Health providers have seen an increase in pregnant patients suffering from serious medical complications due to delayed care in the two years since Roe v. Wade was overturned, according to a new report from House Democrats.
But, at the same time, obstetrician-gynecology residents in states with abortion restrictions are receiving less training to perform abortions.
The report was released late Thursday by Democrats on the House Energy and Commerce Committee and is the culmination of an investigation launched in September 2023.
It was based on interviews committee staff conducted with OB-GYN educators and residents from 20 programs to learn how the ruling in Dobbs v. Jackson Women's Health Organization has impacted the study and practice of obstetrics and gynecology.
“What we found was deeply disturbing. The Dobbs decision has created chaos and confusion for OB-GYNs and their patients,” Rep. Frank Pallone, Jr (D-N.J.), the committee’s ranking member, said in a statement.
The report also found that abortion training for residents in states that restrict or ban the procedure has been practically eliminated in some cases, even though certain skills are the same required to treat pregnancy complications.
In other cases, training has been limited to simulations and textbooks in lieu of observing an abortion firsthand, forcing residents to travel out-of-state to learn the skills needed for their practice. That in turn causes strain on the capacity and resources of programs in abortion-protected states, the report found.
Prior to the Dobbs decision, residency programs often partnered with abortion clinics to provide training if state laws prohibited it from being taught. But in many states with abortion bans, those clinics have been forced to close.
“I fear that over time the stark differences in training between OB-GYNs in protective and restrictive states will effectively create two different pools of OB-GYNs with entirely different sets of training, knowledge, and ways of caring for their patients,” Pallone said.
Residency program leaders who participated in the report universally agreed that abortion care is integral to other components of reproductive health care and can't be eliminated or isolated from residency training.
“It should go without saying that having to navigate a legal minefield to provide OB-GYNs with critical knowledge and training should not be necessary,” Stella Dantas, president of the American College of Obstetricians and Gynecologists (ACOG) said in a statement. ACOG was not involved in writing the report.
“Residency program directors should be able to focus their energy on preparing tomorrow’s ob-gyns with the skills they need to embark on successful careers in an incredibly complex, rewarding field instead of navigating legal intricacies that could expose them, their trainees, and their programs to significant risk,” Dantas added.
Residents and residency directors in restrictive states interviewed in the report recalled harrowing situations where patients present with serious complications but can’t receive the care they need to prevent further complications from developing.
One residency program director in a restrictive state described a case where a pregnant patient was transferred to the emergency room with an infection and no fetal heartbeat. But because an abortion couldn’t have been performed earlier, the patient developed sepsis and died.
Another director noted that “very complex cases” are often “bounced around” from clinic to clinic due to the poorly written laws banning abortion, because doctors are fearful of prosecution and loss of their license.
The report also highlighted other consequences from abortion bans, including fewer applicants to OB-GYN residency programs in states that restrict abortion, and practicing OB-GYNs moving out as well.
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