The Abortion Course

Abortion is a common experience for people around the world; yet it is often excluded from the curricula of health professionals. The Abortion Course: Quality Care and Public Health Implications was created to fill in the gaps left by the exclusion of abortion from mainstream curricula.

For more resources and citations open the dropdown for each video and click on the video title in the light blue box!

IERH acknowledges the importance of inclusive language as a component of patient-centered care and we are working to improve our content. Read more here.

Public Health and Sociopolitical Context of Abortion Care in the US and Internationally

After watching these video lectures, learners will be able to:

  • Describe the epidemiology of abortion
  • List barriers to accessing timely and safe abortion services
  • Identify interventions to reduce death from unsafe abortion
  • Describe the historical trajectory of abortion in the U.S.
  • Define abortion stigma and its negative consequence

Abortion and its Multiple Contexts

IERH acknowledges the importance of inclusive language as a component of patient-centered care and we are working to improve our content. Read more here.

Video Lecture Presented by:

Carolyn Sufrin, MD, PhD
Johns Hopkins School of Medicine

Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Duden B. The women beneath the Skin: A Doctor’s Patient in Eighteenth-century Germany. Cambridge, MA: Harvard UP; 1998.
Ginsburg F, Rapp R. The politics of reproduction. Annu Rev Anthropol 1991;20:311-43.
Institute G. Guttmacher Institute: Home Page. 2015.
Weir L. Pregnancy, Risk and Biopolitics: On the Threshold of the Living Subject. USA and Canada: Taylor & Francis e-library; 2006.

Abortion and its Multiple Contexts Slide Set

Week1-MultipleContexts (Sufrin)


Slide Set from Video Lecture Presented by:

Carolyn Sufrin, MD, PhD
Johns Hopkins School of Medicine

Click to download Abortion and its Multiple Contexts (pdf)

Abortion in the International Context

Video Lecture Presented by:

Teresa DePiñeres, MD, MPH

University of California, San Francisco
Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Cleland J, Ali MM. Reproductive consequences of contraceptive failure in 19 developing countries. Obstet Gynecol 2004 Aug;104(2):314-20.
Raymond EG, Grimes DA. The comparative safety of legal induced abortion and childbirth in the United States. Obstet Gynecol 2012 Feb;119(2 Pt 1):215-9.
Sedgh G, Henshaw SK, Singh S, Bankole A, Drescher J. Legal abortion worldwide: incidence and recent trends. Perspect Sex Reprod Health 2007 Dec;39(4):216-25.
www.unpopulation.org. World Abortion Polices 2007. 2007
www.unpopulation.org. World Contraceptive Use 2009. May 2009.
Guttmacher 2008
Center for Reproductive Rights 2013
CDC 1995
Boland 2010

Abortion in the International Context Slide Set

Week1- International (DePineres)


Slide Set from Video Lecture Presented by:

Teresa DePiñeres, MD, MPH
Senior Technical Advisor Fundacion Orientame and ESAR

Click to download Abortion in the International Context

Preventing Maternal Mortality: The Role of Safe Abortion

Presented by Biftu Mengesha, MD, MAS (she/her)
University of California, San Francisco

Citations

  1. Trends in maternal mortality: 2000-2017: estimates by WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Geneva: World Health Organization; 2019.
  2. Say L, Chou D, Gemmill A, Tuncalp O, Moller AB, Daniels J, Gulmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014 Jun; 2(6):e323-33.
  3. OECD Health Data 2020. Roosa Tikkanen et al. Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries (Commonwealth Fund, Nov, 2020).
  4. Centers for Disease Control and Prevention Pregnancy-Related Mortality Surveillance data. Emily Petersen et al “Vital Signs: Pregnancy-Related Deaths, United States 2011-2015, and Strategies for Prevention, 13 States, 2013-2017,” Morbidity and Mortality Weekly Report 68 no 18 (May 10, 2018); 423-29.
  5. Centers for Disease Control and Prevention. Emily Petersen et al “Racial and Ethnic Disparities in Pregnancy-Related Deaths – United States, 2007-2016” Morbidity and Mortality Weekly Report 68 no 35 (Sept 6, 2019); 762-65.
  6. Ibis Reproductive Health and Center for Reproductive Rights, “Evaluating Priorities: Measuring Women’s and Children’s Health and Wellbeing against Abortion Restrictions in the States,” (2017).
  7. Hawkind SS, Ghiani M, Harper S, Baum CF, Kaufman JS. Impact of state-lvel changes on maternal mortality: a population-based, quasi-experimental study.” American Journal of Preventive Medicine, 2019.
  8. Rini CK, Dunkel-Schetter C, Wadhwa PD, Sandman CA. Psychological adaptation and birth outcomes: The role of personal resources, stress, and sociocultural context in pregnancy. Health Psychol 1999; 18:33-45.
  9. Medoff MH. The relationship between restrictive state abortion laws and postpartum depression. Soc. Work Public Health. 2014; 29:481-90.
  10. Foster DG, Biggs MA, Raifman S, Gipson J, Kimport K, Rocca CH. Comparison of Health, Development, Maternal Bonding, and Poverty among Children Born after Denial of Abortion vs Pregnancies Subsequent to an Abortion. JAMA Pediatr. 2018; 172: 1053-60.
  11. Susan A Cohen, “Facts and Consequences: Legality, Incidence, and Safety of Abortion Worldwide.” Guttmacher Policy Review 12(4). 2009. https://www.guttmacher.org/gpr/2009/11/facts-and-consequences-legality-incidence-and-safety-abortion-worldwide.

The History of Abortion in the US prior to Legalization

IERH acknowledges the importance of inclusive language as a component of patient-centered care and we are working to improve our content. Read more here.

