Because she herself worried that she would be unable to establish a general practice with such a high proportion of abortion patients, she responded by reducing the number of abortion patients she would accept. In Dr. Brill's first job with a practice in a large western city that had no abortion prohibition, he remembered their concern about the same thing. They weren't interested in becoming-they didn't want their practice to grow into being an abortion clinic. But if you had patients of your own who had an unintended pregnancy, undesired pregnancy, and wanted to terminate the pregnancy, that was legit.. .You, you could take a referral from another, like from a family practice doc, but what they didn't want was people calling up and saying, "Well I heard Doctor Brill provides a lot of abortions and I don't have a doctor. But I think I'm pregnant. Can I come in and have an abortion?"
88 Dr. Brill and Dr. Berman's stories exemplify what many physicians fear about incorporating abortion into practice. Because of the declining availability of abortion providers, becoming one brings with it the possibility that abortion could take over, replace other procedures, and in some cases upset staff members who are not supportive of abortion or simply not emotionally prepared to act as counselors for the array of psychosocial issues that accompany abortion. Professionally, physicians worry that they will become less established and known for their other ob-gyn skills. And politically, they worry about damage to their practice by becoming known in the community as abortion providers. Regardless of the fact that Dr. Berman, like those in Dr. Brill's former practice, decided to refer unknown abortion patients elsewhere, she remains a front-line physician because she successfully managed to work around the various obstacles such that she could continue to provide abortions to all of her own private practice patients. Many physicians are more easily deterred. Doing abortions on occasion, and in the context ofaknown patient, has proved to be manageable in her practice. Because the far majority of abortion work in the U.S. is done in dedicated abortion services, other physicians I spoke with who provided abortions regularly were connected to an abortion clinic. From my original sample of30,two physicians in two large western cities had in the past taken fellowships in family planning during which abortion was the majority of their work. Later on, after both became faculty physicians in the academic departments that housed their fellowships, they continued with this focus on abortion. When I asked Dr. Anna Lee, what drew her to this work she replied, It became obvious that I had a certain comfort level that very few people have with abortion care. And so I felt that because of that interest and also
89 because of the lack of interest from everybody else, I felt that it was important for me to go into fellowship and continue this care.
You've reached the end of your free preview.
Want to read all 197 pages?
National Abortion Federation, Abortion and Medicine