An American doctor couldn't finish her abortion training after Roe v. Wade was overturned, so she went to Mexico City

• After Roe v. Wade was overturned, many medical residents have been forced to travel for abortion-care training.
• One doctor had to leave California to get abortion training in Mexico.

When Dr. Anita Vasudevan, a family physician, moved to California for her residency program in 2019, she never expected that she would do part of her medical training abroad in Mexico City.

But in 2022 she found herself in a Mexico City clinic for two weeks learning how to provide abortions.

It's just one of the ripple effects for medical professionals since the Dobbs v. Jackson Supreme Court decision restricted abortions in many states across America last year.

Despite the obstacles, accessing this training for Vasudevan was critical to her training as a primary care doctor.

"The primary care setting is an ideal place to be able to do an abortion, especially something as simple as first-trimester abortion," Vasudevan said.

Getting an abortion is an intimate experience, Vasudevan added, and for a lot of people, accessing abortion care through a family care physician is "more comforting than having to go to another spot."

Even in California, it was hard for her to learn how to provide abortions

Vasudevan is a born-and-raised Texan and attended the University of Texas, Southwestern in Dallas for medical school. There, she discovered she loved family planning.

Even before the Dobbs decision, however, Vasudevan said restrictions in Texas made access to abortion difficult for both patients and doctors looking to receive training. It was one of the reasons she decided to look for a residency program in a different state.

Fortunately, she said, she was placed at Sutter Santa Rosa Family Medicine Residency in California.

Although she missed Texas, Vasudevan was relieved to be practicing medicine in a state with strong abortion protections. But when the Dobbs v. Jackson decision made it so states could decide whether or not abortion was legal in Vasudevan's third year, she soon felt the impact.

A 2022 paper estimated that 43.9% of current OB-GYN residents could lose access to in-state abortion training, forcing them to travel.

After the Supreme Court ruling, California declared itself a sanctuary state for both those seeking abortion and providers looking for abortion training.

This meant clinics that provided abortion training in California were suddenly packed. The Bay Area had become "saturated with trainees," Vasudevan said, making it nearly impossible to find a clinic that could take her for her final rotation. There were just too many trainees and not enough spots.

Currently, an estimated 1,100 OB-GYN residents are in states with the most restrictive abortion bans and may have to travel for training.

"Things were really crazy," Vasudevan said, but she was determined to complete her training.

Since local clinics were overwhelmed, Vasudevan made the decision to travel to Mexico City to complete her final rotation. It ended up being a positive experience, "but I don't know if I would have chosen that experience over a domestic one if I had something available to me here," she said.

Traveling for the two-week rotation was also costly; Vasudevan estimates that the travel plus the tuition for the training was easily a couple thousand dollars. She received funding through the Training in Early Abortion for Comprehensive Healthcare Program (TEACH) program, which she said she's "thankful for" because otherwise "it would have been almost prohibitively expensive."

TEACH trains family physicians how to integrate first-trimester abortions into their practice, and helps secure family medicine residents' first-trimester abortion training.

She hopes to return to Texas one day

Vasudevan said that the rapidly changing abortion landscape is scary because it could prevent many providers from learning how to provide abortion care, which affects a provider's ability to help both with pregnancy termination as well as miscarriage.

"I'm hoping that as the dust settles, we can actually do a better job being able to incorporate out-of-state residents into training," Vasudevan said, "especially in California, we feel the responsibility to meet that need that other states are having."

Vaseduvan just graduated from her residency and is moving into a one-year fellowship with TEACH, where she will assist in teaching residents abortion training.

Vasudevan also said that, at least for now, she won't be returning to Texas.

"I feel like I can do better from afar, being an abortion provider in California and advocating for my people in Texas is my plan for now," Vasudevan said. "But I hope to be able to return someday when things are better."