Iowa has an OB-GYN shortage. Are state abortion bans partly to blame? : screenshots

Jonah Quinn was initially thrilled when she got her first job after residency, working as an OB-GYN in Mason City, Iowa. It was just an hour away from her hometown of West Bend, where she grew up on a farm.

She added that the hospital began restricting some birth control options and fertility treatments based on its affiliation with the Catholic Church. At the same time, her unit was increasingly understaffed as other obstetricians left and retired.

At one point, Quinn said she was seeing up to 50 patients a day.

“That’s twice what the average obstetrician-gynecologist will see in one day,” she said. “I knew I was going to miss something, because there is no way someone could function at that level.”

Last spring, Quinn decided to leave not just Mason City, but all of Iowa.

At that time, it was the state’s highest court He was about to approve the law Prohibit abortion as early as six weeks of pregnancy, with very few exceptions.

It was the last straw for Quinn I got a job In Minnesota and moved her family there. Minnesota has Constitutional protection For abortion.

“Either I stay and destroy myself, my career, my mental health and my relationship with my children, or I can continue to practice maternity surgery, which has always been my dream,” she said.

A few months after Quinn’s departure, Iowa’s abortion ban went into effect on July 29, 2024.

Iowa has a severe shortage of obstetricians

After the Supreme Court overruled Roe v. Wade In 2022, multiple states, including Iowa, Law prohibiting abortion – despite already facing a shortage of OB-GYNs.

The laws have placed doctors under increasing pressure and surveillance, complicating standard medical treatments for miscarriage, ectopic pregnancy, premature rupture of membranes, and other pregnancy problems. Some doctors fear that these laws will drive these much-needed doctors out of some states and discourage other obstetrician-gynecologists from relocating and establishing a practice.

Iowa has Fewest OB-GYNs per capita in the countryaccording to KFF analysis for the period 2021-2022 Federal data from Health resources and services management.

Studies show that inadequate maternal care is linked Low birth weight And increase infants and Maternal mortality.

As doctors leave, the pressure on those who remain increases

Rural hospitals in Iowa are struggling to find more obstetrician-gynecologists.

the Grinnell Regional Medical CenterA 49-bed hospital in a rural college town has been trying to recruit an obstetrician-gynecologist and a family physician with obstetrics training for more than a year.

The hospital witnessed a big jump in births after a neighboring hospital closed Labor and delivery unit last year. The additional number of deliveries was stressful for the unit’s existing obstetricians, he said David Paul Cavazosexecutive officer of the center.

He explained that when the number of patients was lower, it was easier for doctors to be on call during the weekend.

“You just had to hang out at home and talk on the phone,” he said. Doctors on duty recently delivered “five babies on Saturday and six babies on Sunday,” Cavazos said. “It gets more stressful.”

Iowa Legislature I passed a bill The last session increased Medicaid reimbursement rates for maternity care, so that obstetricians and gynecologists can be paid more for caring for pregnant patients.

The new law also directs federal funding toward a project to create additional medical residency slots, including OB-GYN residency slots, in Iowa. Resident doctors tend to stay and Setting up practices In the states where they complete their residency.

These things can help, he said Carla Solheimchair of the Iowa Section of the American College of Obstetricians and Gynecologists. But she said the state’s abortion restrictions are still a red flag for some OB/GYNs when deciding whether to practice in Iowa.

“It’s understandable that they don’t want to put their licenses and livelihoods at risk when it comes to patient care,” Solheim said.

At her previous job in the Quad Cities, Solheim performed an abortion on a patient who had life-threatening complications, she said. This led to numerous phone calls from hospital officials

Solheim recalled peppering her with questions about her decision: “Did I have enough evidence? Were her blood counts low enough to put her life in danger? Should we have waited for her blood pressure to drop?”

Solheim recently stopped delivering babies to focus on gynecology and outpatient care, saying she became exhausted working in Iowa hospital units that didn’t have enough obstetricians.

Recent data on residency applications show that state abortion bans may impact the next generation of doctors.

Fewer medical students are applying to OB-GYN residency programs in states that restrict or ban abortion, according to Data analysis From the Association of American Medical Colleges.

For E., a fourth-year medical student at Iowa State, the law greatly influences her decision about where to apply for, and eventually practice, her OB/GYN residency. She’s concerned about how Iowa law will affect her ability to practice evidence-based care.

E. is the first letter of her middle name – she asked to be identified that way because she is concerned that her comments might negatively impact her future career choices.

““I’m seriously questioning whether Iowa is the state I want to practice in, long-term, and it breaks my heart because I know there’s such a need,” she said.

The research presents a mixed picture

It is still unclear whether abortion is prohibited They drive doctors out of state.

one Recent study In Idaho, it found that two years after the state enacted a highly restrictive abortion law, 35 percent of the state’s 268 obstetrician-gynecologists had stopped practicing obstetrics.

but Another studyand analyzed federal data two years out from 2022 Dobbs The resolution failed to find significant departures of obstetrician-gynecologists from states that prohibit abortion.

“We were surprised, and we deleted the data in every possible way,” he said. Becky Steigeran assistant professor at the UC Berkeley School of Public Health, and the study’s lead author.

While the numbers don’t show a systemic way out, it’s possible that some obstetricians and obstetricians will adapt the way they practice so they can stay with their patients, she said.

“We’ve heard anecdotally, and through qualitative research, that they are very committed to these patients,” Steiger said.

She said The analysis also does not capture How OB-GYNs feel about working in states with abortion restrictions.

“What we can’t observe is anything related to the quality of care the providers are able to provide, the providers’ satisfaction with the job, the providers’ safety,” Steiger said.

This story comes from NPR’s health reporting partnership with Iowa Public Radio and KFF Health News.