Who will step up? A cross-sectional study on factors associated with medical students’ willingness to provide abortion care

INTRODUCTION: The decreasing number of physicians performing abortions in Germany limits access to high-quality care for individuals with unintended pregnancy seeking abortions. To address the barriers preventing higher participation in abortion care, the aim of this study was to quantitatively explore the attitudes of medical students towards abortion. Furthermore, factors associated with medical students' attitudes towards abortion and their willingness to participate in abortion care were examined based on intergroup contact theory and the theory of planned behaviour. METHODS: A Germany-wide online survey was conducted. Validated scales and single items were translated into German using the TRAPD protocol and adapted for medical students via cognitive interviews (n = 10). Survey data from n = 233 medical students were analysed using descriptive statistics, regression, and mediation analyses with abortion attitudes and willingness to provide abortion care as criteria. RESULTS: Participants had overall positive attitudes towards abortion. Female gender and low religiosity were associated with positive attitudes. Fear of stigmatisation and perceived knowledge were negatively associated with attitudes towards abortion. Positive attitudes towards abortion were significantly associated with higher willingness to participate in abortion care. The association between attitudes and contact, as well as the expected mediation effects of fear of stigmatisation, perceived knowledge and perspective-taking, were nonsignificant. CONCLUSIONS: This study demonstrates the association of medical students' attitudes towards abortion with their willingness to participate in abortion care in the future. However, lack of perceived knowledge and fear of stigmatisation may represent barriers for young physicians to provide abortion care in their later work life. Addressing structural barriers with targeted interventions and training programmes is essential that young physicians feel equipped, supported and safe to provide abortion care. TRIAL REGISTRATION: The study was registered via AsPredicted.org prior to data collection (September 8th, 2023). Trial registration number: 142964.