Video Lecture Presented by:

University of California, San Francisco
Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Contraception and Abortion from the Ancient World to the Renaissance John M. Riddle | Harvard University Press. 2015 [cited; Available from: http://www.hup.harvard.edu/catalog.php?isbn=9780674168763
Carole J. Doctors of Conscience: The Struggle to Provide Abortion Before and After Roe V. Wade. Beacon Press; 1996. p. 250.
Cates W, Grimes DA, Schulz KF. The public health impact of legal abortion: 30 years later. Perspect Sex Reprod Health 2003 2003 Jan-Feb;35(1):25-8
Paul M, Lichtenberg S, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care: Wiley-Blackwell; May 2009.
Devereux, A typological study of abortion in 350 primitive, ancient and preindustrial societies, 1954.
NY Times, Nov. 21, 1996.

The History of Abortion Slide Set

Week 1- HistoryAbortion (Joffe)


Slide Set from Video Lecture Presented by:

Carole Joffe, PhD
University of California, San Francisco

Click to download The History of Abortion  (pdf)

EXPLAINED: Abortion On Screen

Gretchen Sisson and Katrina Kimport, of the University of California San Francisco, explain the most up-to-date research on abortion and it’s portrayal in film and television.

For more information, watch the extended lecture version and download the video companion materials.

 

The following links provided the research used in this video:

Sisson G, Kimport K. “Depicting abortion access on American television, 2005-2015.” Feminism and Psychology. [in press]
Sisson G, Kimport K. “Doctors and Witches, Conscience and Violence: Abortion Provision on American Television.Perspect Sex Reprod Health. 2016;48(4):161-8.
Sisson G, Kimport K. “Facts and fictions: Characters seeking abortion on American television, 2005-2014.Contraception. 2016;93(5):446-51.

Abortion Stigma: What is it and how does it affect sexual and reproductive health?

IERH acknowledges the importance of inclusive language as a component of patient-centered care and we are working to improve our content. Read more here.

Video Lecture Presented by:

University of California, San Francisco
Click here to download this video lecture

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Kumar A, Hessini L, Mitchell EM. Conceptualising abortion stigma. Cult Health Sex 2009 Aug;11(6):625-39.
Major B, Gramzow RH. Abortion as stigma: cognitive and emotional implications of concealment. J Pers Soc Psychol 1999 Oct;77(4):735-45.

Abortion Stigma: What is it and how does it affect women’s health? Slide Set

Week 1- Stigma (Freedman)


Slide Set from Video Lecture Presented by:

Lori Freedman, PhD
University of California, San Francisco

Click to download Abortion Stigma: What is it and how does it affect women’s health? (pdf)

Abortion in the US from Legalization to the 2010s

Video Lecture Presented by:

University of California, San Francisco

Additional Resource

New York Times: “A Brief History of Deadly Attacks on Abortion Providers.”

Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish. Click the Closed Captions button on video lectures to access subtitles. 

Angell M. Column: Where are the doctors? USA Today News. 2015 5/15/2012

Abortion in the U.S. after Legalization Slide Set

Week 2- US after Legalization (Steinauer)


Slide Set from Video Lecture Presented by:

Carole Joffe, PhD
University of California, San Francisco

Click to download Abortion in the U.S. after Legalization  (pdf)

When Abortion is Not Available: Abortion is Essential Healthcare

Presented by Ana Delgado, CNM (she/her)

Supplemental Video Content

EXPLAINED: Abortion Safety in the United States Lecture
EXPLAINED: Targeted Regulation of Abortion Providers Lecture

Resources

Safe abortion: technical and policy guidance for health systems

ACOG Committee Opinion 612

ACGME Clarification on Requirements Regarding Family Planning

The International Federation of Gynecology and Obstetrics

World Health Organization

Citations

  1. National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. https://doi.org/10.17226/24950.
  2. Abortion training and education. Committee Opinion No. 612. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;124:1055–9. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/11/abortion-training-and-education
  3. ACGME Clarification on Requirements Regarding Family Planning and Contraception. Accreditation Council for Graduate Medical Education, 2017. http://www.acgme.org/portals/0/pfassets/programresources/220_obgyn_abortion_training_clarification.pdf

Abortion Rights in the United States Through 2014

Video Lecture Presented by:

Maya Manin, JD
University of San Francisco

Note: This video lecture was filmed in the summer of 2014. Laws and polices may have shifted since filming.

Additional Resource

Guttmacher, Restrictions by State.

Click to download this video lecture

Abortion Rights in the United States Slide Set

Week3-Rights (Manian)


Slide Set from Video Lecture Presented by:

Maya Manian, JD
University of San Francisco School of Law

Click to download Abortion Rights in the United States (pdf)

Global Obstacles to Abortion

IERH acknowledges the importance of inclusive language as a component of patient-centered care and we are working to improve our content. Read more here.

Video Presented by:

University of California, San Francisco

Additional Resources

The Center for Reproductive Health, Worldwide Abortion Laws.

Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Citations:

Center for Reproductive Rights, 2014
Wulf D, Singh S. An Overview of Clandestine Abortion in Latin America. Guttmacher Institute; 1996.
Mondragon y Kalb M, Ahued Ortega A, Morales Velazquez J, Diaz Olavarrieta C, Valencia Rodriguez J, Becker D, et al. Patient characteristics and service trends following abortion legalization in Mexico City, 2007-10. Stud Fam Plann 2011 Sep;42(3):159-66.
Gynuity Health Projects » Research and Technical Assistance Organization. 2015 [cited; Available from: http://gynuity.org/

Global Obstacles to Abortion Slide Set

Week1- GlobalOverview (Grossman)


Slide Set from Video Lecture Presented by:

Dan Grossman, MD
University of California, San Francisco

Click to download Global Obstacles to Abortion (pdf)

Counseling in Abortion Care

After watching these video lectures, learners will be able to:

  • Deliver pregnancy test results in a patient centered manner
  • Provide objective and compassionate pregnancy options counseling
  • Practice patient communication skills

Decision Counseling for Positive Pregnancy Test Results

Video Lecture Presented by:
Alissa Perrucci, PhD, MPH
San Francisco General Hospital, Women’s Options Center
Click here to download this video lecture 
Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 
Backline. 2015 [cited; Available from: http://yourbackline.org/
Rachel Herndon, MSW, Adoption Connection

Decision Counseling for Positive Pregnancy Test Results

Week2-Counseling (Perrucci)


Slide Set from Video Lecture Presented by:

Alissa Perrucci, PhD
University of California, San Francisco

Click to download Decision Counseling for Positive Pregnancy Test Results (pdf)

The Framework: The Approach

The Approach Summary :

  • Patient-centered counseling uses this approach: Listen, don’t assume, self-reflect.
  • Patients and providers may not share understanding of complex medical terms.

