It’s been one year since the Supreme Court ended the federal right to an abortion, and OBGYNs say that it has impacted their ability to perform miscarriages and react in pregnancy-related emergencies, according to a new KFF national survey released Wednesday. Now, they fear those restrictions have led to worse maternal mortality rates, and they fear for future recruitment and retention in their profession.
According to the survey, in states with abortion bans, about 4 in 10 OBGYNs said they face constraints on their care for miscarriages and pregnancy-related emergencies; 6 in 10 are concerned about legal repercussions when deciding how to treat people. In many states, abortion bans penalize the provider rather than the pregnant person, with penalties ranging from hefty fines to license suspensions to prison sentences.
In addition, 64 percent think pregnancy-related mortality has been exacerbated; 7 in 10 believe that racial and ethnic inequities in maternal health have worsened.
Brittni Frederiksen, an author of the report and associate director for women’s health policy at KFF, said that these findings reiterate what many in the health care industry already know: Abortion restrictions impact anyone seeking any kind of reproductive care.
“I think the general public doesn’t understand that the same services for medication abortion are also used to manage miscarriages,” Frederiksen said. “So many people experience miscarriages. And when people are unable to provide abortion care, it also means that they may experience these constraints when handling pregnancy-related emergencies and miscarriages.”
The poll also shows that 55 percent of OBGYNs believe it is now harder to attract new physicians to the field, which Frederiksen said could have a big impact for health care in states with abortion bans.
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“Are OB-GYNs getting sufficient training in abortion care?” Frederiksen said. “Will we still find that people want to do their residencies in these states where they know that they can’t get this training? I think this could leave areas of the country without trained OBGYNs.”
The constraints weigh on physicians’ minds, she said.
“When you feel like you can’t actually provide the care that you want to provide — it’s hard to practice in a state like that.”
KFF surveyed 569 OBGYNs, a nationally representative sample, from March 17 to March 18. Each of the respondents provides sexual and reproductive health care to patients in an office-based setting.
Dr. Kristyn Brandi, an OBGYN in New Jersey and board chair of Physicians for Reproductive Health, said she was not surprised by the KFF survey results — she’s been hearing similar stories from obstetricians and gynecologists all over the country since the Dobbs v. Jackson Women’s Health Organization decision came down last June. From the moment states began passing abortion bans or restrictions, Brandi said providers have felt like their ability to take care of their patients has been stripped from them.
“Doctors and other health care providers are interpreting these new laws in real time,” Brandi said. “Trying to figure out, ‘I’m in the emergency room and this law comes down at midnight; at 12:01, what kind of care can I provide?’ It’s made it really challenging to provide care on the ground.”
Complicating the situation further, Brandi said these laws are typically not written by physicians but by lawmakers who see abortion as entirely separate and distinct from other types of care. She said she envisions the impact of abortion bans eventually rippling out to even labor and delivery and the health care workforce at large as care becomes increasingly penalized.
As it stands, Brandi said doctors are being put in an impossible position of dual loyalty between their ability to keep practicing and the wellbeing of their patients.
“These bans are causing a chilling effect where people know how to interpret the laws or are just scared to provide care because they don’t know what’s legal,” Brandi said. “And that will mean that some patients get delayed care or none at all — all based on where they live.”