Idaho Sees Exodus of Obstetricians After Abortion Ban

— State lost 22% of its practicing obstetricians over a 15-month period

by
Michael DePeau-Wilson, Enterprise & Investigative Writer, MedPage Today
February 23, 2024

Idaho has been losing practicing obstetricians since its abortion ban took effect in August 2022, according to a new report by the Idaho Physician Well-Being Action Collaborative (IPWAC).

The report showed that 22% of the practicing obstetricians in Idaho stopped practicing or left the state during a 15-month period from August 2022 to November 2023. In total, the number of obstetricians practicing in the state — with a population of approximately 960,000 women — dropped from 268 to 210 during that period.

The report also noted that two hospital obstetric programs closed during this period, while two other programs are struggling to remain open due to problems recruiting obstetricians, including one that is expected to close on April 1.

Melissa Simon, MD, MPH, an ob/gyn at Northwestern Medicine in Chicago, told MedPage Today that the findings in this report are not unexpected given the environment created by the state’s abortion ban.

“It’s not surprising that providers are specifically wanting to move out of the state that is creating laws that are incongruent with sound, evidence-based medical care,” she said.

Policymakers should fully consider the perspective of physicians when drafting laws that affect medical practice, said Simon, adding that doctors across all specialties are trained and tested to provide a level of care that is approved through board certification. It is simply not good medical practice when laws are passed that contradict or impede a physician’s medical training and certification, she said.

“Why should we continue to practice in a state where we could go to jail for doing the right thing?” she said.

On the patient side, Simon noted that this trend will especially affect pregnant patients who are experiencing complications or facing complex labor and deliveries.

“Many of us are trained in the care of high-risk pregnancies,” she explained. “So when you lose obstetricians, you lose the ability to care for people who … have high-risk pregnancies [and] you lose the ability to have access to emergency obstetric care, including an emergency cesarean section.”

And when patients do have access to that level of care, she added, they likely have to travel 50 to 100 miles just to get to a birthing center or hospital with a labor and delivery unit.

“That is a huge issue, especially given that more and more women who are pregnant are having other complications,” she said.

Idaho’s abortion ban went into effect after the U.S. Supreme Court overturned Roe v. Wade due to two trigger laws the state passed in 2020 and 2021. These laws made it a felony for any person to provide an abortion without exceptions. In July 2023, the Idaho legislature replaced those laws with another ban that made some exceptions for abortion, including when the fetus is dead, according to the Center for Reproductive Rights.

Similar bans have been enacted in more than a dozen states since the Supreme Court’s 2022 decision.

A similar report from the Association of American Medical Colleges (AAMC) showed that fewer medical students, especially those interested in obstetrics, were choosing residency programs in states with abortion bans. The report concluded that this trend would lead to a provider shortage in those states.

The IPWAC report highlighted where the remaining obstetricians are still practicing in Idaho, noting that 85% of obstetricians are practicing in the state’s seven most populous counties, where the total number of providers declined by nearly 50 after the abortion ban. In addition to the loss of providers in those areas, the report showed that only 22 of the 44 counties in Idaho have access to any practicing obstetrician. Notably, nearly all of those counties lost an obstetrician during the observed 15-month period.

Simon emphasized that Idaho is likely not an exception when it comes to obstetricians leaving states with abortion bans.

“It’s not the only state. It just happens to be the state where there are data,” she said. “If we did the studies, we probably would see similar patterns in other states as well.”