Informed Consent, Decision Assessment, and Counseling in Abortion Care

Video Lecture Presented by:
Alissa Perrucci, PhD, MPH
San Francisco General Hospital, Women’s Options Center
Click here to download this video lecture 
Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 
Citations:
Cozzarelli C, Sumer N, Major B. Mental models of attachment and coping with abortion. J Pers Soc Psychol 1998 Feb;74(2):453-67.
Major B, Appelbaum M, Beckman L, Dutton MA, Russo NF, West C. Abortion and mental health: Evaluating the evidence. Am Psychol 2009 Dec;64(9):863-90.
Major B, Richards C, Cooper ML, Cozzarelli C, Zubek J. Personal resilience, cognitive appraisals, and coping: an integrative model of adjustment to abortion. J Pers Soc Psychol 1998 Mar;74(3):735-52.
Trybulski J. Women and abortion: the past reaches into the present. J Adv Nurs 2006 Jun;54(6):683- 90.

Informed Consent, Decision Assessment, and Counseling in Abortion Care Slide Set

Week 2- Consent (Perrucci)


Slide Set from Video Lecture Presented by:

Alissa Perrucci, PhD
University of California, San Francisco

Click to download Informed Consent, Decision Assessment, and Counseling in Abortion Care (pdf)

Counseling for Pregnancy Ambivalence

Video Lecture Presented by:
Alissa Perrucci, PhD, MPH
San Francisco General Hospital, Women’s Options Center
Click here to download this video lecture 

Click here to download the Counseling for Pregnancy Ambivalence Lesson Plan/Facilitator Guide with Quiz.

Citations

Additional Resource

Abortions Welcome is a spiritual companion including meditations, rituals, stories, and scripture curated for different parts of the abortion process.

Patient Decision Making about Abortion after the First Trimester

Video Lecture Presented by:

University of California San Francisco
Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Citations:

Newmann S, Dalve-Endres A, Drey EA, Planning SoF. Clinical guidelines. Cervical preparation for surgical abortion from 20 to 24 weeks’ gestation. Contraception 2008 Apr;77(4):308-14
Jones RK, Kooistra K. Abortion Incidence and Access to Services In the United States. Perspectives on Sexual and Reproductive Health: Guttmacher Institute; 2008
Cowett AA, Golub RM, Grobman WA. Cost-effectiveness of dilation and evacuation versus the induction of labor for second-trimester pregnancy termination. Am J Obstet Gynecol 2006 Mar;194(3):768-73.
Schechtman KBP, Gray DLM, Baty JD, Rothman SMM. Decision-Making for Termination of Pregnancies With Fetal An… : Obstetrics & Gynecology. 2015.
Drey EA, Foster DG, Jackson RA, Lee SJ, Cardenas LH, Darney PD. Risk factors associated with presenting for abortion in the second trimester. Obstet Gynecol 2006 Jan;107(1):128-35.
Foster DG, Jackson RA, Cosby K, Weitz TA, Darney PD, Drey EA. Predictors of delay in each step leading to an abortion. Contraception 2008 Apr;77(4):289-93.
Wyldes MP, Tonks AM. Termination of pregnancy for fetal anomaly: a population-based study 1995 to 2004. Bjog 2007 May;114(5):639-42.
Vargas J, Diedrich J. Second-trimester induction of labor. Clin Obstet Gynecol 2009 Jun;52(2):188-97.
Liu S, Joseph KS, Kramer MS, Allen AC, Sauve R, Rusen ID, et al. Relationship of prenatal diagnosis and pregnancy termination to overall infant mortality in Canada. Jama 2002 Mar 27;287(12):1561-7.
Henshaw RC, Naji SA, Russell IT, Templeton AA. Comparison of medical abortion with surgical vacuum aspiration: women’s preferences and acceptability of treatment. Bmj 1993 Sep 18;307(6906):714-7.
Harwood B, Nansel T. Quality of life and acceptability of medical versus surgical management of early pregnancy failure. Bjog 2008 Mar;115(4):501-8.
Creinin MD. Randomized comparison of efficacy, acceptability and cost of medical versus surgical abortion. Contraception 2000 Sep;62(3):117-24.
Bryant AG, Grimes DA, Garrett JM, Stuart GS. Second-trimester abortion for fetal anomalies or fetal death: labor induction compared with dilation and evacuation. Obstet Gynecol 2011 Apr;117(4):788-92.
Kelly T, Suddes J, Howel D, Hewison J, Robson S. Comparing medical versus surgical termination of pregnancy at 13-20 weeks of gestation: a randomised controlled trial. Bjog 2010 Nov;117(12):1512-20
Kaltreider NB, Goldsmith S, Margolis AJ. The impact of midtrimester abortion techniques on patients and staff. Am J Obstet Gynecol 1979 Sep 15;135(2):235-8.
Kerns J, Vanjani R, Freedman L, Meckstroth K, Drey EA, Steinauer J. Women’s decision making regarding choice of second trimester termination method for pregnancy complications. Int J Gynaecol Obstet 2012 Mar;116(3):244-8.
Steinauer J, Landy U, Filippone H, Laube D, Darney PD, Jackson RA.Predictors of abortion provision among practicing obstetrician-gynecologists: a national survey. Am J Obstet Gynecol 2008 Jan;198(1):39.e1-6.
Jones BS, Weitz TA. Legal barriers to second-trimester abortion provision and public health consequences. Am J Public Health 2009 Apr;99(4):623-30.
Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Timing of steps and reasons for delays in obtaining abortions in the United States. Contraception 2006 Oct;74(4):334-44.

