No significant change in OB/GYN enrollment in states without abortion bans after Dobbs

Key takeaways:

• OB/GYN enrollments in states with vs. without abortion bans did not change in the 2 years before vs. after Dobbs.
• For most years, initial and existing enrollments were higher in states without vs. with bans.

In the 2 years after the Dobbs decision, initial or existing enrollments of OB/GYNs did not significantly change, but fewer OB/GYNs enrolled in states with abortion bans since 2017, according to findings published in Health Affairs Scholar.

“In the 2 years following the Dobbs decision, there has been no significant change in OB/GYN movement into states without abortion restrictions,” Julia Strasser, DrPH, MPH, assistant research professor of health policy and management, director of the Jacobs Institute of Women’s Health and core faculty in the Fitzhugh Mullan Institute for Health Workforce Equity at George Washington University, told Healio. “However, when we look at the set of states that currently have abortion bans, there have been lower numbers of OB/GYNs moving into those states since 2017, suggesting there has been a longstanding workforce acquisition problem.”

Strasser and colleagues evaluated Medicare Provider Enrollment, Chain and Ownership System data of more than 2 million clinicians and identified 48,892 OB/GYNs enrolled during at least one quarter from July 2017 to June 2024. Researchers estimated the effect of Dobbs on enrollments by state abortion policy.

Overall, researchers observed 9,756 initial and 8,912 existing enrollments of OB/GYNs, of which 75.4% and 72.7% occurred in states without abortion bans, respectively.

Difference-in-difference models demonstrated no significant effects for initial or existing OB/GYN enrollments in states with abortion bans 2 years after vs. before Dobbs.

Per-population initial and existing OB/GYN enrollments were higher for states without vs. with bans for all years except 2019 to 2020. Researchers observed year-to-year variation in initial OB/GYN enrollments ranging from 1.76 to 1.91 per 100,000 reproductive-aged women in states with and 2.14 to 2.41 per 100,000 reproductive-aged women in states without abortion bans.

From 2017 to 2024, existing OB/GYN enrollments per 100,000 reproductive-aged women seemed to increase in states with (1.56 to 2.35) and without (1.63 to 2.47) abortion bans.

“This is an early look at this research question, and the effects on the workforce will continue to unroll for many years,” Strasser told Healio. “Future research should continue to examine OB/GYN movement, and other indicators of workforce well-being including burnout and moral injury.”

For more information:

Julia Strasser, DrPH, MPH, can be reached at jstrasser@email.gwu.edu; X (Twitter): @juliastrasser.