Lower obstetrician and gynecologist (OBGYN) supply in abortion-ban states, despite minimal state-level changes in the 2 years post- Dobbs

Abstract

Since the Dobbs v Jackson Women's Health Organization Supreme Court decision in June 2022, emerging reports suggest that the obstetrician and gynecologist (OBGYN) workforce is moving into states without abortion bans. Using a large national administrative database, we identified OBGYNs enrolling in new states from July 2017 through June 2024. We used difference-in-differences (DID) analyses to estimate the effect of Dobbs on enrollments by state abortion policy (ban vs no ban). Enrollments in ban states were lower than in no-ban states in most academic years (June-July) throughout the study period. In the 2 years post-Dobbs, DID models found no significant differences in enrollments in ban states relative to no-ban states. These findings indicate minimal state-level shifts in the OBGYN workforce following Dobbs. Past research has found that a complex constellation of factors drives physician movement, including state licensure, job availability, income, spousal job opportunities, and social support. While the effect of the Dobbs decision on the workforce are likely to be significant, the full impacts on the workforce will take years to fully unfold.

Keywords: Dobbs; OBGYNs; workforce.

Figure 1.

Abortion policies in the United States. Source: Authors’ analysis of Guttmacher Institute's State Bans on Abortion Through Pregnancy (see note 27 in text). States are classified as having a total or 6-week ban if the ban had been in place for at least 6 months as of July 1, 2024. Ban states include Alabama, Arizona, Georgia, Idaho, Indiana, Kentucky, Louisiana, Missouri, Mississippi, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, and West Virgina.

Figure 2

. Initial and existing enrollments among obstetrician and gynecologists (OBGYNs) by academic year and state abortion policy, 2017–2024. Source: Authors’ analysis of Medicare Provider Enrollment, Chain, and Ownership System. Per-population is enrollment count per 100 000 population of reproductive health–aged females (15–44 years) is 45 980 393 in no-ban states and 18 668 781 in ban states as of 2021.