Who will step up? A cross-sectional study on the determinants of medical students’ willingness to provide abortion care

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 abortions. Furthermore, factors contributing to explain medical students' attitudes towards abortion and their intention to participate in abortion care were examined based on intergroup contact theory and the theory of planned behaviour. 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.Participants had overall positive attitudes towards abortions. Female gender and low religiosity were associated with positive attitudes. Fear of stigmatisation and subjective knowledge were identified as significant negative predictors of attitudes towards abortion. Positive attitudes towards abortion significantly predicted higher willingness to participate in abortion care.This study demonstrates the importance of medical students’ attitudes towards abortion for their willingness to participate in abortion care in the future. Addressing structural barriers with targeted interventions and training programmes is essential that young physicians feel equipped, supported and safe to provide abortions. In line with World Health Organization's recommendations, frameworks should be established that effectively integrate abortion care into healthcare services.