SPOTLIGHT ON ABORTION CARE & REPRODUCTIVE JUSTICE
AMSA Repro Goes to Philly!
The Inside Scoop from the 2025 Annual Meeting of the Association of Professors of Gynecology and Obstetrics (APGO)
Written by Jeff Koetje, MD, AMSA Reproductive Health Programming Strategist
and Aliye Runyan, MD, AMSA Reproductive Health Project Consultant
It feels appropriate to mark the end of the month within which we have observed and celebrated Women’s History Month and National Abortion Provider Appreciation Day (March 10) by sharing an inside view from the very recent annual meeting of APGO, the Association of Professors of Gynecology and Obstetrics. APGO is the national association of OB/GYN medical school faculty and residency program administrators, so this meeting had a major emphasis on the current and future state of OB/GYN education and training, especially in light of the accelerating attacks against sexual and reproductive healthcare and related policies at state and federal levels.
The AMSA Reproductive Health Project was well represented at this meeting. We – Drs. Aliye Runyan and Jeff Koetje – were both attendees and presenters. For Dr. Runyan, who is an OB/GYN and abortion provider, this was an opportunity to engage specialty colleagues, and for Dr. Koetje, who is a non-clinical physician, this was an opportunity to engage with fellow medical educators. And, for both of us, as activists, this was an opportunity to engage with other educator-activists and those who may be ready to take that important step deeper into the intersection of education, advocacy, and activism.
This was the first major medical conference that either of us have attended since the beginning of the second Trump administration, and APGO was just a mere five weeks after the inauguration;
you could feel the tension among a group whose professional roles and activities are at the crosshairs of the anti-democratic
and proto-fascist movements that are grabbing power in so many states and in the federal government at this very moment.
Of course, medical care pertaining to sexual and reproductive health have long been politicized in this country, so this is a group of physicians, medical educators, and program administrators who have had to contend with authoritarian attacks for far longer and much more directly than nearly any other specialty within medicine. If you teased out the different components of the tension in the room, you could sense anger, worry, fear, rage, despair, sadness, exhaustion…and also righteousness, resiliency, and resolve.
Among OB/GYN physicians, there is a noticeably growing sense of the necessity of a reckoning. A reckoning with the specialty’s own culpability in perpetuating violence and violation of human dignity and bodily autonomy by its willing participation in white supremacist heteropatriarchy and the supremacist ideology’s sociopolitical and cultural manifestations of anti-Black racism, anti-Indigeneity, and misogyny. To be clear, a reckoning is needed, and long overdue, across the entirety of the profession of medicine, not just within the specialty of OB/GYN, but the particular nature, extent, and frequency of the barbarism conducted by physicians, especially in the 19th and 20th centuries, in the name of discovery and development of the discipline that has come to be known as obstetrics and gynecology, is particularly egregious (perhaps rivaled only by psychiatry).
One of the keynote speakers was Professor Dorothy Roberts, JD, who may be best known (at least, among physicians) for her 1997 magnum opus, Killing the Black Body: Race, Reproduction, and The Meaning of Liberty. In her keynote address to over a thousand physicians in the hotel ballroom, she connected the dots between the institution of slavery, the ideologies of white supremacy and capitalism, and the occurrences of obstetric violence and violation throughout the past 150 years of modern medical practice up to the present moment. Furthermore, she connected the dots of anti-racist, anti-carceral, anti-capitalist abolitionism to the Reproductive Justice framework, and urged us in the profession of medicine to respond to the moral, ethical, and political calls for accountability and reparative action from those leading the Reproductive Justice Movement and the inter-related movements for justice and collective liberation. Interestingly, and seemingly without any irony whatsoever, the first audience question following Professor Roberts’ talk, posed by a white person, was, “What would you recommend as the first thing we should do?” (As if Professor Roberts hadn’t just spoken about the actions that are urgently needed for the previous 30 minutes!) Professor Roberts’ response was, succinctly, you already know what you need to do. (Jeff’s commentary: We who are racialized as white need to stop asking Black women to hold our hands; such requests/demands repeat and reify the racialized power dynamics that position Black women as white people’s mammies.)
As we mentioned, we also attended this conference as presenters, and it was an honor to present the work of the AMSA Reproductive Health Project to an audience of over 100 people. Dr. Runyan spoke about the findings from our Project’s research on the current state of abortion- and family planning-related undergraduate medical education (UME). The findings of our research, which involved surveying current medical students on the inclusion – or exclusion – of didactic and clinical education opportunities related to abortion care and family planning in their medical school curricula, largely pointed to what is already known about reproductive health medical education:
it has been and continues to be inadequate to achieving the goal of student proficiency in the
medical student educational objectives that APGO itself has set.
While our survey project was similar to previous survey projects examining reproductive health medical education, our project was unique for asking current medical students to rate their self-efficacy, essentially a measure of self-confidence, in relation to the APGO educational objectives pertaining specifically to family planning and pregnancy termination. Not surprisingly, many students (between 80-90% of respondents for some of the objectives) expressed low estimates of their self-efficacy in relation to these specific educational objectives. Furthermore, when compared to survey data compiled by Medical Students for Choice over the last 10-15 years, our data shows only marginal improvement in the quantity of self-reported exposure to abortion and family planning in medical education over time.
This tells us that medical schools, in spite of decades of research showing the inadequacy of reproductive health education in general and of medical education pertaining to abortion and family planning specifically, medical schools have refused to address this deficiency in any real, sustained, and meaningful way. Students are completing medical school with low confidence in their knowledge and skill sets related to these forms of basic, necessary, essential primary care. While others may not be so bold to call it what it is, we are, and we will call it what it is: medical education malpractice.
While we believe that there is value in continuing to point out where and how medical education continues to fail to live up to its own declared standards, we are not satisfied with merely pointing this out. We refuse to participate in the self-serving activity of just kicking the can down the road. So, in our presentation we also spoke about what the AMSA Reproductive Health Project is doing to address these inadequacies, when the medical schools, as a whole, will not. One program of the AMSA Repro Project that we highlighted is our accredited Elective in Abortion Care, Family Planning, and Reproductive Justice, which we run in partnership with the University of Michigan Medical School. The elective exposes students to the framework of reproductive justice, and to voices and experiences that usually are not heard within medical training: those of midwives, organizers and community activists, whose work and lived experiences reflect and illustrate the gaps in reproductive and maternal health that are usually presented as statistics, or in many cases, not highlighted during medical training.
During the elective, students learn about pregnancy options counseling, and participate in skills sessions like the MVA (manual vacuum aspiration) or “papaya” workshops. This experience is often a student’s first exposure to the procedure, and for many students, it may be the only exposure they have to abortion care or miscarriage management during their UME training.
We at the Project are proud to host these experiences for medical students, however, we are aware that no amount of optional, or “opt-in”, training can make up for the overall lack of attention to and standardization of the skill set that is pregnancy loss, termination, and family planning. Fifty percent of the population has the ability to become pregnant; it is an embarrassment that medical training consistently graduates physicians without an understanding of the importance and essentiality of these skills, no matter their intended specialty.
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*Note: an excerpt of this Spotlight is included in AMSA Reproductive Health Project eNews #42:
ACA at 15 & AMSA Repro Presents at APGO
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