Patient Decision Making About Abortion After the First Trimester Slide Set

Week4-Decision (Kerns)


Slide Set from Video Lecture Presented by:

Jennifer Kerns, MD, MPH
University of California, San Francisco

Click to download Patient Decision Making About Abortion After the First Trimester (pdf)

 

Safe, High Quality Provision of Clinical Abortion Care

After watching these video lectures, learners will be able to:

  • Describe the methods of abortion throughout pregnancy
  • Define the differences between clinically unsafe and safe abortion, regardless of legal status
  • Discuss unique challenges for people seeking abortion after the first trimester
  • Discuss complications associated with abortion, and how to mitigate or manage them, and common abortion myths
  • Recognize that clinicians are under no obligation to report patients to law enforcement related to self-managed abortion

Medication Abortion

Presented by: Lealah Pollock MD, MS

Family and Community Medicine
University of California, San Francisco

Click here to download this video lecture  and here to download the lesson plan/facilitator guide with quiz.

Additional Resources

ACOG Guideline on First Trimester Abortion.

Citations

  • Teal, et al. Contraception. 2007
  • Guttmacher Institute – State Laws & Policies
  • Johnson JE. J Pers Soc Psychol, 1973
  • Davis A. et al. JAMWA, 2000

First Trimester Aspiration Abortion

Presented by: Sanithia L. Williams, MD
University of California, San Francisco

Click here to download this video lecture and here to download the lesson plan/facilitator guide with quiz.

Additional Resources

Society of Family Planning Guidelines on Cervical dilation before first-trimester surgical abortion (<14 weeks’ gestation).

Society of Family Planning Clinical Recommendations: Contraception After Surgical Abortion.

Citations

Abortion After the First Trimester

Video Lecture Presented by:

University of California, San Francisco

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Abortion After the First Trimester Slide Set

Week4-After1stTri (Drey)


Slide Set from Video Lecture Presented by:

Eleanor Drey, MD, EdM
University of California, San Francisco

Click to download Abortion After the First Trimester (pdf)

Cervical Preparation with Osmotic Dilators

Presented by Patricia A. Lohr, MD, MPH

Medical Director, British Pregnancy Advisory Service

Dilation and Evacuation Animation

Presented by Patricia A. Lohr, MD, MPH

Medical Director, British Pregnancy Advisory Service

Myths about Abortion Complications

IERH acknowledges the importance of inclusive language as a component of patient-centered care and we are working to improve our content. Read more here.

Video Lecture Presented by:
Jen Kerns, MD, MPH
University of California San Francisco
Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 
Citations:
Institute G. Induced Abortion in the United States. July 2014
Institute G. Guttmacher Policy Review 16(2): Table of Contents. 2015
Bazelon E. Is There a Post-Abortion Syndrome? – New York Times. Jan 2007 [cited; Available from:
http://www.nytimes.com/2007/01/21/magazine/21abortion.t.html?pagewanted=all&_r=0
Jagannathan R. Relying on surveys to understand abortion behavior: some cautionary evidence. Am J Public Health 2001 Nov;91(11):1825-31.
Parazzini F, Ricci E, Chiaffarino F, Cipriani S, Tozzi L, Fedele L. Does induced abortion increase the risk of preterm birth? Results from a case-control study. Gynecol Obstet Invest 2010;69(1):40-5.
Henriet L, Kaminski M. Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal survey. Bjog 2001 Oct;108(10):1036-42.
Moreau C, Kaminski M, Ancel PY, Bouyer J, Escande B, Thiriez G, et al. Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study. Bjog 2005 Apr;112(4):430-7.
Martius JA, Steck T, Oehler MK, Wulf KH. Risk factors associated with preterm (<37+0 weeks) and early preterm birth (<32+0 weeks): univariate and multivariate analysis of 106 345 singleton births from the 1994 statewide perinatal survey of Bavaria. Eur J Obstet Gynecol Reprod Biol 1998 Oct;80(2):183-9.
Raatikainen K, Heiskanen N, Heinonen S. Induced abortion: not an independent risk factor for pregnancy outcome, but a challenge for health counseling. Ann Epidemiol 2006 Aug;16(8):587-92.
Kalish 2002
Freak-Poli R, Chan A, Tucker G, Street J. Previous abortion and risk of pre-term birth: a populations study. J Matern Fetal Neonatal Med 2009 Jan;22(1):1-7.
Jackson JE, Grobman WA, Haney E, Casele H. Mid-trimester dilation and evacuation with laminaria does not increase the risk for severe subsequent pregnancy complications. Int J Gynaecol Obstet 2007 Jan;96(1):12-5.
Melbye M, Wohlfahrt J, Olsen JH, et al. Induced Abortion and the Risk of Breast Cancer. New England Journal of Medicine. 1997;336(2):81-85. doi:10.1056/NEJM199701093360201
Lindefors-Harris BM, Eklund G, Adami HO, et al. Response bias in a case-control study: analysis utilizing comparative data concerning legal abortions from two independent Swedish studies. Am J Epidemiol 1991;134:1003-8.
Steinberg JR, Russo NF. Evaluating research on abortion and mental health. Contraception. 2009;80(6):500-503. doi:10.1016/j.contraception.2009.06.003
Santorum R. S.3 – 108th Congress (2003-2004): Partial-Birth Abortion Ban Act of 2003. Published November 5, 2003. Accessed December 9, 2021. https://www.congress.gov/bill/108th-congress/senate-bill/3
Kelly K. The spread of ‘Post Abortion Syndrome’ as social diagnosis. Soc Sci Med 2014 Feb;102:18-25.
Weitz TA, Moore K, Gordon R, Adler N. You say “regret” and I say “relief”: a need to break the polemic about abortion. Contraception. United States; 2008. p. 87-9.
Reframing Regret | Humanities | JAMA | JAMA Network. Accessed December 9, 2021. https://jamanetwork.com/journals/jama/article-abstract/1810383
Stotland NL. Psychosocial aspects of induced abortion. Clin Obstet Gynecol. 1997;40(3):673-686. doi:10.1097/00003081-199709000-00026
Lee SJ, Ralston HJP, Drey EA, Partridge JC, Rosen MA. Fetal PainA Systematic Multidisciplinary Review of the Evidence. JAMA. 2005;294(8):947-954. doi:10.1001/jama.294.8.947

