title: Enablers of and barriers to abortion training.
abstract: BACKGROUND
  Since the legalization of abortion services in the United States, provision of abortions has remained a controversial issue of high political interest. Routine abortion training is not offered at all obstetrics and gynecology (Ob-Gyn) training programs, despite a specific training requirement by the Accreditation Council for Graduate Medical Education. Previous studies that described Ob-Gyn programs with routine abortion training either examined associations by using national surveys of program directors or described the experience of a single program.
  
  
  OBJECTIVE
  We set out to identify enablers of and barriers to Ob-Gyn abortion training in the context of a New York City political initiative, in order to better understand how to improve abortion training at other sites.
  
  
  METHODS
  We conducted in-depth qualitative interviews with 22 stakeholders from 7 New York City public hospitals and focus group interviews with 62 current residents at 6 sites.
  
  
  RESULTS
  Enablers of abortion training included program location, high-capacity services, faculty commitment to abortion training, external programmatic support, and resident interest. Barriers to abortion training included lack of leadership continuity, leadership conflict, lack of second-trimester abortion services, difficulty obtaining mifepristone, optional rather than routine training, and antiabortion values of hospital personnel.
  
  
  CONCLUSIONS
  Supportive leadership, faculty commitment, and external programmatic support appear to be key elements for establishing routine abortion training at Ob-Gyn residency training programs.
authors.forename: Maryam
authors.initials: M
authors.lastname: Guiahi
authors.forename: Sahnah
authors.initials: S
authors.lastname: Lim
authors.forename: Corey
authors.initials: C
authors.lastname: Westover
authors.forename: Marji
authors.initials: M
authors.lastname: Gold
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Westhoff