and Unable: Doctors' Constraints in Abortion Care
By Lori R.
and Unable explores the social world where abortion politics and
mainstream medicine collide. The author interviewed physicians
of obstetrics and gynecology around the United States to find
out why physicians rarely integrate abortion into their medical
practice. While abortion stigma, violence, and political contention
provide some explanation, her findings demonstrate that willing
physicians are further encumbered by a variety of barriers within
their practice environments.
Structural barriers to the mainstream practice of abortion effectively
institutionalize the buck-passing of abortion patients to abortion
clinics. As the author notes, "Public-health-minded HMOs
and physician practices could significantly change the world of
abortion care if they stopped outsourcing it."
Drawing from forty in-depth interviews, the book presents a challenge
to a commonly held assumption that physicians decide whether or
not to provide abortion based on personal ideology. Physician
narratives demonstrate how their choices around learning, doing,
and even having abortions themselves disrupt the pro-choice/pro-life
moral and political binary.
"Book of the Week ... Why don't more OB/GYNs do abortions?
Lori Freedman's new book, Willing and Unable, is the most thorough
answer yet to that question."
--Emily Bazelon, XX Factor, Slate.com
pro-choice or pro-life, readers will benefit from the authentic
face that Freedman provides for this sociopolitically charged
topic... Highly recommended."
is a finely crafted and emotionally moving study which both documents
and provides a persuasive explanation for the precarious nature
of abortion provision in the United States today. The book will
make an excellent addition to the required reading lists not only
for courses in health & medicine and sex & gender, but
for courses in work & organizations, social conflict, and
social movements as well."
--Lyn H. Lofland, Research Professor of Sociology, University
of California, Davis
be of greatest interest to those considering obstetric careers,
those involved in medical education, and advocates on either side
of the abortion question."
--World Medical & Health Policy
of abortion providers is one of the greatest challenges facing
the abortion rights movement today. In this well-researched and
gracefully written book, Lori Freedman perceptively explores the
reasons for this shortage, with the threat of violence being only
one of several contributing factors. Willing and Unable is a must-read
for anyone who wants to understand the complex status of abortion
provision in contemporary American medicine"
.--Carole Joffe, author, Dispatches from the Abortion Wars: The
Costs of Fanaticism to Doctors, Patients and the Rest of Us
Freedman's qualitative research is critical to understanding why
only half of ob-gyns who intend to do elective abortions when
starting residency actually offer them for patients once in practice.
The depth and sophistication of her analyses make her findings
especially profound and will shake this area of research, abortion
training and provision, to its core. What she has uncovered--the
complex ways stigmatization affects ob-gyns in practice--will
inform many people and programs in reproductive health research,
medical training, and the reproductive rights movement. With these
insights, we will be better able to help ob-gyns overcome obstacles
to provision in practice. We will also better understand where
in medicine and medical practice we can focus our efforts of mainstreaming
--Jody Steinauer, MD, Research Director, Kenneth J. Ryan Residency
Training Program in Abortion and Family Planning, University of
California, San Francisco, and Founder of Medical Students for
this page to a friend!