About-face on abortion fellowship leaves U with whiplash

Bowing to pressure from conservative students and lawmakers, the University of Minnesota has backed out of a grant-funded fellowship to expand the practice and training of reproductive health and abortion services.

The fellowship, approved by one faculty member last fall, became political dynamite this spring after triggering outrage among abortion opponents and some lawmakers just as the Legislature was considering a budget request from the U and a vacancy on the Board of Regents.

Now university leaders are being criticized on all sides — from abortion advocates, for "caving" to pressure; from abortion opponents, for leaving the door open to the fellowship next year; and from at least one legislator who faulted their handling of abortion politics.

"They'd better realize nothing is done in isolation," said state Rep. Gene Pelowski, DFL-Winona, the former chair of the House Higher Education Committee. "When you make a decision like this, the Legislature quite often reacts." Lawmakers last week did not advance the university's request for $10 million in supplemental funds to freeze tuition rates, though no one publicly linked that decision to the fellowship.

Abortion advocates and opponents agree that the U's decision will weaken the future training and provision of abortion services in Minnesota — though they disagreed on whether that's desirable.

"The university is caving to the whims of anti-choice groups," the University Pro-Choice Coalition said in statement. The campus chapter of Students for Life of America called it a "great victory."

The episode started quietly last fall, when a faculty member agreed to a fellowship grant from the Reproductive Health Access Project, a New York advocacy group that is trying to give family doctors expertise in reproductive health services, including abortion. U officials declined to identify the faculty member.

Trouble emerged in the spring, when abortion opponents noticed the fellowship job posting online and voiced concerns in Campus Reform, a conservative higher education news website.

Minnesota Citizens Concerned for Life (MCCL) forwarded those concerns to state lawmakers. The resulting blowback brought the existence of the fellowship to the attention of university leaders, including President Eric Kaler and medical school dean Dr. Jakub Tolar. They decided May 4 to put it on hold.

In a letter to lawmakers, Tolar said the fellowship would be suspended for at least one year and that the U would "examine the value of this training in the context of our mission along with the values of the community."

Even so, the controversy didn't die. Legislators last week used the issue to gauge the abortion views of candidates for an open spot on the Board of Regents. Randy Simonson, the candidate with the clearest opposition to abortion, was chosen.

The university's decision does not eliminate its training involving abortion. Accredited obstetric residency programs are required to provide abortion training, although residents with ethical objections can opt out. Medical students don't learn abortion techniques specifically, but during obstetric clerkships they observe miscarriage procedures that are very similar, according to the Association of American Medical Colleges.

Still, the decision disappointed leaders at the Reproductive Health Access Project, who have used the fellowship on the East Coast to improve the training and capabilities of primary care doctors. Minnesota was the project's first attempt to expand to the Midwest, which has vast rural areas where family-practice doctors provide reproductive services in addition to primary care, said Lisa Maldonado, the group's executive director.

"There are huge disparities to access to health care — contraception, prenatal, miscarriage and abortion care — across the U.S.," she said. "The care you get really depends upon where you live. It shouldn't be that way."

While the number of elective abortions has declined in Minnesota, from 14,450 in 2000 to 9,953 in 2016, the number of abortion providers has declined as well, raising concerns among advocates that access will worsen.

Under the grant's design, the fellow, most likely a family doctor fresh out of residency, would work at the U-affiliated Smiley's Clinic in south Minneapolis, but also rotate through medical facilities, including Planned Parenthood's St. Paul clinic, to learn reproductive health and abortion procedures. The fellow would then pass on lessons through lectures and presentations to medical students and residents.

Absent the fellowship, Maldonado said, "clinicians aren't being trained to their full scope of practice. There are going to be clinicians who provide care, but might not be providing the best care."

MCCL leaders were equally unhappy. Suspending the fellowship sounds like delaying it until it's politically convenient to resume, said Bill Poehler, an MCCL spokesman.

Poehler also argued that creating a special fellowship is different from the basic minimum training required of a medical school. It means "creating a position to not only be trained in abortions, but to advocate abortions and to train others in abortions," he said.

Leaders at the Access Project, meanwhile, said they'll seek a new Midwest partner for the fellowship.

For its part, the U has only "hit the pause button," and might seek the fellowship in future years after more discussion, said U spokesman Chuck Tombarge. "Ultimately, the university's faculty will determine how best to approach training for the next generation of our state's health providers."

Jeremy Olson • 612-673-7744