residency

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Where Does Life Begin, And Other Tough Abortion Questions For Doctors In Training

Our recent post on how residents training to be OB-GYNs think about providing abortions (or not providing them) went viral earlier this month and triggered a broader conversation among readers. The topic was also featured on Radio Boston and WBUR’s All Things Considered.

I asked Janet Singer, a nurse midwife on the faculty of Brown University’s obstetrics-gynecology residency program, and the person who organized the initial discussion among the residents, to follow up. She, in turn, ​asked Jennifer Villavicencio, a third-year resident​, to lead a discussion digging even more deeply into the topic.

Two of the residents ​in the discussion ​perform abortions, two have chosen not to do so. ​But they are colleagues and friends who have found a way to talk about this divisive issue in a respectful and productive way. ​Here, edited, is ​a transcript of ​their discussion, which gets to the heart of a particularly fraught question: When does life truly begin? ​Three of the residents have asked that their names not be included, for fear of hostility or violence aimed at abortion providers.

Jennifer Villavicencio (Resident 3): Let’s talk about a woman who comes in, has broken her water and is about 20 to 21 weeks pregnant and after counseling from both her obstetricians and the neonatologist [a special pediatrician who takes care of very sick newborns] has opted for an abortion. Let’s talk about how we each approach these patients.

Resident 2: As a non-abortion provider I will start just by saying that a patient of this nature in some ways is on one extreme of the spectrum. As an obstetrician, I view the loss of her pregnancy as an inevitability. I think we would all agree with that. So, taking part in the termination [another word for abortion] of her pregnancy is different to me than doing that for someone whose pregnancy, but for my involvement, would continue in a healthy and normal fashion.

Opponents and supporters of an abortion bill hold signs outside the Texas Capitol on July 9 in Austin. (Eric Gay/AP)

Opponents and supporters of an abortion bill hold signs outside the Texas Capitol on July 9 in Austin. (Eric Gay/AP)

JV: Would your opinion change if she were 22 or 23 weeks and theoretically could make it to viability [the concept that a fetus could survive outside of the mother. Currently, in the U.S., the generally accepted definition of viability is 24 weeks gestation or approximately six months pregnant]?

Resident 2: Personally, it wouldn’t, because I feel there is a very slim chance of an intact survival [refers to an infant not having significant mental or disabilities] of an infant. If she were 22 or 23 weeks gestation and could potentially make it to the point of a survivable child, that likelihood is so rare. But for my involvement, she will still lose this pregnancy. My point is, if I help terminate this pregnancy, I am not playing an integral role in the loss of this pregnancy. I feel that supporting her in proceeding in the safest possible way, protecting her while accepting the loss of her pregnancy, is my job.

Future Health Of The Child

JV: Does the future health of the child really play a role in it for you?

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