Anti-abortion law not the cause of obstetrician-gynecologist shortage: study

These results contradict predictions by abortion rights advocates that in 2022 Dobbs vs. Jackson Women’s Health Organization A ruling that there is no federal right to abortion would lead to a shortage of medical students in obstetrics and gynecology in states with abortion restrictions, as well as the closure of medical facilities that can provide obstetrics and gynecology care.

Democrats running in 2024 have cited abortion bans in 24 states as a reason why women have limited access to obstetrical and gynecological care, even in emergency situations such as miscarriage or ectopic pregnancy.

But a new study recently released by CLI, a think tank that is part of the anti-abortion group SBA Pro-Life America, finds that structural problems with medical education have been contributing to the problem for more than two years. Dobbs.

Between 2011 and 2023, more than 217 maternity wards in hospitals were closed across the country, resulting in the creation of so-called “maternity deserts,” areas where women have no access to basic maternity services.

This Dobbs The decision also raised awareness of the U.S. maternal mortality rate, which is among the highest in the developed world. Maternal mortality remains higher for minority women and women in rural areas who live in maternity deserts.

However, data from both medical school enrollment and clinical training programs provide little evidence Dobbs According to the CLI study, a decision contributed to this trend.

The study’s authors assume that medical school enrollment is growing, even in the 24 states where abortion is banned, and that there is a nationwide shortage of spots in obstetrician-gynecologist training programs.

Medical school enrollment is on the rise

Medical school enrollment data collected by the Association of American Medical Colleges shows that the number of students applying to medical schools has increased over the past five years, even in states where abortion is illegal.

Medical school enrollment increased 6.6% in the 2023–2024 academic year compared to the 2019–2020 school year in the 14 states that have passed laws banning abortion on demand throughout pregnancy.

In states where abortion is banned between the sixth and 15th week of pregnancy, there was a 7 percent increase in attempted abortions during the same period.

By comparison, in states with no abortion restrictions, medical school enrollment increased by only 4.6%.

Enrollment in osteopathic medical schools has also increased by 77% over the past decade, with more than half of these medical schools located in states with abortion restrictions. An average of 1 in 4 physicians received their medical education from an osteopathic school.

Additionally, over the past five years, 25 new obstetrics and gynecology medical school programs have been accredited, 56% of them in states where abortion is illegal.

No residencies in obstetrics and gynecology

Although the number of medical school graduates, including obstetrician-gynecologists, is growing overall, there is a shortage of spots in residency programs for physicians after graduation.

After completing medical school, doctors complete internships that can last from three to seven years, depending on the specialty covered in the program. They usually remain in the state or area where they completed their final training.

Although applications for obstetrics and gynecology residency in states with abortion bans declined by 2% from 2022 to 2023, virtually all obstetrics and gynecology residency positions were filled in the year immediately following Dobbs decision.

According to data from the National Resident Matching Program, in 2024, 2,143 candidates applied for 1,539 obstetrics and gynecology residency positions nationwide.

The CLI study authors cite Nebraska, which has a ban on elective abortions after 12 weeks of pregnancy, as an example. In 2024, applications for obstetrics and gynecology residencies in Nebraska fell from 253 to 191. However, there are only nine available obstetrics and gynecology positions in the state, split between the University of Nebraska-Lincoln and Creighton University.

The number of residencies at each facility is largely determined by Medicare funding, but academic hospitals must also meet requirements set by states and academic accrediting agencies.

Falling birth rate plays role in crisis

The fact that fewer women are deciding to have children also naturally affects the number of maternity ward closures, which exacerbates the effects of maternity absences.

The total fertility rate, or the average number of children a woman will have in her lifetime, fell to 1.62 births per woman in 2023, down 2% from 2022 and the lowest recorded since the federal government began keeping statistics in the 1930s.

Just 3.6 million babies were born in the U.S. last year, according to the Centers for Disease Control and Prevention, and the number of live births has been declining since a peak in 2005, when it was about 4.14 million.

Maternity departments in rural hospitals are particularly at risk of closure due to falling birth rates in their regions and overall population decline in rural areas.

For example, politicians and commentators were quick to point to Idaho’s abortion ban as the reason for the closure of the maternity ward at Bonner General Health hospital in the northern part of the state.

However, the hospital itself cited the “low number of patients” as the reason for difficulties in employing pediatricians and obstetrician-gynecologists, and the number of deliveries “was decreasing year by year”, which made the department unprofitable.

CLICK HERE TO READ MORE IN THE WASHINGTON EXAMINER

Even if a city has maternity facilities that prevent an area from becoming a maternity desert, travel time and distance can be an additional burden in accessing care, especially for lower-income and minority mothers.

Neither the American College of Obstetricians and Gynecologists nor the American Medical Association, which oppose gestational age restrictions for abortion, have responded. Washington ExaminerCLI requests comment on study.