Myths about Abortion Complications Slide Set

Week4-Myths (Kerns)


Slide Set from Video Lecture Presented by:

Jennifer Kerns, MD, MPH
University of California, San Francisco

Click to download Myths about Abortion Complications (pdf)

Complications of Procedural Abortion & Prevention Strategies

Presented by Lara Crystal-Ornelas, MD (she/her/ella)
University of California, San Francisco

Citations

  • Allen Contraception 2007
  • Autry et al. AJOG 2002
  • Bartz et al. Obstetrics and Gynecology 2013
  • Ben-Ami et al. AJOG 2009
  • Darney, Phillip D., and Richard L. Sweet. “Routine intraoperative ultrasonography for second trimester abortion reduces incidence of uterine perforation.” Journal of ultrasound in medicine 8.2 (1989): 71-75.
  • Fakih et al. Contraception 1986
  • Frick et al. Obstet Gynecol 2012
  • Hakim-Elahi et al. Obstet Gynecol 1990
  • Hern et al. Obstet Gynecol 1984
  • Kapp Cochrane Syst Database Rev 2010
  • Kapp et al. Contraception 2012
  • Nichols et al. J Reprod Med 2002;
  • Paul et al. NAF Textbook 2009
  • Peterson et al. Obstet Gynecol 1983
  • Serapio ET, Pearlson GA, Drey EA, Kerns JL. Estimated versus measured blood loss during dilation and evacuation: an observational study. Contraception. 2018 May;97(5):451-455. doi: 10.1016/j.contraception.2018.01.008. Epub 2018 Feb 2. PMID: 29410259.

Managing Complications of Procedural Abortion

Presented by Josephine Urbina, MD (she/her/ella)
University of California, San Francisco

Citations

  • Society of Family Planning, Management of Postabortion Hemorrhage, Contraception 2013
  • Society ofFamily Planning, Management of Postabortion Hemorrhage, Contraception 2013
  • Zane S, Creanga AA, Berg CJ, Pazol K, Suchdev DB, Jamieson DJ, Callaghan WM. Abortion-Related Mortality in the United States: 1998-2010. Obstet Gynecol. 2015 Aug;126(2):258-265. doi: 10.1097/AOG.0000000000000945. PMID: 26241413; PMCID: PMC4554338.
  • Peterson WF, Berry FN, Grace MR, Gulbranson CL. Second-trimester abortion by dilatation and evacuation: an analysis of 11,747 cases. Obstet Gynecol. 1983 Aug;62(2):185-90. PMID: 6866362.
  • Fox MC, Hayes JL; Society of Family Planning. Cervical preparation for second-trimester surgical abortion prior to 20 weeks of gestation. Contraception. 2007 Dec;76(6):486-95. doi: 10.1016/j.contraception.2007.09.004. Epub 2007 Nov 9. PMID: 18061709.
  • Diedrich J, Steinauer J. Complications of surgical abortion. Clin Obstet Gynecol. 2009 Jun;52(2):205-12. doi: 10.1097/GRF.0b013e3181a2b756. PMID: 19407527.
  • Bartlett LA, Berg CJ, Shulman HB, Zane SB, Green CA, Whitehead S, Atrash HK. Risk factors for legal induced abortion-related mortality in the United States. Obstet Gynecol. 2004 Apr;103(4):729-37. doi: 10.1097/01.AOG.0000116260.81570.60. PMID: 15051566.
  • Kerns JL, Ti A, Aksel S, Lederle L, Sokoloff A, Steinauer J. Disseminated Intravascular Coagulation and Hemorrhage After Dilation and Evacuation Abortion for Fetal Death. Obstet Gynecol. 2019 Oct;134(4):708-713. doi: 10.1097/AOG.0000000000003460. PMID: 31503145.
  • Kerns J, Steinauer J. Management of postabortion hemorrhage: release date November 2012 SFP Guideline #20131. Contraception. 2013 Mar;87(3):331-42. doi: 10.1016/j.contraception.2012.10.024. Epub 2012 Dec 4. PMID: 23218863.
  • Newmann S, Dalve-Endres A, Drey EA; Society of Family Planning. Clinical guidelines. Cervical preparation for surgical abortion from 20 to 24 weeks’ gestation. Contraception. 2008 Apr;77(4):308-14. doi: 10.1016/j.contraception.2008.01.004. Epub 2008 Mar 4. PMID: 18342657.
  • Shaw KA, Lerma K. Update on second-trimester surgical abortion. Curr Opin Obstet Gynecol. 2016 Dec;28(6):510-516. doi: 10.1097/GCO.0000000000000318. PMID: 27684047.
  • Shaw KA, Lerma K, Shaw JG, Scrivner KJ, Hugin M, Hopkins FW, Blumenthal PD. Preoperative effects of mifepristone for dilation and evacuation after 19 weeks of gestation: a randomised controlled trial. BJOG. 2017 Dec;124(13):1973-1981. doi: 10.1111/1471-0528.14900. Epub 2017 Sep 27. PMID: 28834186.
  • Borgatta L, Roncari D, Sonalkar S, Mark A, Hou MY, Finneseth M, Vragovic O. Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14-16 weeks: a randomized trial. Contraception. 2012 Nov;86(5):567-71. doi: 10.1016/j.contraception.2012.05.002. Epub 2012 Jun 6. PMID: 22682721.
  • Darney PD, Sweet RL. Routine intraoperative ultrasonography for second trimester abortion reduces incidence of uterine perforation. J Ultrasound Med. 1989 Feb;8(2):71-5. doi: 10.7863/jum.1989.8.2.71. PMID: 2651693.
  • Pridmore BR, Chambers DG. Uterine perforation during surgical abortion: a review of diagnosis, management and prevention. Aust N Z J Obstet Gynaecol. 1999 Aug;39(3):349-53. doi: 10.1111/j.1479-828x.1999.tb03413.x. PMID: 10554950.
  • Sawaya GF, Grady D, Kerlikowske K, Grimes DA. Antibiotics at the time of induced abortion: the case for universal prophylaxis based on a meta-analysis. Obstet Gynecol. 1996 May;87(5 Pt 2):884-90. PMID: 8677129.
  • Whitehouse K, Tschann M, Soon R, Davis J, Micks E, Salcedo J, Savala M, Kaneshiro B. Effects of Prophylactic Oxytocin on Bleeding Outcomes in Women Undergoing Dilation and Evacuation: A Randomized Controlled Trial. Obstet Gynecol. 2019 Mar;133(3):484-491. doi: 10.1097/AOG.0000000000003104. Erratum in: Obstet Gynecol. 2019 Jun;133(6):1287-1288. PMID: 30741801.
  • Kerns JL, Pearlson G, Mengesha B, Harter K, Jackson RA, Drey EA. A randomized controlled trial of methylergonovine prophylaxis after dilation and evacuation abortion. Contraception. 2021 Feb;103(2):116-120. doi: 10.1016/j.contraception.2020.10.009. Epub 2020 Oct 17. PMID: 33075332.
  • Steinauer JE, Diedrich JT, Wilson MW, Darney PD, Vargas JE, Drey EA. Uterine artery embolization in postabortion hemorrhage. Obstet Gynecol. 2008 Apr;111(4):881-9. doi: 10.1097/AOG.0b013e3181685780. PMID: 18378747.

