Pro-Choicers Have a Problem
Iowa’s fight over telemed abortions underscores the increasing scarcity of providers.

Telemedicine terminal in Des Moines, Iowa.


Betsy Woodruff

An abortion provider who spoke with me on the condition of anonymity tells me that since it’s so controversial, most abortions happen at clinics rather than hospitals. That makes it less likely that med students will learn the procedure and, thus, less likely they’ll eventually incorporate it into their practices. If students aren’t immediately committed to learning how to provide abortions, they probably won’t ever do so.

And young med students are less likely to be passionate about abortion rights than the first generation of providers, she explains. Members of the “old guard,” as she calls it, remember treating botched illegal abortions before Roe v. Wade.


“Uniformly when you talk to them, and talk to them about why they provide abortions,” she tells me, “most of them will say something like, ‘It’s because of this case of this septic abortion that I took care of when I was in medical school, and I never want to see that happen again.’”

“I think people in my generation don’t have that same public-health reference to understand what a real lack of access is,” she adds.

Plus, performing abortions carries a strong social stigma. The abortion provider I spoke with works for a large hospital system and moonlights at a Planned Parenthood two hours away. Most of her hospital co-workers have no idea about her second gig. She says she’d face “social discomfort” if she was open about her work, especially given that she lives in a politically and religiously conservative area.

“I by no means offer up to these people, ‘Hey, I’m the abortion provider,’” she says. “I am very careful” about sharing that information.

She wouldn’t lie if someone asked her point-blank, she says, but she avoids the topic; she lives in a small community and has a three-year-old daughter.

Dr. John Bruchalski, an OB-GYN who performed abortions before returning to the Catholic Church, has a different perspective on the abortion-provider shortage. He tells me that he encourages pro-choice med students to learn how to perform the procedures.

“I’ve told people, ‘If you really believe that abortion is a loving, good choice, you damn well better do it,’” he says.

And taking his challenge often leaves students repulsed, he adds.

“It’s very hard to recruit people to do abortions,” he says, “because once they do it, even if you’re pro-choice, it’s — the words I hear are, ‘disgusting, revolting, brutal, but it has to be done. It’s very difficult to do, but someone has to do it.’ And so you’re finding that only the hardest-core are going into it, and that’s not many people.”

Bruchalski also sees another hurdle for those trying to recruit more abortion providers: Med students who want to deliver babies typically don’t want to perform abortions.

“It’s schizophrenic,” he says. “You go into the profession because you want to take care of two patients.”

— Betsy Woodruff is a William F. Buckley Fellow at the National Review Institute.