Are OBGYNs fleeing Idaho because of abortion laws?
[This article is a transcript of “Are OBGYNs feeling Idaho because of abortion laws?” courtesy of volunteer Ben Tomlin. If you’re interested in volunteering to transcribe more of our content, please complete our volunteer survey.]
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Can you guess which state just lost one-third of its OB-GYN doctors in just two years? It’s Idaho.
Dr. Kristin Lyerly (@drkristinlyerly on IG), “The numbers are staggering, but the human cost is even worse.”
This is Dr. Kristen Lyerly. She’s an OB-GYN and an abortion provider.
Just two months after Roe was overturned, Idaho’s trigger ban hit.
Dr. Lyerly
Dr. Lyerly is claiming these OBs are leaving because of Idaho’s abortion ban. That’s very unlikely.
94 out of 268 OB-GYNs are gone, and I know you know why.
Dr. Lyerly
She’s talking about this research letter that says since 2022, when Idaho banned abortion, a lot of their OB-GYNs have left, so they looked at the change in OBs, after Dobbs, 2022, in Idaho. The research has no control group. They didn’t look at the change in other kinds of doctors like pediatricians or neonatologists in Idaho since Dobbs. They didn’t look at the changes in OB-GYNs before Dobbs even happened. They didn’t look at the change in OB-GYNs in other states besides Idaho since Dobbs. They didn’t compare it to anything. They just said, “Hey, since Dobbs, this is what has happened.”
If you’re involved in academic research at all, you know it’s actually really important to have control groups because they give you context, and sometimes that context will paint a very different picture.
At Bonner General Health in rural northern Idaho, for example, the entire maternity ward just shut down.
Dr. Lyerly
Bonner General shut down their maternity ward largely because they didn’t have pediatrician coverage to safely staff the maternity ward. Pediatricians literally never perform abortions. They are not leaving their practices in rural Idaho because of abortion laws. So why are they leaving? They cited a bunch of reasons, including decreasing birth rates, older populations moving to Bonner County, and, in particular, a different Idaho hospital, I think is about an hour drive away, that had a new updated unit and 24/7 coverage of OB-GYNs and neonatologists, and people were just choosing to drive there instead of going to Bonner’s hospital, which was closer.
[Read more – Idaho hospital ends L&D services due to decreasing patient volumes; media blames abortion bans]
The research letter Dr. Lyerly referred to said similar things. It talked about the consolidation of practices in urban areas. More rural states and areas have had problems with healthcare coverage for decades. Idaho has had one of the lowest ratios of doctors to the population for decades, like since at least the late 70s. This is not a new problem, and this research letter kind of acknowledges that when it says that the small sample size restricts replication in more populous regions and has limited generalizability. That’s academic talk for saying if you look at other states or in less rural areas, you probably won’t get these results.
But we already knew you wouldn’t get these results elsewhere. Earlier this year, there was much more comprehensive research that looked at the changes in OB-GYN levels in all of the states. They found that the share of physicians who are OB-GYNs decreased less in pro-life states than in pro-choice ones: opposite to the expected finding if OB-GYNs were leaving states where abortion is threatened.
[Read more – No, OBGYNs aren’t fleeing pro-life states]
If even one more doctor leaves a rural community that’s already stretched thin, entire communities lose all maternity care.
Dr. Lyerly
She’s right that this is a serious problem, and it’s a serious problem for a whole bunch of reasons that have been going on for a while: maternity care is underpaid; fewer and fewer doctors have their own practices and have to be consolidated in hospitals or private equity groups. Lack of healthcare coverage for people in rural areas is a serious issue, but if you really cared about it, you’d be looking into the reasons it’s actually happening and not trying to twist everything to be about defense and expansion of abortion.
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