Doctors reluctant to practice in states that have banned abortion: Shots

Dr. Franz Theard performs an ultrasound on a patient seeking abortion services at the Women’s Reproductive Clinic in Santa Teresa, New Mexico, a state that has not banned abortions.

Robyn Beck/AFP via Getty Images

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Robyn Beck/AFP via Getty Images

Dr. Franz Theard performs an ultrasound on a patient seeking abortion services at the Women’s Reproductive Clinic in Santa Teresa, New Mexico, a state that has not banned abortions.

Robyn Beck/AFP via Getty Images

The rush of conservative states to ban abortion after the overthrow of Roe vs. Wade has a startling consequence that opponents of abortion may not have considered: fewer medical services available to all women living in these states.

Doctors show – by their words and actions – that they are reluctant to practice in places where making the best decision for a patient could result in huge fines or even jail time. And when clinics that offer abortions close, all other services offered there also close, including regular checkups, breast cancer screenings, and contraception.

Concern about the impact on women’s health is not only raised by abortion rights advocates. A recent warning comes from Jerome Adams, who served as surgeon general in the Trump administration and now works on health equity issues at Purdue University in Indiana.

In a recent tweet threadAdams wrote that “the trade-off of a restricted-access (and criminalizing doctors) approach to reducing abortions could end up making pregnancy less safe for everyone and increasing infant and maternal mortality.”

The medical “brain drain”

A first indication of this impending medical “brain drain” appeared in February, when 76% of respondents to a survey of more than 2,000 current and future doctors said they would not even apply to work or train in states where abortion is prohibited. “In other words,” the study’s authors wrote in an accompanying article, “many qualified applicants would no longer even consider working or training in more than half of the U.S. states.”

Indeed, states with abortion bans saw a larger drop in the number of medical seniors applying for residency in 2023 compared to states without a ban, according to a study by the Association of American Medical Colleges. While applications for OB-GYN residencies are down nationwide, the decrease in states with comprehensive abortion bans was more than twice as large as those without restrictions (10.5% vs. 5.2% ).

This means fewer doctors to perform essential preventive care like pap smears and screenings for sexually transmitted diseases, which can lead to infertility.

Care for pregnant women is particularly at risk, as hospitals in rural areas close maternity wards because they cannot find enough professionals to staff them – a problem that predates the abortion decision but has not. only got worse since.

In March, Bonner General Health, the only hospital in Sandpoint, Idaho, announced it would be ending its labor and delivery services, in part because of “Idaho’s legal and political climate.” which includes state lawmakers continuing to “introduce and pass bills that criminalize doctors.” for medical care that is nationally recognized as the standard of care.

Amplified risks

Heartbreaking reports from across the country show that abortion bans are also jeopardizing the health of some patients who experience miscarriage and other non-viable pregnancies. Earlier this year, a pregnant woman with a non-viable fetus in Oklahoma was told to wait in the parking lot until she got sick after being told doctors “can’t touch you. unless you crumble before us”.

A study by University at Buffalo researchers in the journal Women’s Health Issues finds doctors practicing in states that restrict abortion are less likely than those in states that allow abortion to have been trained to perform the same early abortion procedures used for women with miscarriages. at the start of pregnancy.

But it’s more than a lack of doctors that could complicate pregnancies and deliveries. States with the strictest abortion restrictions are also the least likely to offer support services to low-income mothers and babies. Even before the overthrow of roe deera report by the Commonwealth Fund, a nonpartisan research group, found that maternal mortality rates in states where abortion was banned or restricted were 62% higher than in states where abortion was more readily available.

Women who know their pregnancies could become high-risk think twice about getting or becoming pregnant in states where abortion is banned. Carmen Broesder, an Idaho woman who opened up about her struggles getting treatment for a miscarriage in a series of viral TikTok videos, told ABC News she has no plans to try to get pregnant again .

“Why would I want to see my daughter almost lose her mother again to have another child?” she says. “It seems selfish and wrong.”

Make birth free?

The anti-abortion movement has in the past seemed more sensitive to arguments that its policies neglect the needs of women and children. An icon of the anti-abortion movement — Rep. Henry Hyde (R-Ill.), who died in 2007 — has been keen to join liberal Rep. Henry Waxman (D-Calif.) on legislation to expand coverage of Medicaid and to provide more benefits to combat infant mortality in the late 1980s.

Few anti-abortion groups are following this lead in pushing policies to facilitate pregnancy, childbirth and childrearing. Most of these efforts go under the radar.

This year, Americans United for Life and Democrats for Life of America released a joint position paper urging policymakers to “make birth free.” Among their suggestions are automatic insurance coverage, with no deductibles or co-payments, for pregnancy and childbirth; eliminate payment incentives for caesareans and hospital births; and a “monthly maternity allowance” for the first two years of a child’s life.

“Making births free to American mothers can and should be a national unifier in a particularly divided time,” the newspaper said. Such a policy could not only make it easier for people to start a family, but it could also address the country’s dismal record on maternal mortality.

But a birthless policy seems unlikely to move very far or very quickly in a year when the same Republican lawmakers who support a nationwide ban on abortion are pushing even more vehemently for deep federal budget cuts in the fight against the debt ceiling.

This leaves abortion opponents at a crossroads: Will they follow Hyde’s lead and champion policies that expand and protect access to care? Or will women’s health suffer from the victory of the movement?

KFF Health Newsformerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism on health issues and is one of the main operating programs of KFF — the independent source for health policy research, polling and journalism.