Shira Fishbach was preparing to apply to medical school when she found out she was pregnant.
Fishbach, now a 4th-year medical student at the University of Chicago Pritzker School of Medicine, had just moved to Baltimore to start a postgraduate program in the summer of 2017, with the intention of applying to medical school the following year. She had just begun her pre-med requirements when she decided to take a pregnancy test -- and got a positive result.
"The minute I found out I was pregnant, I knew that my family was going to be emotionally and financially supportive no matter what I chose," Fishbach told 鶹ý. "Still, I never quite imagined myself being in that position."
She decided to get a surgical abortion in June. Fishbach said her abortion experience was overwhelmingly positive. All of her providers made her feel empowered in her decision, and were supportive of her dream to become a doctor.
"I felt a connection between my having an abortion and my ability to pursue my own education, to have economic freedom, to live my life the way that I wanted to," Fishbach said. "It felt like they were literally handing me that gift."
Fishbach is one of many physicians who decided to have an abortion, according to a new survey published in . The research letter found that 11.2% of physicians who wanted biological kids and had a pregnancy, or whose partner had a pregnancy, reported an abortion.
Among physicians of reproductive age (45 years or younger), the abortion rate was 10.2%, said researchers led by Morgan Levy, BS, of the University of Miami School of Medicine, and colleagues.
Levy said these findings show that abortion is common among physicians, albeit slightly less common than in the general population, as previous studies estimated that the abortion rate among reproductive-age women was 23.7%. "While [the abortion rate] doesn't reach that level, it is not an insignificant portion of our sample," Levy told 鶹ý.
"The patients that we all treat can also be a part of our community of physicians," Levy said. "That's a really important thing to realize."
From April to May 2021, Levy and colleagues recruited physicians and physicians-in-training to participate in a survey about their experiences with abortion. Physicians who identified as female reported their own abortion experiences, while males who partnered with females answered questions about their partner's experience with abortion.
Of the 3,104 participants who completed the survey, 55% wanted biological children and said that they or their partner had been pregnant at least once. On average, patients who had an abortion were older than those who had not (41 vs 39 years, respectively).
Of the 1,566 participants who reported being pregnant, 11.5% had an abortion. Of the 145 participants who reported that their partner had been pregnant, 7.5% reported that their partner had an abortion.
A total of 15.4% of medical students had an abortion, the researchers found. Participants who reported an abortion were more likely to report delaying childbearing for training purposes compared with those who did not have an abortion (68.1% vs 59.8%, respectively). And those who had an abortion were more likely to have a partner who was also a physician than those who did not (34.7% vs 24.8%, respectively).
Levy and colleagues noted that their study is limited by its non-representative sample and the reliance on self-reported data. Additionally, the study may be subject to social desirability bias, which is common in abortion research. The sample included only participants who desired biological children, and may underestimate the abortion rate, the researchers noted.
Fishbach, who recently matched into an ob/gyn residency program at the University of Michigan, said the abortion care she received influenced the type of doctor she hopes to become. She said abortion is a good option for people in the training pathway, who can often be dealing with barriers such as student debt, long work hours, or simply not being ready to have a child.
"These are real choices that people who can become pregnant are making, sacrifices that they are making in pursuing a career in medicine," Fishbach said.
Additionally, she hopes that more research into how physicians and other medical professionals make decisions around family planning and abortion can humanize the experience -- and how doctors think about patients who choose abortion.
"When you're studying to be a doctor, you just are so far removed from the experience of a patient sometimes," Fishbach said. "We forget that we have all been patients, and we will all be patients."
Disclosures
The American Medical Women's Association Physician Fertility Initiative supported the dissemination of the survey.
Levy and co-authors did not report any potential conflicts of interest.
Primary Source
Obstetrics and Gynecology
Levy MS, et al "Abortion among physicians" Obstet Gynecol 2022; DOI: 10.1097/AOG.0000000000004724.