Fall of Roe v. Wade has made access to obstetricians tougher in many states, says report

Ever since the Supreme Court overturned Roe v. Wade in June 2022, even more women have struggled to find reproductive care, a new report warns.

Issued Thursday by the Commonwealth Fund, the report shows that women living in states long plagued by health disparities—particularly in the Southeast—have been harmed the most. And it isn't just about being able to afford care: Women in these areas are less likely to be able to even find an OB/GYN in their area.

Some of the statistics were particularly grim: In 2022, women living in more than one-third of U.S. counties had little or no access to maternity care.

"Women's health is in a very fragile place," lead report author Sara Collins said during a Wednesday media briefing, NBC News reported. "Our health system is failing women of reproductive age, especially women of color and low-income women."

Those inequities are not new, Commonwealth Fund President Dr. Joseph Betancourt noted during the briefing, "but recent policy choices and judicial decisions restricting access to reproductive care have and may continue to exacerbate them."

The report weighed a dozen measures of women's health care, including maternal mortality, preterm birth and postpartum depression, in all 50 states in 2022, the year the Dobbs ruling was issued.

That ruling "significantly altered both access to reproductive health care services and how providers are able to treat pregnancy complications in the 21 states that ban or restrict abortion access," the report authors wrote.

States with the most restrictive abortion policies, including Mississippi, Oklahoma, Texas and West Virginia, scored lowest in the new report. States that protected abortion care, including Connecticut, Massachusetts and New Jersey, ranked highest.

Insurance status also mattered: Women in states that had not expanded Medicaid coverage were the most affected.

"It's hard to stress how critical a source of coverage Medicaid is for pregnant women," David Radley, senior scientist for the Commonwealth Fund, said during the briefing, NBC News reported.

Reasons for the disparity are twofold, Collins noted. Women living in the lowest-ranking states are less likely to have health insurance, and even if they do, there aren't enough ob/gyns to take care of them.

Why? Doctors specializing in obstetrics and gynecology are either leaving states with abortion restrictions or aren't going there in the first place, experts said.

"It's not surprising that states with the most abortion restrictions or women's health policy restrictions are the same states that are having a real dearth of women's health workforce," Dr. Deborah Bartz, an OB/GYN at Brigham and Women's Hospital in Boston, told NBC News. "People are leaving those states because they can no longer provide the best care for their patients."

That leaves many women stranded when it comes to reproductive care, experts said.

"Your ZIP code shouldn't dictate your reproductive health destiny," Dr. Jonas Swartz, an assistant professor of obstetrics and gynecology at Duke Health in North Carolina, told NBC News. "But that is the reality."

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