Issue date: 2/22/07 Section: Opinion

Hundreds of Philadelphia women rely on Penn doctors for the cutting edge in reproductive care.

Every day, gynecologists and obstetricians at the Hospital of the University of Pennsylvania tackle both the most complex of research questions and the most mundane of patient concerns. Some doctors study infertility and cancer, others deliver babies.

Their department strives for "safe and comprehensive and well-delivered services," said Courtney Schreiber, a gynecologist at HUP.

But as of now, many of these doctors aren't able to provide their patients with an essential part of reproductive care: abortion.

It's not that Penn doctors are against the procedure. Most in the department see it as an important family-planning choice.

Most elective abortions - done because a woman chooses to, not because her life is in danger - take place in offices, not in operating rooms. But HUP doesn't have the necessary office space, meaning safe and routine abortions become costly affairs in the hospital's operating rooms.

Most women in the early stages of pregnancy who want abortions go to clinics instead, where doctors often prescribe Mifepristone, a pill with few threatening side effects, to induce abortion.

"Economically and financially, [it] makes more sense" in a clinic, Schreiber said. "We don't have a real setup for that at the moment."

So basically, these world-class doctors with world-class facilities don't perform abortions because they don't have enough office space.

Abortion is and will likely always be controversial, doctors say, but as long as it is legal in Pennsylvania, they consider it a medical option for their patients.

"Abortion is a common event in the lives of women," HUP gynecologist Steven Sondheimer said. "Anybody in medicine is going to be exposed to women or families where abortion has occurred."

Beyond HUP, there are, of course, other options. Philadelphia is a relative haven for reproductive rights in a state increasingly hostile to family planning, and there are a number of clinics throughout the city that provide affordable abortion services.

But when women can't turn to their own doctors for an emotionally difficult procedure, both patients and physicians suffer. Women feel like criminals, sent to unfamiliar clinics, away from the doctors they know and trust.

Many doctors don't even know how many of their patients choose to terminate their pregnancies, according to Schreiber, since they don't tell their gynecologists and head straight to Planned Parenthood.

And by not offering comprehensive abortion services on campus, HUP discourages Penn medical students and young doctors from learning firsthand about the procedure.

"Most medical students feel like they're not exposed to elective terminations," according to Marta White, a Penn medical student who serves on the national board of Medical Students for Choice.

Abortion and family planning are increasingly absent topics in medical-school curricula nationwide, White said. Almost one third of medical schools across the country cover contraception in 15 minutes or less in pre-clinical training. This means that students who don't specialize in gynecology get very little exposure to the procedure and the issues surrounding it.

Penn's curriculum is much better: All MD students get multiple lectures on contraception and abortion, Sondheimer said.

But new doctors doing their residencies at Penn don't get that same exposure. Just as women who seek abortions sometimes feel like their choice is socially unacceptable, young gynecologists at Penn may feel like providing abortions is a risk they don't need to take.

Luckily, Schreiber and the department of obstetrics and gynecology are planning a step in the right direction.

Schreiber was hired about a year ago to expand a program called Penn Family Planning. The program will provide resources for HUP gynecologists to provide more comprehensive family planning for their patients - including abortions.

While the program is still in the works, Schreiber said she expects it to get off the ground in the next few months. It will mean more office space, an administrator hired specifically for the program and a more comprehensive family-planning curriculum for gynecology residents.

And more importantly, it means that doctors will be there for their patients before, during and after an emotionally draining procedure. It shows both women and new doctors that abortion doesn't take place on the edges of society; it's a medical procedure like any other performed at one of the top hospitals in Philadelphia.

It's also a sign that Penn Medicine is committed to patients' health, and is serious about fully educating the next generation of American doctors.

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Mara Gordon is a College junior from Washington, D.C. Her e-mail address is gordon@dailypennsylvanian.com. Flash Gordon appears on Thursdays.

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