OB-GYN Exodus: Impact of State Abortion Laws Post-Roe v. Wade (2010-2024)

• Post on LinkedIn
• Like on Facebook
• Tweet on Twitter
• Email Link
• Pin on pinterest

• Posted June 18, 2024

Since Roe v. Wade was overturned in 2022, the landscape of reproductive healthcare in the United States has undergone significant shifts. One notable trend is the migration of obstetricians and gynecologists (OB-GYNs) from states with restrictive abortion laws to those with more permissive laws. This exodus not only reshapes access to abortion services but also profoundly affects every woman’s health overall across the nation.

Data Sources

The data illustrating the migration trends of OB-GYNs from 2010-2024 is derived from publicly available sources, specifically the National Plan & Provider Enumeration System (NPPES) database. Data includes all providers that have primary taxonomy code of one of the following: 207V00000X, 207VC0200X, 207VE0102X, 207VF0040X, 207VH0002X, 207VM0101X, 207VX0000X, 207VX0201X and 2080N0001X. Historical data of this information from NPI Dashboard has been utilized to compare migration trends, providing a comprehensive view of how physician mobility has evolved in response to changing legislative landscapes.

Surge in Migration

According to recent data from 2022 to mid-2024, there has been a dramatic increase in the number of OB-GYNs leaving states with restrictive abortion laws, such as Texas, Missouri, and Florida, and relocating to states where abortion remains less restricted, like California, New York, and Washington. The numbers paint a clear picture:

• Texas: In 2010-2021 275 OB-GYN’s left v. 2022-mid 2024 549 OB-GYN’s left.
• North Carolina: 149 OB-GYNs departed from North Carolina between 2010 and 2021, versus 302 between 2022 and mid-2024.
• Florida: Florida experienced a loss of 199 OB-GYNs from 2010 to 2021 and 299 from 2022 to mid-2024.
• Missouri: Missouri saw the departure of 154 OB-GYNs from 2010 to 2021 and 288 from 2022 to mid-2024.
• Arizona: Between 2010 and 2021, Arizona lost 101 OB-GYNs, while 186 left between 2022 and mid-2024.
• Indiana: During the period of 2010 to 2021, Indiana lost 65 OB-GYNs, compared to 176 during 2022 to mid-2024.
• Georgia: From 2010 to 2021, Georgia experienced the departure of 107 OB-GYNs, compared to 153 between 2022 and mid-2024.
• Tennessee: Tennessee saw a departure of 102 OB-GYNs from 2010-2021, compared to 142 from 2022 to mid-2024.
• Kentucky: In the timeframe of 2010-2021, 77 OB-GYNs left Kentucky, while 130 left from 2022 to mid-2024.
• Louisiana: Between 2010 and 2021, Louisiana lost 55 OB-GYNs, while 102 left between 2022 and mid-2024.
• West Virginia: West Virginia saw a departure of 40 OB-GYNs from 2010-2021, compared to 97 from 2022 to mid-2024.
• Oklahoma: 48 OB-GYNs left Oklahoma in the years 2010-2021, while 93 left during 2022 to mid-2024.
• South Carolina: Between 2010 and 2021, 55 OB-GYNs left South Carolina, whereas 85 left between 2022 and mid-2024.
• Utah: Between 2010 and 2021, Utah lost 55 OB-GYNs, while 82 left between 2022 and mid-2024.
• Nebraska: Nebraska saw 33 OB-GYNs depart from 2010 to 2021, while 64 left from 2022 to mid-2024.
• Alabama: In Alabama, 35 OB-GYNs left during 2010-2021, whereas 55 left during 2022 to mid-2024.
• Idaho: From 2010 to 2021, 13 OB-GYNs exited Idaho; in contrast, 30 left from 2022 to mid-2024.
• Arkansas: During 2010-2021, 11 OB-GYNs left Arkansas; from 2022 to mid-2024, the number increased to 26.
• North Dakota: In the years 2010-2021, North Dakota saw 11 OB-GYNs leave; in the period from 2022 to mid-2024, 26 left.
• Mississippi: 16 OB-GYNs left Mississippi in the years 2010-2021, while 18 left during 2022 to mid-2024.
• South Dakota: In South Dakota, 7 OB-GYNs left from 2010 to 2021, in contrast to 14 who left from 2022 to mid-2024.