When Abortion is Not Available: Self-management of Abortion

Presented by Bhavik Kumar, MD, MPH (he/him)

Supplemental Video Content

Global Obstacles to Abortion

Guidelines for Safe Abortion Care

EXPLAINED: Abortion Safety in the United States Lecture

Additional Resources

Access, Delivered: A Toolkit for Providers Offering Medication Abortion

IPAS Abortion Self-Care

IPAS Medical Abortion and Self-Managed Abortion Human Rights

Eukiapp

Women Help Women

Women on Web

American Bar Association’s resolution opposes criminalization of abortion or miscarriage

Citations

  1. An Overview of Abortion Laws. Guttmacher 2020. https://www.guttmacher.org/state-policy/explore/overview-abortion-laws#
  2. Singh S, Remez L, Sedgh G, Kwok L, Onda T. Abortion Worldwide 2017: Uneven Progress and Unequal Access. Guttmacher 2018. https://www.guttmacher.org/report/abortion-worldwide-2017
  3. Donovan Self-Managed Medication Abortion: Expanding the Available Options for U.S. Abortion Care. Guttmacher 2018; 21.
  4. Jones R, Donovan M. Self-managed abortion may be on the rise, but probably not a significant driver of the overall decline in abortion. Guttmacher 2019. https://www.guttmacher.org/article/2019/11/self-managed-abortion-may-be-rise-probably-not-significant-driver-overall-decline
  5. Self-Managed Abortion- What Healthcare Workers Need to Know. Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health.
  6. Baker C. Self-Managed Abortion Is Medically Very Safe. But Is It Legally Safe? MS Magazine 2020. https://msmagazine.com/2020/04/01/self-managed-abortion-is-medically-very-safe-but-is-it-legally-safe/
  7. Worldwide, an Estimated 25 Million Unsafe Abortions Occur Each Year. Guttmacher and WHO News Release, 2017. https://www.guttmacher.org/news-release/2017/worldwide-estimated-25-million-unsafe-abortions-occur-each-year
  8. Harris L, Grossman D. Complications of Unsafe and Self-Managed Abortion. N Engl J Med 2020; 382:1029-1040 https://pubmed.ncbi.nlm.nih.gov/32160664/
  9. Statement on Decriminalization of Self-Induced Abortion. ACOG 2017. https://www.acog.org/clinical-information/policy-and-position-statements/position-statements/2017/decriminalization-of-self-induced-abortion
  10. Fulfilling Roe’s Promise: 2019 Update. If/When/How 2019. https://www.ifwhenhow.org/resources/roes-unfinished-promise-2019-update/
  11. When Self-Abortion is a Crime. National Institute for Reproductive Health 2017. https://www.nirhealth.org/decriminalize/
  12. World Health Organization. (2012) Safe abortion: technical and policy guidance for health systems – 2nd ed. https://apps.who.int/iris/bitstream/handle/10665/70914/9789241548434_eng.pdf?sequence=1

When Abortion is Not Available: Caring for Patients After Self-management of Abortion

Presented by Biftu Mengesha, MD, MAS (she/her)

Supplemental Video Content

Early Pregnancy Loss: Diagnosis and Evaluation

Early Pregnancy Loss: At-home-management

Early Pregnancy Loss: Medication Management

Medication Abortion

Resources

 If/When/How

Self-Managed Abortion- What Healthcare Workers Need to Know. Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health

Perspectives on self-managed abortion among providers in hospitals along the Texas–Mexico border

Citations

  1. Conti J, Cahill EP. Self-managed abortion. Curr Opin Obstet Gynecol. 2019 Dec;31(6):435-440.
  2. If When How Lawyering for Reproductive Justice. “Self-Managed Abortion, the Law, and COVID-19 Fact Sheet.” https://www.ifwhenhow.org/wp-content/uploads/2020/04/20_04_Final_SMA_TheLaw_COVID-19_FactSheet_PDF.pdf
  3. Center for Reproductive Rights. “Medical Abortion and Self-Managed Abortion: Frequently Asked Questions on Health and Human Rights.” Dec 2020. https://reproductiverights.org/document/medical-abortion-self-managed-abortion-faq
  4. Donovan MK. Self-Managed Medication Abortion: Expanding the Available Options for US Abortion Care. Guttmacher Institute. Volume 21. Oct 2018.
  5. Rowan A. Prosecuting Women for Self-Inducing Abortion: Counterproductive and Lacking Compassion. Guttmacher Institute. Volume 18, Issue 3. Sept 2015.

