The decision whether or not a resident trainee should become an abortion provider is often fraught with emotion and inner conflict. The recent article “Four Residents’ Narratives on Abortion Training: A Residency Climate of Reflection, Support, and Mutual Respect” recounts four individual experiences of residents confronted with this decision. Personal and societal conflicts often impact an individual after he/she has decides to become an abortion provider. Creating an infrastructure within a residency program to allow learners to discuss their thoughts and feelings regarding abortion training may provide much needed support and community.
The ob-gyn residency program at Women & Infant’s Hospital/Brown University in Providence, RI provides this community to residents through a group called Resident Abortion Provider Support group (RAPS).
Given the success of our support group we would like to offer 6 tips for initiating an abortion training support group at your training program.
(1) Its all about the providers
Creating a support group is about focusing on providers. Although this group of individuals will likely get involved with outreach and activism, the focus of your support group should be on the issues that surround being an abortion provider. This can be difficult. As physicians and caregivers we spend most of our time focused on patients; stepping back and focusing on our peers and ourselves is often not a priority and therefore can be a challenge. We suggest working hard to keep your support group goals set on discovering and discussing the joys and challenges of being an abortion provider.
(2) Talk, talk, talk
Growth comes from discussion. Encourage discussion in any way possible; read articles, watch movies, meet after cases. This can be done as a whole group or as break-outs. Support is not always scheduled and in fact most often happens on the fly.
(3) Be inclusive
Although including only those who have little qualms regarding abortion provision can seem attractive and less challenging in terms of structuring a support group, it can take away from the value of the support, discussion and an inclusive community. Encouraging all caregivers to have a voice allows for more colorful and meaningful conversations and helps you explore the boundaries of being a provider.
(4) Keep it safe
The down side of all-inclusiveness can be the loss of a “safe space”. The ultimate goal of an abortion provider support group should be a safe place for providers to express themselves. Fostering this will depend on your particular members and their comfort level, but may include having “provider only” events to allow for frank and honest communication that may not otherwise be possible in front of those who are non-providers.
(5) Meet often
Residents have busy schedules and it’s challenging to have regular meetings. Having long periods between meetings can dilute the sense of community and cause providers who are uncomfortable seeking out much needed dialog feel isolated for long periods of time. Providing a dependable forum for discussion is key to having trainees feel supported.
(6) Be flexible and include supporters!
The needs of your residents will change over time. Poll your members on the issues that are important to them and enlist their help in determining where to focus your discussion. In addition, including understanding and dedicated faculty members can be an excellent source of support for the residents. Speaking with those who are outside of residency and in the “real world” can provide important points of view regarding abortion provision.
RAPS was founded by Janet Singer, a Nurse Midwife at Women & Infant’s Hospital as well as several other devoted and supportive faculty members and residents. From its creation the purpose of RAPS was to allow learners training to provide abortions a safe forum to discuss their feelings and views.
About the authors: This article was written by Drs. Jen Villavicencio (PGY3) and Martha Kole (PGY3) from Women and Infants Hospital at Brown University. You can reach Dr. Villavicenio directly at JVillavicencio@Wihri.org if you have any further questions regarding the content in this article.