September 19, 2014
Amid Abortion Debate, the Pursuit of Science
Posted on Jan 8, 2014
By Nina Martin, ProPublica
This piece originally appeared at ProPublica.
For the last decade or so, Tracy Weitz has been one of the most prominent abortion researchers in the United States.
As director of the University of California at San Francisco’s Advancing New Standards in Reproductive Health (ANSIRH), part of the Bixby Center for Global Reproductive Health, she has co-authored seven studies in major journals in the past year alone, on topics ranging from how low-income women pay for abortions to why some women who want an abortion delay until it is too late.
This summer, one of the studies she oversaw persuaded California lawmakers to allow trained non-doctors (nurse practitioners, certified midwives, physician assistants) to perform first-trimester abortions, possibly the biggest expansion of abortion access since the Food and Drug Administration approved the abortion pill in 2000.
Now, just as some of ANSIRH’s most ground-breaking work is starting to see the light of day, Weitz is leaving the world of clinical research. She has taken a job at an organization she declined to name but where she hopes her impact on women’s reproductive health issues will be broader and deeper.
Square, Site wide
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NM: How did abortion become the main focus of your work? What is your background?
TW: I’m a medical sociologist by training. I started off trying to figure out how to deliver health care services. I did that for many years as an administrator and was frustrated that we seemed to just be rearranging the deck chairs on the Titanic. I also have a real interest in policy and politics. Abortion for me has always been the natural place in which all of those things come together. It is a political issue. It is a social issue. It is a health care issue. It is a feminist issue.
NM: What are some of the main challenges to doing abortion research in this country?
TW: The federal government has a prohibition on funding any research that involves abortion care. You cannot get funding from the National Institutes of Health to study, say, abortion techniques 2014 how to make it safer. But this ban has been interpreted very, very broadly to preclude funding anything involving abortion, even a topic like women’s emotional responses. That has left the funding of research on abortion to the philanthropic community.
Now, it’s very unusual for foundations to fund clinical research. It’s not historically what they do 2014 research is the domain of government. But in the last 10 years, there’s been recognition in the philanthropic community that in order to make progress [on reproductive rights], whether culturally or politically or in the service-delivery arena, there are research questions that we need to answer.
This [private funding] has opened up an enormous avenue for researchers who are interested in questions about abortion care, abortion policy, and abortion in American culture. But it comes with its own downside, which is that people are very suspect of research that is funded by organizations that have particular ideological agendas.
NM: As researchers, what kind of hurdles and antagonism do you face?
TW: There’s definitely a difference between the social scientists who do the research and the MDs who actually do abortions. Abortion doctors have had assassinations, barricades and constant protesters. As researchers, our safety hasn’t really been in question.
Most of the harassment comes at the level of trying to discount our academic reputation2014 suggesting that anyone who does abortion-related research who believes that abortion should be legal shouldn’t be trusted. That somehow our science is tainted, that we haven’t used good methods. That’s why we have a strong interest in being published in the peer-reviewed literature. We think that the science should be open to scrutiny. It should be put through the same kind of rigor that other clinical or social research is.
NM: Let’s talk about the study that has probably had the greatest impact so far: the one looking at whether trained non-doctors 2014 nurses, midwives, physicians assistants 2014 can safely perform vacuum-aspiration abortions in the first trimester. That study included nearly 20,000 patients throughout California 2014 one of the largest studies on abortion ever done in the United States. The study had two key findings. First, it found almost no difference in complication rates in abortions done by doctors versus non-doctors. Second, the overall rate of complications for both groups was very low 2014 much lower than abortion opponents claim. Has the study shed light on other abortion-related issues as well?
TW: Yes. One has to do with hospital transfers [patients who require hospital care after having an abortion]. We were interested in this topic, of course, because it’s a category of complication, and you want to track it. But it wasn’t something we intended to focus on.
Then states [including Texas] started passing new laws that require physicians who offer abortion care to have admitting privileges to hospitals. And we realized that, thanks to [the non-doctor] study, we had very good data showing that complications requiring transfers to hospitals are actually exceedingly rare.
Of about 20,000 patients over several years, only four were directly transferred.
NW: There’s a second study I want to talk about, which is known as the Turnaway Study. It’s a long-term study looking at what happens when women who want an abortion can’t get one. They show up at a clinic too late and are turned away.
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