortion providers nationwide has steadily declined since the 1970’s. In 1973 over 80% of hospitals provided abortion care for women. Today this number has dropped to only 7% nationwide and 0% in Wisconsin. We have seen a similar drop in the number of individual physicians who provide abortions. Between 1982 and 2000, the number of abortion providers declined by about 38% nationwide from a high of 2,900 to 1,800. In Wisconsin, we have seen a decrease from 16 providers in 1992 to 9 providers in 2005. Currently, there are only four abortion clinics in Wisconsin – one in Madison, two in Milwaukee and one in Appleton that provides abortions one day a week.
The decline in the number of abortion provides has caused rural women in Wisconsin to have very limited access to abortion. 93% of Wisconsin counties lack an abortion provider – 63% of Wisconsin women live in these counties. The four Wisconsin clinics are located in densely populated cities. With gas prices at an all time high it is easy to understand why many rural women cannot afford to travel the distance into these urban areas. In a survey of abortion patients, 8% of women had to drive more than 100 miles to the closest provider, a drive of around two hours. As abortion clinics shut their doors and hospitals change their policies, women are forced to travel farther away to exercise their right to chose. So why are experiencing such a decline in the number of providers? Lack of Training Opportunities Fewer medical students are being trained to provide abortions. This is partially due to demand and partially due to a decrease in the accessibly of training programs. In most medical schools, abortion training is no longer a mandatory part of the curriculum for students. Students pursing medicine in their residency are given the option of observing and assisting with abortions. Only 12% of OB-GYN residency programs nationwide require training of first semester abortion procedures; 7% require training in second trimester procedures. This lack of training severely limits the number of physicians able to perform abortion procedures and decreases the staffing pool for clinics. Our current abortion providers are ageing and retiring without younger physicians replacing them. Harassment and Safety The fear of harassment and violence has made becoming an abortion provider unattractive for many physicians. Doctors and patients experience verbal harassment, picketing, and physical violence around clinics. Since 1977 here have been 2,400 reported cases of violence against abortion providers, 7 murders, and 16 attempted murders. Constant bombardment of picketers as he or she enters the clinic for work each day can be exhausting for a doctor, turning many physicians away from pursing a career in abortion care. TRAP (Targeted Regulation of Abortion Providers) Laws: In an attempt to drive doctors out of practice andmake abortion care more expensive and difficult to obtain, the anti-choice movement has passed legislation in Wisconsin that purposefully imposes unnecessary regulations on abortion providers. Wisconsin imposes a variety of burdensome requirements on abortion providers that are not imposed on other health care providers, including:
• Physicians may only perform first-trimester abortions within 30 minutes traveling time of a hospital. No exception is made for rural areas or for non-surgical abortions.
• Wisconsin law mandates that only physiciansmay perform an abortion, including provision of medical abortion, prohibiting certain qualified health care professionals from performing abortions. • Wisconsin has an unconstitutional requirement that all abortions after the first trimester be performed in a hospital. These regulations make accessing abortion an especially difficult for rural women. Source: Jones, Rachel K. Mia R. S. Zolna, Stanley K. Henshaw and Lawrence B. Finer. Abortion in the United States: Incidence and Access to Services, 2005. Perspectives on Sexual and Reproductive Health. 40:1, March 2008.
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