Broader Impact on Women's Health

This migration trend is not solely driven by abortion access. OB-GYNs are also leaving states with more restrictive abortion laws because these same states also have a broader range of restrictive healthcare policies affecting multiple aspects of women's healthcare. The reduced numbers of both general OB-GYNs and specialists have led to critical shortages in healthcare facilities. These shortages translate to longer wait times for routine and specialized care, including prenatal care, contraception counseling, fertility treatments, and management of complex gynecological conditions. Women across these states are facing diminished access to comprehensive healthcare services, impacting their overall well-being and preventive health measures.

Comparison with Pre-2022 Trends

Comparing the recent data to the period from 2010 to 2022 underscores the magnitude of this shift. From 20210 to 2022, a total of 1,608 OB-GYNs migrated from states with more restrictive abortion laws. In contrast, post Roe, in 2022 alone, 2,917 OB-GYNs have left the states with more restrictive abortion laws, highlighting a nearly twofold increase in migration rates. This stark rise reflects the escalating challenges faced by women’s healthcare providers under new legislative frameworks that constrain their ability to practice medicine according to their professional standards and patients’ needs.

Summary

The migration of OB-GYNs from states with more restrictive abortion laws to states with more permissive abortion laws represents a significant upheaval in women's healthcare delivery in the United States. It underscores the profound impact of legislative changes on women’s healthcare providers’ mobility and on women's access to comprehensive reproductive healthcare services. Based on the data to date it is likely these trends will continue, and policymakers, healthcare professionals, and healthcare advocates must grapple with the consequences of decreasing availability of women’s healthcare for every woman in states with more restrictive abortion laws.

In essence, the exodus of OB-GYNs is not merely a statistic but a critical indicator of the evolving landscape of reproductive healthcare post-Roe v. Wade, shaping the future of women's health in America. The data sourced from the NPPES database and historical NPI Dashboard records provide a robust foundation for understanding these migration trends and their broader implications for women's health beyond just abortion access.

The Current Legal Landscape

In recent years, 21 states, have enacted laws that severely limit or outlaw access to abortion services with the issuance of the Dobbs decision. These laws range from mandatory waiting periods, parental consent requirements, to outright bans on abortion. These laws often include criminal, severe monetary civil penalties, and the loss of their medical license for OB-GYN’s performing abortions irrespective of the OB-GYN’s medical judgment with respect to the potential mother or baby. The fear of prosecution has led many OB-GYNs to either cease offering abortion services or to relocate to states where abortion remains legal.

Ethical Dilemmas and Professional Autonomy

These laws also force OB-GYNs into difficult ethical positions. The ability to make clinical decisions based on medical necessity and patient well-being is compromised when state laws dictate the terms of care. For example, in cases where a patient’s health is at risk, restrictive laws may prevent OB-GYNs from performing medically necessary abortions. This erosion of professional autonomy can place physicians in serious ethical dilemmas in which the OB-GYN medical training and expertise all demand that he performs an abortion to save the life of the mother or baby but also understands the restrictive state abortion laws prevent taking the action his medical training and expertise require. Even worse than forcing OB-GYN’s into situations in which both options have serious negative legal consequences, an OB-GYN complying with restrictive abortion laws is still faced with the emotional toll when her patient and the patient’s baby die due to the restrictive abortion laws.

Migration of OB-GYNs

Factors Driving Relocation

The exodus of OB-GYNs from states with restrictive abortion laws is driven by several factors:

• Legal and Professional Security: States with fewer or no restrictions on abortion provide a safer legal environment for practitioners, reducing the risk of civil monetary judgments, criminal charges, and professional sanctions.
• Professional Fulfillment: Many OB-GYNs are motivated by the desire to care comprehensively for their patients including complex ob-gyn care that can necessitate abortion services. States with restrictive laws hinder the doctor’s ability to use her medical expertise to provide the best healthcare her patient medically requires.
• Workplace Climate: The political and social climate in states with restrictive abortion laws can be hostile to doctors providing women’s healthcare, creating a stressful and unsupportive work environment.

Consequences for Healthcare Access

The migration of OB-GYNs from states with restrictive abortion laws states further exacerbates existing healthcare disparities. Rural and underserved areas, which already face shortages of healthcare providers, are more severely affected. The departure of OB-GYNs from rural and underserved areas forces patients there to endure longer wait times for appointments, reduced availability of specialized care, and increased travel distances for patients seeking services. These problems can result in poorer health outcomes for women in rural and underserved areas and greater strain on remaining healthcare providers.