Professionalism, Providers, and Training in Abortion Care

After watching these video lectures, learners will be able to:

  • Understand the professional responsibilities of health-care providers caring for women seeking abortion
  • Recognize appropriate and inappropriate applications of “conscience” in the setting of abortion care
  • Understand the importance of abortion provision in the primary care setting
  • Identify steps to take to enhance professionalism in personally challenging clinical encounter
  • Describe the importance of integrating abortion into training for health professions learners and how to teach professionalism in abortion care

Physicians’ Professional Responsibilities in Abortion Care

Video Lecture Presented by:

Jody Steinauer, MD, MAS
University of California, San Francisco

Click here to download this video lecture

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Opinion AC. ACOG Committee Opinion No. 385. The Limits of Conscientious Refusal in Reproductive Medicine. American College of Obstetricians and Gynecologists; 2007.

Curlin FA, Lawrence RE, Chin MH, Lantos JD. Religion, conscience, and controversial clinical practices. N Engl J Med 2007 Feb;356(6):593-600.

Johnson BR, Kismödi E, Dragoman MV, Temmerman M. Conscientious objection to provision of legal abortion care. Int J Gynaecol Obstet 2013 Dec;123 Suppl 3:S60-2.

Physicians’ Professional Responsibilities in Abortion Care Slide Set

Week2-Responsibilities (Steinauer)

 

Slide Set from Video Lecture Presented by:

Jody Steinauer, MD, MAS
University of California, San Francisco

Click to download Physicians’ Professional Responsibilities in Abortion Care (pdf)

Nursing Roles in Abortion Care

Video Lecture Presented by:

Amy Levi, PhD, CNM, WHNP-BC

University of New Mexico

Additional Resources

Revised code of Ethics in 2015

The ICN code of Ethics for Nurses

Click here to download this video lecture

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Abortion Train. 20 Cavendish Square London: Royal College of Nursing; 2008
Who we are. 2015 [cited; Available from: http://www.icn.ch/who-we-are/who-we-are/
Association AN. Code of Ethics for Nurses. 2015 [cited; Available from: http://www.nursingworld.org/codeofethics

Nursing Roles in Abortion Care: Clinical Responsibility and Professional Ethics Slide Set

Week2-Nursing (Levi)


Slide Set from Video Lecture Presented by:

Amy Levi, PhD, CNM, WHNP-BC
Albers Professor of Midwifery
University of New Mexico

Click to download Nursing Roles in Abortion Care: Clinical Responsibility and Professional Ethics (pdf)

 

Teaching Professionalism for Abortion Care

Video Lecture Presented by:

Jody Steinauer, MD, MAS
University of California, San Francisco

Click here to download this video lecture

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Citations:

MedEdPortal. [cited; Available from: https://www.mededportal.org/
Ipas | Abortion attitude transformation: A values clarification toolkit for global audiences. 2011 [cited; Available from: http://www.ipas.org/en/Resources/Ipas%20Publications/Abortion-attitudetransformation–A-values-clarification-toolkit-for-global-audiences-2.aspx
Innovating Education in Reproductive Health. 2015 [cited; Available from: http://www.innovatingeducation.org/
The Reproductive Health Access Project. 2015 [cited; Available from: http://www.reproductiveaccess.org/
Neumann M, Edelhäuser F, Tauschel D, Fischer MR, Wirtz M, Woopen C, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med 2011 Aug;86(8):996-1009.
Provide. Bringing a Referrals Training to Your Site – Provide. 2015
Shapiro J. Walking a mile in their patients’ shoes: empathy and othering in medical students’ education. Philos Ethics Humanit Med 2008;3:10.
Adapted from Obtaining Abortion Training: a Guide for Informed Decision-Making. NAF, 1998.

Teaching Professionalism for Abortion Care Slide Set

Week2-Professionalism (Steinauer)


Slide Set from Video Lecture Presented by:

Jody Steinauer, MD, MAS
University of California, San Francisco

Click to download Teaching Professionalism for Abortion Care (pdf)

The Importance of Integrated Abortion Training in Medical and Nursing Education

Video Lecture Presented by:
Jody Steinauer, MD, MAS

University of California, San Francisco

Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

The Importance of Integrated Abortion Training in Medical and Nursing Education Slide Set

Week5-Training (Steinauer)


Slide Set from Video Lecture Presented by:

Jody Steinauer, MD, MAS
University of California, San Francisco

Click to download The Importance of Integrated Abortion Training in Medical and Nursing Education (pdf)

Abortion in the Primary Care Setting

Video Lecture Presented by:

University of California, San Francisco
Click here to download this video lecture

Citations:

