No, OB-GYNs aren’t leaving pro-life states en masse
Data contradict anecdotes of a pro-abortion exodus
Getty Images / SDI Productions

More than one-third of OB-GYN physicians in Georgia who responded to a survey earlier this year said they were considering leaving the state because of a law that protects unborn babies after six weeks of pregnancy. In June, Sen. Jon Ossoff, D-Ga., and the American College of Obstetricians and Gynecologists released findings from a survey of 38 Georgia OB-GYNs. According to the report, 11 doctors said they personally knew a colleague who had already left the state due to the law.
The majority of survey respondents voiced concerns that Georgia’s policy could endanger women, and some feared they would not be able to provide proper care for patients because of potential legal repercussions. Eighteen respondents claimed they had already encountered cases in which the state’s law contributed to a mother’s health complication or death.
After the Supreme Court’s Dobbs decision in June 2022, some doctors chose to leave states that had pro-life laws, prompting concerns that the laws could cause a mass exodus of providers who wanted to perform abortions. Three years later, the data do not support that prediction, though some physicians have anecdotally said they or colleagues have left pro-life states. The laws are stoking more fear among medical students who worry that pro-life laws could inhibit their training or put them in legal trouble.
Georgia’s LIFE Act, like many heartbeat laws, protects all babies with detectable heartbeats from abortion except in cases of rape, incest, or medical emergencies. It includes exceptions if the pregnant woman’s life is at risk or if a physician determines the unborn child has a profound anomaly that makes survival after birth unlikely. The law also allows doctors to treat miscarriages and ectopic pregnancies.
A similar Alabama law makes abortion a felony unless performed to prevent a serious health risk to the mother. Dr. Robin Cardwell, a pro-life OB-GYN in Huntsville, Ala., said she reviews the state’s law every time a woman’s pregnancy prompts concerns about her health. “It’s just hard to read,” she said.
Alabama’s law stipulates that deciding whether to perform an abortion is up to the provider’s reasonable medical judgment, which Cardwell said doesn’t provide clear guidance. “That’s not really medical jargon,” she said.
Even in cases when an abortion clearly falls under the law’s exceptions, Cardwell said that many OB-GYNs, nurses, and anesthesiologists have told her they are afraid of prosecution. Because many pro-life laws have not been tested in court, doctors are unsure whether a judge would agree with the decisions they make as medical professionals, she said, adding that more complex cases present challenges for medical teams. “There’s this 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,” she said.
Cardwell does not perform elective abortions, and she supports protecting unborn babies. But she also believes that making abortion a felony stokes fear among providers that lawmakers will review every decision they make. She argues legislatures should clarify what constitutes a serious health risk to a mother.
Anecdotal claims that OB-GYNs are fleeing pro-life states over these fears abound. In 2023, a Tennessee physician wrote that she left the state to continue performing abortions. Last year, an Idaho member of the American College of Obstetricians and Gynecologists told state lawmakers that some of her colleagues left the state over confusion surrounding its pro-life law.
However, a research team at the University of California Berkeley School of Public Health in April concluded that the number of providers did not significantly change across states with differing abortion laws in the first two years after the Dobbs decision. Researchers reviewed the administrative records of more than 60,000 OB-GYNs in a federal database and found that the number of OB-GYNs increased in all states from 2018 to 2024, regardless of abortion policies. “On a systematic, national basis, we do not find evidence of a ‘mass migration,’” study author Rebecca Staiger told me in an email.
A report from the Association of American Medical Colleges found that in 2023, slightly fewer medical school graduates applied to OB-GYN residency programs in pro-life states. However, the study authors also found that total applications dropped across the country that year when the AAMC attempted to reduce each student’s number of applications. Despite the decline, medical school graduates filled nearly all residency positions for OB-GYNs, including in states with laws protecting babies from abortion.
Some doctors-in-training may worry that they will not be equipped to provide adequate care for patients if they cannot perform abortions, since training programs and the American College of Obstetricians and Gynecologists claim abortions are part of essential healthcare and comprehensive care standards. The Accreditation Council for Graduate Medical Education says that abortion training is standard in an OB-GYN residency.
“Within the OB-GYN community, pretty much everyone takes the ACOG stance, which is that every woman should have access to an abortion if they want it,” said Dr. Madison Chapman, a pro-life OB-GYN in Grand Rapids, Mich. If students do not want to abort babies, they have to opt out of the abortion training rotation. In pro-life states like Texas, where Chapman completed his residency last month, programs will pay to send students to pro-abortion states for several weeks to complete the training. He said about 50% of his cohort chose to do the rotation.
Even without abortion training, all OB-GYNs learn to care for patients in emergency situations, Chapman said. The procedures to remove a miscarried baby are largely the same as early abortions, with the key difference being the intentional killing of an unborn baby. The only procedure Chapman said residents in pro-life states may have fewer opportunities to practice is the dilation and evacuation procedure, used to remove miscarried babies or kill unwanted babies after the first trimester of pregnancy. “This involves more skill and more training that is usually not done in abortion-restricted states,” he said. Many pro-life doctors prefer to induce labor in cases where a baby dies after the first trimester.
More than half of the 25 OB-GYN programs that received accreditation in the last five years are in pro-life states. While working at a teaching hospital in South Carolina, Dr. Francis Nuthalapaty saw how pro-abortion programs alienated students who believed in the sanctity of all human life. He later moved to Florida, where he started a new residency program at AdventHealth, which is associated with the Seventh-day Adventist Church.
Nuthalapaty said at one point he saw some pro-life students who considered choosing the specialty decide against it because the culture of OB-GYN circles did not align with their beliefs.
“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,” he said.
When Nuthalapaty counsels students on where to apply for residency or where to practice, he said they should first decide where they stand on key issues like abortion. “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 … be a light in that place,” he said. “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.”

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