The great migration that wasn’t

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LINDSAY MAST, HOST: Next, when the U.S. Supreme Court overturned Roe v. Wade in 2022, abortion advocates claimed pro-life laws would drive obstetricians and gynecologists out of states with those laws. Some doctors did choose to leave those states, but was it really a mass exodus?

PAUL BUTLER, HOST: Three years later, the data does not support that prediction. Pro-life laws haven’t cleared out the profession, but numbers show they’ve affected the medical pipeline— stoking fear among medical students about training and legal risk.

Still, some doctors say the new protections for unborn babies may be drawing in pro-life students who once avoided the OBGYN specialty. WORLD’s Lauren Canterberry reports.

LAUREN CANTERBERRY: Last month, 14 OB-GYNs in Georgia who responded to a survey said they were considering leaving the state over a law that protects unborn babies after six weeks of pregnancy. Another 11 doctors said they personally knew a colleague who had already left the state.

Here’s Democratic Sen. Jon Ossoff at a hearing last year.

JON OSSOFF: Eight weeks ago, we heard from OB-GYNs that testified the state’s abortion ban puts the lives of women at unnecessary risk and drives OB-GYNs out of Georgia where already more than 50% of counties have no OB-GYN at all.

Ossoff and the American College of Obstetricians and Gynecologists polled 38 physicians in the survey. According to the findings, 18 doctors claimed they had encountered cases in which the state’s law contributed to a mother’s health complications or death.

Georgia’s law protects babies after their heartbeats are detected, usually around six weeks of pregnancy. A similar law in Alabama protects babies from abortion in nearly all cases.

Dr. Robin Cardwell is a pro-life OB-GYN in Huntsville, Alabama. She says she reviews the law every time a woman’s pregnancy prompts concerns about her health.

ROBIN CARDWELL: It says in reasonable medical judgment, the unborn child's mother has a condition that so complicates her medical condition that it necessitates the termination of her pregnancy to avert death or to avert serious risk of substantial physical impairment of a major bodily function. That's not really medical jargon.

Even in cases when an abortion clearly falls under the law’s narrow exceptions, Cardwell said many OB-GYNs, nurses, and anesthesiologists are still afraid of prosecution.

CARDWELL: We have multiple discussions amongst providers, and even when, you know, we get the lawyers involved or the maternal fetal medicine specialist, there's this like aura of fear around taking care of these patients, and it does delay care because it may take some time to kind of come to a consensus.

Cardwell does not know anyone personally who has left the state over its law, but anecdotes of OB-GYNs doing just that have captured headlines. Reports out of Tennessee and Idaho suggest physicians are leaving their states to continue performing abortions.

Meanwhile, a study published in April concluded that the number of providers did not significantly change across states with differing abortion laws in the two years after the Dobbs decision. Researchers at the University of California Berkeley School of Public Health found that, from 2018 to 2024, the number of OB-GYNs increased in every state.

That study only examined physicians already practicing, and did not capture the decisions of residents or medical students. Some doctors-in-training say they are concerned about meeting the residency standards outlined by the American College of Obstetricians and Gynecologists and the accrediting body that oversees graduate medical programs. Both groups claim abortions are part of essential healthcare, and include abortion training in their standards.

Dr. Madison Chapman is a pro-life OB-GYN in Grand Rapids, Michigan, and completed his residency last month.

MADISON CHAPMAN: Within the OB-GYN community, pretty much everyone takes the ACOG stance, which is, you know, every woman should have the access to an abortion if they want it.

If students do not want to abort babies, they have to opt out of the abortion training rotation. Chapman completed his residency in Texas, which has protections for unborn babies.

CHAPMAN: The program would pay for you to go to California for three to four weeks and complete abortions.

Chapman says even without the rotation, all OB-GYNs learn to care for patients in emergency situations. And that the only procedure residents in pro-life states may have fewer opportunities to practice is the dilation and evacuation procedure. It is used to remove miscarried babies or kill unwanted babies after the first trimester of pregnancy.

CHAPMAN: This involves more skill and more training that is usually not done in abortion-restricted states.

Many pro-life doctors prefer to induce labor in cases when a baby dies after the first trimester. Meanwhile, pro-abortion groups have fueled misinformation about pro-life practices by encouraging doctors to put aside personal beliefs when counseling women seeking abortions.

Dr. Francis Nuthalapaty has seen pro-abortion programs alienate students who believe in the sanctity of life.

FRANCIS NUTHALAPATY: I actually see the tide turning, where now some of those people who said before, ‘I don’t think I’d want to go into OB-GYN,’ now may feel more comfortable doing it.

Nuthalapaty now runs a new residency program at AdventHealth in Florida. He says many students enter medical school without thinking deeply about bioethical issues.

NUTHALAPATY: You might think that this is a standard part of medical education, and it's not, it's an oft overlooked or or barely emphasized portion of the curriculum.

He believes students should begin discussing these topics as early as high school so they know where they stand before they ever enter a hospital. When he counsels students on where to apply for residency or where to practice, he tells them to consider their personal values.

NUTHALAPATY: I’ve learned that there are some people who really have a strong worldview. They’re well rooted in their faith, and they can go into any environment and just be fine and be a light in that place and really, you know, go head to head with folks. If you’re not really well-established yourself, chances are, if you go into that kind of an environment, it’s going to change you more than you change it.

Reporting for WORLD, I’m Lauren Canterberry.

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