Eleanor Drey, MD

Providing Complete Care

Dr. Eleanor Drey’s interest in providing reproductive health services began when she was a high school English teacher. “I was struck by how many people were facing issues around poorly timed, surprise pregnancies. For example, I remember one of my male students getting really upset because he had caused a third pregnancy, and was going to be a father for the third time while still in high school. I think he ultimately felt very out of control. And my female students really didn’t appreciate that they were behaving as sexually active grown-ups. I thought that perhaps having someone who could talk to them in a respectful, grown-up way about the issue of sexuality would help them come to terms with the fact that they were sexually active.”

Now an Associate Clinical Professor of Obstetrics and Gynecology and Reproductive Sciences at the University of California San Francisco, Dr. Drey went to medical school thinking that she might become an ob/gyn, pediatrician or adolescent specialist. She was motivated by a belief that, “Issues about families and individuals wanting to have control over life choices are very important, very basic.”

Today, abortion provision is an integral part of Dr. Drey’s practice. “Providing complete and respectful healthcare is providing contraception and abortion, along with counseling around those decisions,” she says. “It is essential that women be able to make the most fundamental decisions about how they’re going to shape their lives.”

Like many physicians, Dr. Drey is concerned about the ongoing politicization of abortion. “It’s already an emotional decision, and to make it that much more difficult really infuriates me,” she says. To help combat this, Dr. Drey incorporates elements of activism into her practice, specifically around education and training. “It makes me feel really good that I can do something very immediate to serve women’s medical and emotional welfare while working in a political sense to train future providers, do research and hopefully broaden women’s access to abortion and reproductive care. I am very lucky because I get to train residents and medical students, and I really do feel that it’s a type of activism. I’m training them to treat women well.”

Much of Dr. Drey’s research centers on repeat and second-trimester procedures, and she has identified a concern among the physician community. “There is a general lack of empathy among healthcare providers for women who present either in the second trimester or more than once for abortions,” she says. “And I think that this really has a negative impact on women’s ability to get this kind of crucial healthcare. It’s well documented that most women having abortions were using contraception at the time that they got pregnant, and yet somehow this is not well known. There are many providers who assume that the woman just wasn’t being responsible.”

When questioned about why repeat and second-trimester abortions can bring up such judgmental attitudes in providers, Dr. Drey provides an interesting insight: “Healthcare practitioners often have had to be quite controlling about their own fertility. They’ve had to make a lot of choices and be really diligent about their own contraception,” she says. “Therefore they might not be as understanding when they see a patient who didn’t notice that three months went by without a period. These are people who had to be really careful to get through medical school or nursing school, and so I think it can be hard to have empathy.”

Dr. Drey is very concerned about the lack of second-trimester providers. “There aren’t enough providers in general, and especially those that can do second-trimester or medically complicated procedures,” she says. “We need to find a way to efficiently train our colleagues to increase their skills. Given the relatively small number of second-trimester abortions that occur each year (about 12% of all abortions in the U.S.), Dr. Drey thinks that the shortage of providers in this area can be overcome. “I don’t know how to create a system to increase the skills of current providers,” she says. “But I know the interest is there and I know that it can be done.”