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OBGYN practice trends post-Dobbs

Trends in OBGYNs’ practice locations have not significantly differed across states based on abortion-related policy environments following the Supreme Court’s Dobbs v Jackson Women’s Health Organization (Dobbs) decision in 2022, according to a recent study published in JAMA Network Open.¹

Abortion bans have been implemented in 14 states since the Dobbs decision, alongside an additional 6 states banning abortions after 6- to 12-weeks’ gestation. This has led to a rise in professional unease about an increase in legal risks caused by these bans, with media reports indicating physicians leaving states where bans have been implemented.²

“The future legality of abortion remains uncertain in several additional states where litigation and ballot initiatives are developing,” wrote investigators.¹

Assessing trends across states

To evaluate trends in OBGYNs practicing in states with abortion bans, investigators conducted a descriptive cohort study. Practicing OBGYNs were included in the analysis, identified using National Provider Identifiers.

In the primary analysis, participants included allopathic or osteopathic attending physicians or trainees with a taxonomy linked to obstetrics and gynecology practicing between January 1, 2018, and September 30, 2024. Three additional populations were included in the secondary analyses.

These populations included medical residency program graduates in the prior year, maternal-fetal medicine (MFM) specialists, and OBGYNs separately evaluated based on gender. State abortion policy categories included total ban states, threatened states with gestational age bans, and protected states without abortion bans.

Practice outcomes

The number of OBGYNs per quarter practicing in these state types were reported as the first primary outcome. The other primary outcome was the share of all physicians who were OBGYNs in each quarter, by practice environment.

In secondary analyses, the number of resident graduates practicing in a policy environment was divided by all other residents in their graduation-year cohort. Investigators also divided the percentage change in OBGYN counts in each quarter by that in Q1 2022, the quarter before the Dobbs decision.

There were 6,617,452 practitioners in the sample, 1,575,820 of whom were physicians or trainees and 60,085 were OBGYNs. Of OBGYNs, 12.9% were recent residency graduates and 3.8% MFM specialists.

Small changes in share of OBGYNs

Similar trends in counts and shares were reported between state policy environments, with total ban states experiencing a mean increase in per-quarter counts of 8.3%, threatened states 10.5%, and protected states 7.7%. According to investigators, these differences in increases were not statistically significant.

For shares of OBGYNs, decreases of 2.4%, 1.5%, and 2.1%, respectively, were reported, which were also not significantly different for total ban states vs protected states. However, the difference for threatened vs protected states was statistically significant.

When comparing Q1 2022 to Q3 2023, no significant differences in OBGYN movement across policy environments was reported, as 95.8% of OBGYNs remained in protected states. Additionally, 94.8% and 94.2% remained in threatened and total ban states, respectively.

Additional OBGYN trends and conclusion

Stable trends in the policy environment of postresidency location were also reported among residency graduates, with a rise of recent graduates in protected states under 2% vs under 4% in total ban states. Other secondary populations of interest also had no significant differences in practice location.

“Although these findings do not provide insight into changes in the quality of care provided, they suggest that there are no major changes in the supply of OBGYNs associated with the Dobbs decision,” wrote the investigators.

References:

1. Staiger B, Bolotnyy V, Borrero S, Rossin-Slater M, Van Parys J, Myers C. Obstetrician and gynecologist physicians’ practice locations before and after the dobbs decision. JAMA Netw Open. 2025;8(4):e251608. doi:10.1001/jamanetworkopen.2025.1608
2. Frederiksen B, Ranji U, Gomez I, Salganicoff A. A national survey of OBGYNs’ experiences after Dobbs. Kaiser Family Foundation. 2023. Accessed April 25, 2025. https://files.kff.org/attachment/Report-A-National-Survey-of-OBGYNs-Experiences-After-Dobbs.pdf.