Data on OB-GYNs in Restrictive States

Number of Obstetricians Leaving Reproductive Health Restricting States

The following tables and charts show the number of OB-GYNs who have left states with restrictive reproductive health laws from 2022 to the first half of 2024, compared to those who left from 2010 to 2021 before the Dobbs decision in 2022:

2010 - 2021 (Before Dobbs Decision)

2022 - First Half of 2024

Detailed Breakdown of OB-GYN Specialties (2010-2021)

To further understand the impact of restrictive reproductive health laws, it is essential to examine the specific specialties of the OB-GYNs who have left these states from 2010 to 2021:

Detailed Breakdown of OB-GYN Specialties (2022-First Half of 2024)

For a comparative perspective, here is the detailed breakdown of OB-GYN specialties from 2022 to the first half of 2024:

Migration Data Analysis: 2010 - 2021

From 2010 to 2021, significant numbers of OB-GYNs migrated from states with restrictive abortion laws to those with fewer or no legal restrictions on abortion. The following table shows the migration data for this period, grouped by destination state and source state:

Migration Data Analysis: 2022 to Mid-2024

From 2022 to the first half of 2024, the migration patterns of OB-GYNs reflect a continuation and intensification of trends observed in the previous decade. The data below highlights the migration of OB-GYNs during this period:

Comparison and Key Insights

Key Trends:

Continued Outflux from Texas: Texas remains the primary source state for OB-GYN migration. However, the outflux has significantly increased, with 549 OB-GYNs leaving Texas between 2022 and mid-2024 compared to 275 in the previous 11-year period.

Top Destination States: California, Virginia, and Ohio continue to attract the highest number of OB-GYNs. California saw an influx of 425 OB-GYNs in the recent period, compared to 186 in the previous 11-year period.

Emerging Destinations: States such as Colorado (CO), Pennsylvania (PA), and Washington (WA) have seen notable increases in incoming OB-GYNs, suggesting shifting preferences for relocation.

State-Specific Observations:

• Texas: Texas continues to be the leading source of OB-GYN’s, with a significant increase in outgoing OB-GYNs, reflecting its growing attractiveness due to factors such as unfavorable work environments and declining work opportunities.
• North Carolina and Florida: Both states have seen substantial increases in outgoing OB-GYNs, indicating their rising number of healthcare professionals leaving these states.
• California: The dramatic rise in the number of OB-GYNs entering California highlights ongoing opportunities within the state that may be driving healthcare professionals to seek opportunities there.

Broader Implications for Reproductive Healthcare

Impact on Medical Education

The restrictive environment in 21 states also affects medical education and training. Medical students and residents may receive inadequate training in abortion procedures due to limited opportunities for hands-on experience. This educational gap has long-term consequences, as future OB-GYNs may lack the skills and confidence to provide comprehensive reproductive care, even in states with fewer or no legal restrictions on abortion.

Public Health Concerns

Restrictive abortion laws have broader public health implications. Women in states with limited or no access to abortion services may resort to unsafe methods to terminate pregnancies, leading to increased rates of complications and maternal mortality. Additionally, these laws contribute to the stigmatization of abortion, which can deter women from seeking necessary reproductive health services and exacerbate existing health disparities.

Conclusion

The enactment of restricting and outlawing abortion in several states has far-reaching consequences for OB-GYNs and the broader healthcare system. These laws create a hostile and legally precarious environment for practitioners, leading many to relocate to more states that have fewer or no legal restrictions on abortion. The resulting migration exacerbates healthcare disparities, particularly in rural and underserved areas, and undermines the quality of women’s health and reproductive healthcare. Addressing these issues requires a concerted effort to protect the rights of healthcare providers and ensure access to comprehensive reproductive care for all women.

---

If you would like to contact us for more information regarding this data set or other data sets, please Contact Us.

