Iowa OB-GYN education future unclear as abortion training standards change

When Iowa lawmakers were considering legislation in 2018 to ban most abortions, University of Iowa officials said the law could threaten its standing to educate doctors who specialize in female reproductive health.

Now that the state and U.S. supreme courts have eliminated obstacles to that law and Gov. Kim Reynolds is working to reinstate it, questions are again looming about the effect on obstetrics and gynecology education.

The answer is not yet clear because accreditation standards are changing nationwide following the U.S. Supreme Court’s decision on abortion. In states that ban abortions, universities may have to send students out of state to study the procedure.

There’s no need for the Department of Obstetrics and Gynecology at the University of Iowa Hospital and Clinics to make immediate changes. Abortion is still legal in Iowa until 20 weeks of pregnancy.

But if further abortion restrictions are put in place, the University OB-GYN department may need to change its program. Jennifer Brown, a communications specialist with University of Iowa Health Care, said that the provider is closely monitoring how court rulings and proposed legislation impacts both education and patient care at their system’s hospitals and clinics.

“As of today, it is too early to know whether the Supreme Court ruling will have an impact on the clinical services and medical education offered by University of Iowa Health Care,” Brown said.

Reynolds announced plans in June to ask a Polk County judge to reverse an injunction preventing the fetal heartbeat law enforcement. The law would require doctors to check for signs of a fetal heartbeat before performing an abortion. If a heartbeat is detected – which typically happens six weeks into a pregnancy – the doctor would not be allowed to proceed with the abortion. The laws include exemptions which include when the mother’s life is at risk and in cases of rape and incest.

When the law first passed, there were concerns about the future of the OB-GYN program because abortion training was a requirement for accreditation. The program receives annual accreditation through the Accreditation Council for Graduate Medical Education, ACGME, an organization which approves medical residency and fellowship training programs nationwide.

ACGME requires OB-GYN residency programs to provide family planning training, which includes teaching on abortion and contraception. Residents can opt out of this training if they state a religious or moral objection.

The accreditation process will still require family planning training, Susan White, ACGME vice president of communications said. But the organization proposed revised requirements for obstetrics and gynecology residencies so that the education remains legal.

Abortion is now illegal or heavily restricted in 12 states following the Supreme Court decision to overturn Roe v. Wade, which established abortion as a constitutional right.

In states where abortion is illegal, OG-GYN programs still must provide resident physicians access to clinical experience with induced abortion to receive accreditation, White said. That means arrangements and accommodations will be needed for residents to receive abortion-related curriculum in a place where the procedure is legal.

If travel isn’t an option, programs must provide students “didactic activities” around the procedure, including simulating an abortion and evaluating residents on a uterine evacuation, the surgical process of removing pregnancy tissue from the uterus.

These new proposed standards “address the need for continued access to abortion education and training as essential for physicians in this specialty, while allowing provisions for residents in jurisdictions with legal restrictions,” White said. The new requirements are currently open for public comment until Aug. 8.

The new rules would not impact the University of Iowa’s program under current state law. But many abortion rights activists are expecting more restrictions to come soon, as the Iowa Supreme Court found the state constitution does not guarantee a right to abortion.

The governor has not announced specific plans on abortion past her challenges to previous court decisions on the fetal heartbeat law. She also asked Iowa’s highest court to redecide the state’s 24-hour waiting period case, but the court has denied that request.