In the years since the U.S. Supreme Court reversed Roe v. Wade 鈥� and Texas's law banning most abortions went into effect 鈥� Dr. Austin Dennard said fear has become more present in her practice.
The Dallas-based OB-GYN said state restrictions have led to more conversations with patients concerned about becoming pregnant or accessing contraceptives. Patients who had not previously asked about permanent sterilization began expressing interest in the procedure.
鈥淏uilding a family and starting that chapter in your life is supposed to be an exciting one, and it has lots of twists and turns. That鈥檚 how life is,鈥� Dennard said. 鈥淏ut there is an overcast of fear and uncertainty that was never there in years before when I was practicing.鈥�
on the effects of Texas abortion restrictions found that same fear among surveyed physicians and residents 鈥� and second thoughts about practicing in Texas.
Of nearly 450 patients and 47 OB-GYN residents surveyed for the study by the consulting firm Manatt Health, more than three-fourths said they feel unable to practice evidence-based medicine because of Texas' abortion restrictions.
Alex Morin, Manatt Health managing director, said the study flags 鈥渆arly but clear indicators鈥� of an already stressed workforce that could further degrade in the coming years.
鈥淚f the trends that we鈥檙e seeing play themselves out over many years or if they worsen, then we are facing, I think, an even greater crisis of access, which by extension will create an even greater crisis in reproductive health outcomes in the state,鈥� he said.
Asked about legal ramifications of practicing evidence-based medicine, 60% of survey respondents said they fear legal repercussions and 29% said they do not have a clear understanding of the laws.
Dennard called the results 鈥渟taggering.鈥� She said abortion affects everyone, including women who are finished having children, older parents who hope their children have children of their own in state, and small businesses looking to attract out-of-state talent.
However, it鈥檚 not always seen that way, she said.
鈥淚f you put that into context into any other subspecialty in health care, I think the disgust would be tenfold,鈥� Dennard said. 鈥淏ut for some reason, because it relates to abortion care and abortion access, people don鈥檛 want to talk about it.鈥�
Over 40% of surveyed physicians said they have considered changing or decided to change how or where they practice. Some respondents said they have considered leaving the state to practice, retiring early or leaving medicine entirely.
Dennard said she and her husband, also a physician, have considered moving. She traveled out of state for an abortion in 2022 after her fetus was diagnosed with a rare, fatal condition. The couple鈥檚 conversations about a potential move intensified during and after the trip, and they have compiled a list of cities and states as potential options.
鈥淚 hope that we never have to get to that point,鈥� Dennard said. 鈥淏ut if contraception becomes something that we have to negotiate because of restrictions in our state, that would probably for me personally be the limit where I would need to go somewhere else.鈥�
Dennard joined other Texas women in a 2023 lawsuit filed by the Center for Reproductive Rights that challenged the state鈥檚 abortion restrictions. The Texas Supreme Court in May ruled in the state's favor, overturning a lower court鈥檚 ruling that granted a temporary injunction from the bans.
Impact on medical school, residency programs
Medical residents are similarly weighing their choices. Over half of residents surveyed said they factored abortion laws into their decision whether to stay in Texas after their residency.
Texas-based OB-GYN residency programs saw a 16% decline during the 2023-24 cycle relative to applications the prior year, though medical programs are still filling all allotted residency slots 鈥� and the study did not find a decrease in application quality. Program directors interviewed for the study were reluctant to link the decrease to state abortion restrictions, in part because the application process recently changed and the number of OB-GYN residency applications also fell nationwide.
Alex Morin with Manatt Health said more work 鈥� and time 鈥� is needed to understand how state laws may affect residency applications and the number of physicians in Texas.
鈥淩eally understanding and tracking that group of individuals over the next 鈥� 5 or 6 years is going to be essential to understand if there is a more dramatic impact and cause for concern in Texas and around the country,鈥� he said.
Got a tip? Email Kailey Broussard at kbroussard@kera.org.
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