The great departure: Texas OB-GYNs are leaving the Lone Star State

After the U.S. Supreme Court overturned Roe v. Wade, Texas joined a list of states that passed highly restrictive abortion laws. The state’s near-total abortion ban made performing an abortion a crime punishable with up to life in prison. The details of the ban encourage Texas’ citizens to file lawsuits against medical professionals who do so. Despite having exceptions in the case of life-saving care, the shift created a field of uncertainty for doctors and patients alike. As a result, some OB-GYNs are fleeing the state or retiring early, and potential residents are avoiding Texas altogether.

‘A quiet sense of doom’

A recent survey from healthcare consulting firm Manatt Health showed that the abortion laws passed in Texas after the fall of Roe v. Wade are “stressing the state’s already beleaguered OB-GYN workforce” and “threatening the pipeline of new doctors that would help provide relief,” said The Texas Tribune. More than 70% of practicing OB-GYNs in Texas feel the near-total ban has “negatively impacted their work, prohibiting them from providing high quality, evidence-based care for their patients.” The majority of OB-GYN medical residents said the abortion laws weigh heavily on their decision to stay in Texas after they finish their training. Nearly 15% of surveyed doctors said they were planning to retire early, which could “accelerate the state’s looming shortage of OB-GYNs.”

By 2030, the state is expected to have “15% fewer OB-GYNs than is needed to keep up with demand.” Many rural areas throughout the state have already begun to “feel the effects of these shortages.” Over 45% of Texas counties are already considered “maternity-care deserts,” which means there is “no doctor to see during your pregnancy and nowhere to give birth.”

While Texas authorities are not officially “keeping track of the exodus of doctors,” among practitioners, there is a “quiet sense of doom,” said The New Yorker. The pipeline is drying up,” Charles Brown, former Texas regional chair of the American College of Obstetricians and Gynecologists, told the outlet. “We’re just not going to have enough people to take care of women in this state.”

‘Patients don’t want a confused doctor’

The survey results and anecdotal evidence among healthcare professionals have raised concerns about the long-term effects of these laws. Many local doctors have chosen to stay, but it is understandable why new doctors might decide to go elsewhere, Todd Ivey, a Houston OB-GYN, said to the Texas Tribune. A decrease in new OB-GYNs coming to the state is “going to impact women’s health greatly,” Ivey said. Hopefully, that does not lead to the day where “women can’t get their pap smear screening, they can’t get their breast cancer screening, they can’t get prenatal care.”

Anitra Beasley, another Houston OB-GYN, said she and other doctors bring the fear of criminalization into the room with the patient. “It turns it into something that’s about me and my risk instead of being about the patient and their situation,” she said. Despite spending time researching Texas’ abortion restrictions, she remains uncertain about when the law would allow her to intervene to perform an abortion. “Patients don’t want a confused doctor,” she said.

In the months following the passage of stricter abortion restrictions, “a new reality set in for OB-GYNs in Texas,” said The New Yorker. The law has “made it so that there’s no guarantee that the right thing can be done,” OB-GYN Elissa Serapio told the outlet. Even after getting the mandatory clearances from lawyers and administrators, “you still don’t know if you’re going to have an anesthesiologist who will agree to do it.” By that time, “the person has bled out and could die.”