Jones RK, Jerman J. Abortion incidence and service availability in the United States, 2011. Perspect Sex Reprod Health 2014 Mar;46(1):3-14.
Robert Graham Center
O’Connell K, Jones HE, Simon M, Saporta V, Paul M, Lichtenberg ES. First-trimester surgical abortion practices: a survey of National Abortion Federation members. Contraception 2009 May;79(5):385-92.
Paul M, Nobel K, Goodman S, Lossy P, Moschella JE, Hammer H. Abortion training in three family medicine programs: resident and patient outcomes. Fam Med 2007 Mar;39(3):184-9.
Westfall JM, Sophocles A, Burggraf H, Ellis S. Manual vacuum aspiration for first-trimester abortion. Arch Fam Med 1998 Nov-Dec;7(6):559-62.
Godfrey EM, Rubin SE, Smith EJ, Khare MM, Gold M. Women’s preference for receiving abortion in primary care settings. J Womens Health (Larchmt) 2010 Mar;19(3):547-53.
Rubin SE, Godfrey E, Gold M. Patient attitudes toward early abortion services in the family medicine clinic. J Am Board Fam Med 2008 Mar-Apr;21(2):162-4.
Shochet T, Trussell J. Determinants of demand: method selection and provider preference among US women seeking abortion services. Contraception 2008 Jun;77(6):397-404.
Herbitter C, Greenberg M, Fletcher J, Query C, Dalby J, Gold M. Family planning training in US family medicine residencies. Fam Med 2011 Sep;43(8):574-81.
Dehlendorf CE, Grumbach K. Medical liability insurance as a barrier to the provision of abortion services in family medicine. Am J Public Health 2008 Oct;98(10):1770-4.

Abortion in the Primary Care Setting Slide Set

Week5-Primary (Dehlendorf)


Slide Set from Video Lecture Presented by:

Christine Dehlendof, MD, MAS
University of California, San Francisco

Click to download Abortion in the Primary Care Setting (pdf)

Conscientious Provision and Refusal of Abortion Care

Video Lecture Presented by:

University of California, San Francisco

Additional Resources

Guttmacher state laws and policy regarding conscientious refusal in the United States

FIGO guidelines on conscientious objection

Center for Reproductive Rights Law and Policy, Guide on Conscientious Objection (International Perspective)

Click here to download this video lecture 

Lecture can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles. 

Chavkin W. Conscientious objection to the provision of reproductive healthcare. Int J Gynaecol Obstet 2013 Dec;123 Suppl 3:S39-40.
Freedman LR, Landy U, Steinauer J. When there’s a heartbeat: miscarriage management in Catholicowned hospitals. Am J Public Health 2008 Oct;98(10):1774-8.
Freedman LR, Stulberg DB. Conflicts in Care for Obstetric Complications in Catholic Hospitals. 2012:1- 10.
Institute G. State Policies in a Brief: Refusing to Provide Health Services. 2015 [cited; Available from: http://www.guttmacher.org/statecenter/spibs/spib_RPHS.pdf
Harris LH. Recognizing conscience in abortion provision. N Engl J Med 2012 Sep;367(11):981-3.
Lithwick D. Why Should We Worry About Religious Conscience Clauses? 2013 2013-10-03T10:35:11Z.
Lynch HF. Conflicts of Conscience in Health Care: An Institutional Compromise: MIT Press.
Dickens, Conscientious Commitment, 2008.

Conscientious Provision and Refusal of Abortion Care Slide Set

Week2-Refusal (Freedman)


Slide Set from Video Lecture Presented by:

Lori Freedman, PhD
University of California, San Francisco

Click to download Conscientious Provision and Refusal of Abortion Care Slide Set (pdf) 

 

EXPLAINED: Who Can Safely Provide Abortion?

Dr. Monica McLemore, of the University of California San Francisco, explains the most up-to-date research on who can safely provide abortions.

For more information, watch the extended lecture version and download the video companion materials.

The following links provided the research used in this video:

Aztlan-James EA, McLemore M, Taylor D. Multiple Unintended Pregnancies in U.S. Women: A Systematic Review. Womens Health Issues.
Freedman L, Battistelli MF, Gerdts C, McLemore M. Radical or routine? Nurse practitioners, nurse-midwives, and physician assistants as abortion providers. Reprod Health Matters. 2015;23(45):90-92.
McLemore M, Levi A. Nurses and care of women seeking abortions, 1971 to 2011. J Obstet Gynecol Neonatal Nurs. 2011;40(6):672-677.
McLemore MR, Desai S, Freedman L, James EA, Taylor D. Women know best–findings from a thematic analysis of 5,214 surveys of abortion care experience. Womens Health Issues. 2014;24(6):594-599.
McLemore MR, Kools S, Levi AJ. Calculus formation: nurses’ decision-making in abortion-related care. Res Nurs Health. 2015;38(3):222-231.
Taylor D, Postlethwaite D, Desai S, et al. Multiple determinants of the abortion care experience: from the patient’s perspective. Am J Med Qual. 2013;28(6):510-518.
Upadhyay UD, Desai S, Zlidar V, et al. Incidence of emergency department visits and complications after abortion. Obstet Gynecol. 2015;125(1):175-183.
Weitz TA, Taylor D, Upadhyay UD, Desai S, Battistelli M. Research informs abortion care policy change in California. Am J Public Health. 2014;104(10):e3-4.

Course Development & Description

Led by Jody Steinauer, MD, PhD (she/her), Abortion: Quality Care and Public Health Implications was developed as a MOOC presented on Coursera.com in the fall of 2014. More than 20 UCSF faculty and other experts on the clinical, social science, global health, and public health aspects of abortion contributed lectures and content to the course. Innovating Education in Reproductive Health has maintained free access and updated these course materials since its launch.

Most lectures in the abortion course can be viewed with subtitles in Spanish or French. French translation was made possible by the Safe Abortion Action Fund and International Planned Parenthood Federation. Click the Closed Captions button on video lectures to access subtitles.

If you would like to be able to assign this content to learners and track their progress, you can request a login for RHEcourse, our free online platform for SRH education, which offers additional features for users who want to engage more deeply. If you are a learner who would like to enroll in these courses for self-paced learning, you can request a RHEcourse login for self-paced learning.

IERH acknowledges the importance of inclusive language as a component of patient-centered care and we are working to improve our content. Read more here.