Texas OBGYNs Want to Leave the State

Since 2022, Texas has threatened abortion providers with life in prison, and before that total ban took effect, the state became the first in the nation to enforce a six-week abortion ban (SB 8) in 2021. The impact of these laws, designed to force doctors to abdicate their most fundamental responsibilities to their patients, can’t be understated.

In September, NBC published the first maternal mortality data from Texas since SB 8 took effect in September 2021, and found maternal deaths in the state increased by a staggering 56% from 2019 to 2022, compared to an 11% increase nationwide during the same time period. Now, a new survey, out this week, shows the state of maternal health in Texas is on track to become exponentially more dangerous.

The survey, conducted by Manatt Health, received responses from 450 practicing doctors and 47 medical residents in Texas, with 70% saying the state’s abortion ban prohibits them from providing high-quality, evidence-based care. Even more concerning, a fifth of respondents said they’ve considered leaving Texas and 13% said they plan to retire early as a result of the abortion ban. The majority of OBGYN residents said Texas’ abortion laws will be a factor in whether they stay in the state.

Further, a third of respondents said they don’t understand what actually qualifies as life-threatening under the abortion ban’s narrow and ambiguous exception for medical emergencies, while 60% say they fear legal repercussions for providing any basic health services that could be associated with abortion.

The same day that Manatt Health published this study, a group of Texas OBGYNs spoke to reporters at an event hosted by the Texas Democratic Party. “We've found that maternal mortality is going up. We've found that infant mortality is going up,” Houston-based OBGYN Dr. Damla Karsan said, adding that “these are all the results” of the state’s total abortion ban. Last year, Karsan’s patient, Kate Cox, received national attention when the Texas Supreme Court denied her petition to receive an emergency abortion for a nonviable, dangerous pregnancy, which forced her to travel out of state for life-saving care.

Currently, more than 45% of Texas counties are classified as maternal care deserts due to the lack of doctors providing prenatal services and the lack of places to give birth. Unsurprisingly, in a country with the worst maternal mortality rate among wealthy nations, Texas ranks 50th among all states and D.C. for women’s health outcomes, according to a recent study from The Commonwealth Fund. The organization offered this appraisal based on the limited availability of reproductive health services, access to health insurance, and maternal mortality and morbidity outcomes. Texas is ranked in the bottom five with Mississippi, Nevada, Oklahoma, and Arkansas. 

Another study from May found U.S. medical students are less likely to apply to residency programs in states with abortion bans, while a survey from December showed three-quarters of future U.S. doctors say abortion bans are a key factor in where they’ll apply for residencies. In Idaho—where abortion is totally banned—the state is in the midst of a maternal care crisis. Since 2022, Idaho has lost a quarter of all OBGYNs, over half of its maternal and fetal medicine specialists, and three labor and delivery wards.

Last year, about two dozen women sued Texas for endangering their lives, arguing the medical emergency exception is too ambiguous and forced their doctors to weigh their legal options instead of providing time-sensitive, life-saving care. But the Texas Supreme Court dismissed their lawsuit in May. 

“Not having people coming up is going to impact women’s health greatly,” Houston-based OBGYN Dr. Todd Ivey told the Texas Tribune. “I just hope we don't get to the day where women can't get their pap smear screening, they can't get their breast cancer screening, they can't get prenatal care.”