---

Appendix - Status of Abortion Access across the United States

Current as of May 2, 2024

	Legal status of Abortion	Details
Alabama	Banned	Abortion is banned with no exceptions for rape or incest.
Arkansas	Banned	Abortion is banned with no exceptions for rape or incest.
Idaho	Banned	Near-total ban in place.
Indiana	Banned	Abortion is banned with limited exceptions. The Indiana Supreme Court certified a ruling that outlaws nearly all abortions in the state and denied a petition for a rehearing.
Kentucky	Banned	Abortion is banned with no exceptions for rape or incest.
Louisiana	Banned	Abortion is banned with no exceptions for rape or incest.
Mississippi	Banned	Near-total ban in place, includes exception for rape but not incest.
Missouri	Banned	Abortion is banned with no exceptions for rape or incest.
North Dakota	Banned	Abortion is banned with exceptions for rape or incest in the first six weeks of pregnancy.
Oklahoma	Banned	Abortion is banned with no exceptions for rape or incest.
South Dakota	Banned	Abortion is banned with no exceptions for rape or incest.
Tennessee	Banned	Abortion is banned with no exceptions for rape or incest.
Texas	Banned	Abortion is banned with no exceptions for rape or incest.
West Virginia	Banned	Near-total ban in place. A federal judge ruled in August that the state can also restrict the sale of abortion pills
Florida	Legal with gestational limit of 6-18 weeks	A six-week ban took effect May 1, replacing a 15-week ban.
Georgia	Legal with gestational limit of 6-18 weeks	Abortion is banned as early as six weeks of pregnancy. The state’s Supreme Court upheld the six-week ban in a ruling in October, reversing a lower court’s decision to void the 2019 ban.
Nebraska	Legal with gestational limit of 6-18 weeks	Abortion is banned after 12 weeks of pregnancy with exceptions for sexual assault, incest and medical emergencies.
North Carolina	Legal with gestational limit of 6-18 weeks	A 12-week ban on most abortions went into effect on July 1.
South Carolina	Legal with gestational limit of 6-18 weeks	Abortion is banned as early as six weeks of pregnancy. The South Carolina Supreme Court upheld a "heartbeat" abortion ban in August.
Utah	Legal with gestational limit of 6-18 weeks	A court has blocked the state from enforcing its "trigger" abortion ban, but an 18-week ban remains in effect.
Arizona	Legal with gestational limit of 6-18 weeks	Abortion is banned 15 weeks of pregnancy. On May 2, Gov. Katie Hobbs signed a bill overturning a Civil War-era ban barring abortion in nearly all circumstances.
Connecticut	Legal	Abortion remains legal until viability.
Delaware	Legal	Abortion remains legal until viability.
Hawaii	Legal	Abortion remains legal until viability.
Illinois	Legal	Abortion remains legal until viability.
Iowa	Legal	Abortion remains legal until 22 weeks. A district judge temporarily blocked a law that would have banned most abortions as early as six weeks into pregnancy, before most people know they are pregn= ant.
Kansas	Legal	Abortion remains legal until 22 weeks, after Kansas voted against amending the state constitution to say that a right to an abortion is not guaranteed.
Maine	Legal	Abortion remains legal until viability.
Maryland	Legal	Abortion remains legal until viability.
Massachusetts	Legal	Abortion remains legal until 24 weeks.=
Michigan	Legal	Voters approved constitutional amendment to enshrine abortion rights in 2022.
Minnesota	Legal	Abortion remains legal until viability.
Montana	Legal	Abortion remains legal in Montana until viability and protected in state constitution, but legislature has indicated it may pass new restrictions.
Nevada	Legal	Abortion remains legal until 24 weeks.=
New Hampshire	Legal	Abortion remains legal until 24 weeks.=
New Jersey	Legal	Abortion remains legal with no gestational limit.=
New Mexico	Legal	Abortion remains legal with no gestational limit.
New York	Legal	Abortion remains legal until viability.
Ohio	Legal	A law banning abortion after cardiac activity can be detected, typically six weeks, has been blocked by an injunction while litigation continues. Currently, abortion is legal until 22 weeks.
Oregon	Legal	Abortion remains legal with no gestational limit.
Pennsylvania	Legal	Abortion remains legal until 24 weeks, though not expressly protected by state law.
Rhode Island	Legal	Abortion remains legal until viability.
Vermont	Legal	Abortion remains legal with no gestational limit.=
Virginia	Legal	Abortion remains legal until the third trimester, though not expressly protected by state law.
Washington	Legal	Abortion remains legal until viability.
Wisconsin	Legal	Abortion remains legal until 22 weeks. After a judge ruled that an 1849 law did not apply to abortion, Planned Parenthood of Wisconsin announced on Sept. 18 that it would resume abortion care services.
Wyoming	Legal	A district judge temporarily blocked a state abortion ban in March, days after it took effect. Abortion remains legal until viability. Wyoming is also the first state to pass legislation explicitly banning the use of abortion pills. The ban was intended to take effect July 1 but was put on pause by a judge in late June.