Abstract Ever-increasing technological innovations surrounding birth are creating new challenges in biomedical ethics in U.S. obstetrics. The politicization of abortion has agumented these challenges and led to increased conflict between physicians' personal morality and professional responsibility. This paper focuses on some of the problems generated by abortion policies and procedures in an obstetric/gynecology residency program. Examples of conflicts among residents are presented to demonstrate the effect of pluralistic moral perspectives. A system is described where some residents will do abortions and some will not. Patients seeking abortion are often treated in an unprofessional manner when it appears that a conflict exists between the values of patients and those of residents. Unless the socialization of residents includes ethical training, defined educational policy and institutional direction, ethical dilemmas will lead to increased resident stress, an inadequate doctor-patient relationship and a continued shortage of physicians willing to perform abortions despite new policies called for in graduate medical education.