Study finds recent OB-GYN graduates plan to avoid working in abortion-restrictive states

A study published Sept. 27 in the journal Obstetrics & Gynecology found that a significant number of graduating OB-GYN residents who had taken part in an abortion training program were planning not to take fellowships or practice medicine in states with abortion restrictions.

The study was conducted by researchers from the University of Utah School of Medicine and the University of California, San Francisco, Bixby Center for Global Reproductive Health. They noted that of the 349 graduating OB-GYN residents who had done abortion training through the Kenneth J. Ryan Residency Training Program in Abortion & Family Planning at the Bixby Center and responded to their survey, 17.6% indicated that the U.S. Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade in June 2022, had influenced their decisions.

“First, despite my convictions that states that restrict abortion still need fierce advocates to fight for pregnant people, I don’t have enough fight left in me to stay in a state that does not support my work as a physician,” one resident wrote in response to a question about how the Dobbs decision had impacted their professional plans. 

Another resident wrote:

Years prior to Dobbs, I knew I wanted to be a gyn oncologist. I was applying and interviewing to fellowship right after the Dobbs decision. The Dobbs decision impacted which interviews I accepted and how I ranked programs because I knew I did not want to practice in a state with abortion restrictions. I did not want to have the additional abortion restrictions on top of all the difficulties of taking care of patients (e.g. young pregnant patient with cervical cancer). Women’s healthcare is challenging and frustrating as is, and I think my burnout would become unbearable if I were not able to provide the care that my patient wants.

The study concluded, “This reduction in obstetrics and gynecology workforce could significantly exacerbate maternity care deserts.” 

Dr. Leilah Zahedi-Spung, a Denver-based OB-GYN, told USA Today, “We’re going to see medical students and residents and physicians continue to leave these spaces because they don’t feel like they can practice the full spectrum of care that they spent their life learning how to do. … It’s only going to get worse. We’re going to watch so many more pregnant people die, unfortunately.” 

In June 2023, the health nonprofit KFF published a survey of office-based OB-GYNs in the United States. One of the survey’s key findings was that 68% of respondents said the Dobbs decision “worsened their ability to manage pregnancy-related emergencies. Large shares also believe that the Dobbs decision has worsened pregnancy-related mortality (64%), racial and ethnic inequities in maternal health (70%) and the ability to attract new OBGYNs to the field (55%).”

In May, Wisconsin Health News reported an 8% decrease in applications to OB-GYN residencies in the state. 

“Big concerns that we have, especially in Wisconsin, is not only is there already a doctor shortage, but it is going to be worse because we’re going to have fewer residents coming to Wisconsin to do OB-GYN training and family medicine training,” Dr. Wendy Molaska, a family medicine physician and former president of the Wisconsin Medical Society, told the American Independent Foundation in June. “And especially in a lot of states like Wisconsin, where there’s kind of two urban areas, but the majority of the state is rural, we really need family medicine docs as well because they provide the majority of OB care in rural areas.”

The study published in Obstetrics & Gynecology said many of the OB-GYN residents surveyed said their reasons for avoiding restrictive states included personal future pregnancy plans.

“My immediate professional plans have not been affected in any way as I intended to remain in [abortion protective state] for fellowship training and early attending years,” one resident noted. “However, it has definitely affected where I will seek to settle my family as part of my 5-10 year plan. I will choose to establish my personal and professional life in a state with more liberal laws re: reproductive health for patients.”

Published with permission of The American Independent Foundation.