Washington University in St. Louis, Missouri has a world-renowned medical school and affiliated teaching hospital. In the early 20th century, one of its most distinguished professors was the obstetrician and gynecologist Frederick J. Taussig.
Taussig wrote extensively on abortion, and his work was frequently cited by other experts; I read both of his major treatises when I was writing Sex and Herbs and Birth Control and purchased my own copies on E-Bay. Taussig was a careful observer, and unlike most physicians of his era he was willing to acknowledge the superior skill of midwives in providing safe abortions. Taussig also believed that more married men should take responsibility for contraception by having a vasectomy, since it was an outpatient procedure and “perfectly harmless.” He lamented that “it is as yet difficult to persuade many men to undergo this slight sacrifice for the sake of their wives.”
In 1910, when Taussig published his first major treatise, like most of his professional colleagues he was vehemently opposed to the legalization of abortion. But over the course of his career (and under the influence of his wife Florence Gottschalk, who was a prominent Suffragette) Taussig began to advocate wide-ranging reform of the law codes. He put his support for legalization firmly in a feminist context. In his 1936 volume on the subject, Dr. Taussig noted: “With the spread of the Woman’s Suffrage Movement throughout the world and the newer independence of women, the revolt of womankind against the age-long domination of man has finally materialized. There can be no question that more consideration must be given to the right of women to control their own bodies…. Thus far all laws and social regulations on abortion have been man-made, and women, who are the chief sufferers, have had no chance to express their views in any referendum.”
Dr. Taussig’s 1936 book was extremely influential among physicians and others with an interest in maternal health. His comprehensive scientific treatment of both spontaneous and induced abortion along with his sensitivity to social context made his work the standard reference on the subject for decades, as both supporters and opponents of abortion law reform have acknowledged.
Dr. Taussig insisted on viewing abortion as a necessary component of gynecological training, and under his tutelage medical students gained the expertise they needed to safely perform abortions and tend to complications of pregnancy.
It is a terrible irony that the Washington University School of Medicine, after so many years of being a national leader in women’s reproductive health, is now increasingly under attack by the Missouri State Legislature for its efforts to provide the next generation of physicians with the training they need.
The American College of Obstetricians and Gynecologists (ACOG) recommends standardized education on abortion in all residency programs (in which U.S. physicians-in-training work in a teaching hospital for three years to gain practical experience in their specialty after they finish medical school). But it is a sad fact that fully half of U.S. medical schools do not offer training in abortion care, or at most offer one lecture on abortion and contraception combined. In order to keep their accreditation, hospitals with residency programs in obstetrics and gynecology are required to either provide abortion training themselves or allow their residents to go out of state to obtain it. As it stands now, Washington University students need to go to Illinois for their abortion training. Yet state legislators want to tax the university’s endowment on the grounds that, as Republican Mike Moon put it: “Washington University is a premier institution which trains students to perform abortions… These students are then hired to murder developing human babies across our nation. They won’t stop on their own. This [bill] will place a financial hardship on their ability to train these students.”
States such as Missouri, Texas and Idaho are not only greatly restricting the conditions under which abortion can be legally obtained. They are also threatening to prosecute anyone who teaches abortion techniques, seeks an abortion outside of the state, or performs an abortion on a state citizen regardless of where the procedure is done. Whether or not such laws will withstand court challenges, and whether or not the laws could be enforced in practice, they have an intimidating effect on medical professionals as well as on women seeking a full range of reproductive health options.
The competition to obtain a place in a residency program in a woman-friendly state in which training in abortion is not under attack has become more severe. As medical reporter Sarah Varney put it: “Increasingly, aspiring obstetricians and gynecologists who want training in abortion procedures are seeking out teaching hospitals and universities that champion that training as a vital skill in women’s health care, creating a crush of qualified applicants for prized spots in Seattle, San Francisco, and New York…”
The medical school of the University of Washington (UW) in Seattle is offering Zoom classes on contraception and abortion to medical students in Idaho, one of the many states that are drastically restricting abortion and access to abortion training. As of two years ago UW stopped reserving a few spots in their program for residents choosing not to learn abortion care. “If we live in a state where abortion care is legal, we need to recruit medical students into our program that want to provide abortion care,” said Dr. Alyssa Stephenson-Famy, an associate professor of maternal-fetal medicine in the department. “We should not waste our spots on people not willing to provide abortion.”
It bears stressing that state legislators are delusional if they think that obstetricians and gynecologists can be properly trained without understanding abortion care techniques. ACOG requires abortion training for medical residents because adequate care of pregnant women is impossible without knowledge of the basic procedures. Obstetricians must be capable of expertly cleaning out a woman’s uterus in the event of a miscarriage or if fetal heartbeat ceases. As Dr. Eve Espey, a professor of obstetrics and gynecology at the University of New Mexico, has observed: “Any obstetrician who says there is never need for abortion care is not telling the truth about obstetrics.”
Sources: Sarah Varney, “Fewer medical students trained for abortion procedures,” NBC News online, March 22, 2022; Frederick J. Taussig, The Prevention and Treatment of Abortion (1910) and Abortion: Spontaneous and Induced (1936).