A new generation of abortion specialists is springing up in the US, according to the , energised by the plight of women who have to travel miles and miles to find a doctor willing to do terminations. “It doesn’t matter what you believe if you don’t back it up with action,” says Michelle Cleeves, a medical student at the University of Colorado. “The right to abortion doesn’t mean anything if women don’t have access.”

The question is whether there will be enough enthusiasts to offset a sharp decline in numbers. Although abortion is said to be one f the most common surgical procedures in the US, the number of providers has fallen for decades. It dropped 37% between 1982 and 2000, with the number of abortions reportedly dropping by 17%.

The Guttmacher Institute, which is associated with Planned Parenthood, says that there were only 1,800 abortion providers in the US in 2000 — compared with 6,200 plastic surgeons, 9,700 dermatologists and 10,600 gastroenterologists. One in four women must travel at least 50 miles to end their pregnancy. Nearly one- third of metropolitan areas and 97% of rural counties have no abortion providers.

Older doctors, however, are not upbeat about their specialty. Dr Warren Hern, of Boulder, Colorado, described by the Times as “a legend in the abortion rights movement”, has some disheartening advice for medical students. “Do something else. Fix broken legs. No reasonable person would do this,” he says. Abortion has become so stigmatised that other doctors shun him. Even his patients look at him with disgust. “They’ve absorbed so much anti-abortion rhetoric, they feel a sense of revulsion that they have to come into my office and seek treatment.”

Dr Hern specialises in second and third trimester abortions and even he feels unnerved by what he does sometimes. He once wrote that “the sensations of dismemberment flow through the forceps like an electric current”. “We are hard-wired as a species to protect small, young helpless creatures,” he says. “The foetus is not a baby, but it’s close. Some are very close. It’s difficult”

The upshot of this is that medical students who want to do abortions must be highly committed. Most medical schools barely cover the topic and only half of the obstetrics and gynaecology residencies integrate abortion into physician training. Keen students must study on their own.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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