Abortion bans are driving doctors away and closing clinics, putting other healthcare systems at risk

dr Franz Theard performs a sonogram on a patient who uses abortion services at the Women’s Reproductive Clinic in Santa Teresa, New Mexico, a state that has not banned abortions. Image: Robyn Beck/AFP via Getty Images

The rush in conservative states to ban abortion after the fall Roe vs Wade leads to a startling consequence that opponents of abortion may not have considered: less medical care is available to all women living in these states.

Physicians show by their words and actions that they are reluctant to practice in places where deciding what is best for a patient could result in hefty fines or even imprisonment. And when clinics that offer abortions close their doors, all the other services they offer will also shut down, including regular checkups, breast cancer screening, and contraception.

Concerns about the impact on women’s health are not only voiced by pro-choice advocates. A recent warning comes from Jerome Adams, who served as surgeon general in the Trump administration and is now studying health equity at Purdue University in Indiana.

In a current tweet threadAdams wrote: “The trade-off between restricting access (and criminalizing doctors) to reduce abortion could ultimately make pregnancies less safe for everyone and increase infant and maternal mortality.”

Medical brain drain

A first hint of the impending medical “brain drain” came in February, when 76% of respondents in a survey of more than 2,000 current and future doctors said they would not even apply for a job or training in states with abortion restrictions. “In other words,” the study’s authors wrote in an accompanying article, “many qualified candidates would not even consider working or training in more than half of the U.S. states.”

In fact, according to a study by the Association of American Medical Colleges, in 2023 states with abortion bans saw a larger decline in medical school graduates applying for residency compared to states without abortion bans. While applications for OB/GYN residencies are declining nationwide, the decline in states with full bans on abortion was more than twice as large as in states with no restrictions (10.5% versus 5.2%).

That means fewer doctors have to perform critical preventive measures like Pap smears and screening for sexually transmitted diseases that can lead to infertility.

Pregnant women’s care, in particular, is at risk as hospitals in rural areas close maternity wards because they can’t find enough skilled workers to staff them – a problem that existed before the abortion regulation but has only gotten worse since.

In March, Bonner General Health, the only hospital in Sandpoint, Idaho, announced it would be suspending its labor and delivery services, in part due to “the legal and political climate in Idaho” causing state legislatures to continue to ” Introduce and pass laws criminalizing doctors”. for medical care that is recognized nationally as the standard of care.”

Increased risks

Heartbreaking reports from across the country show that abortion bans are also threatening the health of some patients who suffer miscarriages or other non-viable pregnancies. Earlier this year, a pregnant woman with a nonviable fetus in Oklahoma was told to wait in the parking lot until she got sick after being told doctors “shouldn’t touch you unless you fall in front of us.” away”.

A study by University at Buffalo researchers in the journal Women’s Health Issues finds that physicians practicing in states that restrict abortion are less likely than physicians in states that allow abortion to have been trained to do the same Perform early abortion procedures used in women who miscarry early in pregnancy.

But it’s more than just a shortage of doctors that could make pregnancy and childbirth difficult. States with the strictest abortion restrictions are also the least likely to provide support services for low-income mothers and babies. Before the overthrow of roeA report by the Commonwealth Fund, a non-partisan research group, found that the maternal mortality rate was 62% higher in states with abortion restrictions or bans than in states where abortion was more accessible.

Women who know their pregnancies could be at high risk think twice about conceiving or becoming pregnant in states with abortion restrictions. Carmen Broesder, an Idaho woman who opened up about her struggles treating a miscarriage in a series of viral videos on TikTok, told ABC News she has no plans to try and conceive again.

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

make birth free?

The anti-abortion movement once seemed more sensitive to arguments that its policies neglected the needs of women and children. An icon of the anti-abortion movement—Rep. Henry Hyde (R-Illinois), who died in 2007—put great emphasis on partnering with Liberal Rep. Henry Waxman (D-California) on legislation to expand Medicaid coverage and provide more services to combat child mortality in the late 1980s.

Few anti-abortion groups are following suit, urging action to make it easier for people to conceive, give birth and raise children. Most of these efforts remain under the radar.

This year, Americans United for Life and Democrats for Life of America released a joint position paper urging policymakers to “make births free.” Their proposals include automatic coverage with no deductibles or co-payments for pregnancy and childbirth; removing incentives to pay for cesarean sections and hospital deliveries; and a “monthly mother’s grant” for the first two years of a child’s life.

“Giving free births to American mothers can and should bring national unity at a particularly divided time,” the newspaper said. Not only could such policies make it easier for people to start families, but they could also address the country’s dismal maternal mortality rate.

However, birth-free policies seem unlikely to advance very far, or very quickly, in a year when the same Republican lawmakers who support a statewide ban on abortion are even more vehemently pushing for sweeping federal budget cuts in their debt-ceiling battle becomes.

This leaves anti-abortion activists at a crossroads: will they follow Hyde’s lead in championing policies that expand and protect access to health care? Or will women’s health suffer as a result of the movement’s victory?

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 core operating programs of KFF – the independent source for health policy research, surveys and journalism.

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Abortion bans are driving doctors away and closing clinics, putting other healthcare systems at risk

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