Abortion: Quality Care and Public Health Implications
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Course Date: 13 October 2014 to 24 November 2014 (6 weeks)
Abortion is a common experience for women around the world; yet, abortion is often excluded from the curricula of health professionals. This course, geared toward clinicians, health care workers, and students, aims to address this gap and will contextualize abortion care within a public health framework from both clinical and social perspectives.
Jody Steinauer, MD, MAS is an Associate Professor of Obstetrics, Gynecology and Reproductive Sciences based at San Francisco General Hospital (SFGH.) She is the Co-Director of the Fellowship in Family Planning, Director of Ob-gyn Clinical Research at SFGH, Research Director of the Kenneth J. Ryan Residency Training Program in Family Planning, and Director of Reproductive Health Education and Practice. After medical school and residency at UCSF she completed fellowships in Clinical Research and Family Planning in the departments of Medicine and Ob-gyn, respectively, during which she completed a Master’s Degree in clinical research in the Department of Epidemiology and Biostatistics. Her clinical research focuses on two areas: 1) understanding contraceptive decision-making and studying contraceptive interventions to reduce unintended pregnancy and 2) understanding risk factors for and studying interventions to prevent complications of pregnancy termination. She also has a strong focus in education. She teaches strategies to improve self-awareness, empathy, and professionalism, as well as general ob-gyn and family planning, in undergraduate, graduate and continuing medical education. She also has a research grant to study training in and provision of family planning services by physicians. Dr. Steinauer provides clinical care and teaching at San Francisco General Hospital.
a common experience for reproductive-aged women around the world. In the US, half of all pregnancies are
unintended and half of these end in abortion. (Finer 2013) Around the world,
43.8 million abortions were done in 2008 representing one fifth of all
pregnancies. (Sedgh 2012) Abortion is
safe and has lower morbidity and mortality than childbirth when carried out by
trained practitioners in sanitary conditions (Raymond 2012), but nearly half of
the abortions done in the world are unsafe, according to the WHO definition.
its universality, abortion remains controversial and inaccessible for many
women. Both the clinical and public health contexts of abortion are often
excluded from curricula in medicine, nursing, and other health professions. Restrictions
at the hospital or clinic level, and conscientious objection at the provider
level compounded with legal restrictions further reduce women’s access to
In this six-week
course, over twenty faculty from various institutions and multiple disciplines will place abortion within the context of
public health and fill in the gaps left by its exclusion from mainstream
curricula in health professions. Each week’s lectures will incorporate the
stories of women who seek abortion in order to better portray abortion significance and rationale. Other topics will include a brief
history of abortion, the clinical aspects of medication and procedural
abortions in and after the first trimester, an overview of patient-centered
abortion-care, the basics of abortion counseling, the professional obligations
of health care practitioners to ensure that women have access to safe abortion
care, and the maze of restrictions that make safe abortion care inaccessible to
In addition to video lectures, there will be
weekly quizzes, peer assessments, and optional additional content and reading
for learners who want to explore the topic further.
Will I get a Statement of Accomplishment after completing this class?
Yes. Students who successfully complete the class will have the opportunity to receive a Statement of Accomplishment signed by the instructor.
Is this class eligible for Signature Track?
Yes. Prior to the beginning of the class, and during the first two weeks, students may sign up for Signature Track to earn a Verified Certificate. Details on Signature Track are available from Coursera in their Signature Track Guidebook.
Will Continuing Education credit for practicing physicians be available for this class?
We intend to offer AMA PRA Category 1 CME Credits to practicing physicians and other health professionals who successfully complete this course. Check back when the class begins for additional details.
WEEK 1: Introduction and Abortion around the
Introduction to the public-health framework
of this course
Who has abortions, why, and how do they
History of abortion and abortion stigma
WEEK 2: Patient-centered care for
Principles of pregnancy options counseling,
abortion counseling, and informed consent
Clinical aspects of medication abortion,
aspiration abortion, post-abortion contraception, and pain management for
Guidelines for safe abortion care and the
principles of high-quality abortion care across settings
WEEK 3: Patient-centered abortion care after
the first trimester
Who has abortions after the first trimester
and how do they access care
Clinical aspects of abortion after the first
Role of patient preference in appropriate care
Complications and myths about abortion
WEEK 4: Obstacles to Accessing Safe Abortion
in the US and Worldwide
Abortion in the US after liberalization
Legislative and policy obstacles to abortion
Impact of obstacles on clinical care
Sociology of abortion especially related to
health and health-care disparities
WEEK 5: Overcoming Obstacles to Abortion
Professional responsibilities around abortion
Abortion training for health professionals
Values clarification about abortion care
Conscientious provision and refusal in
WEEK 6: Early Pregnancy Loss and Course
Patient-centered care for early pregnancy
Counseling and decision making for early
Relationship between early pregnancy loss
care and abortion care
should plan to spend 3-5 hours of time on this course each week. This time will include 2 to 2½ hours for
video lectures, 30 minutes for reading, and 30 minutes to 1 hour for assessments.