The abortion ban has made it harder for fledgling OB-GYNs to learn necessary skills during their residencies, putting women's health at risk. Texas AbortionIsHealthcare abortionrights AbortionIsAWomansRight WomensHealth
The fetus Michelle was carrying was dead. At her 14-week checkup, the doctor had detected only low cardiac activity. Now, two weeks later, the physician confirmed it: The fetus likely had been dead for most or all of the intervening time. The 35-year-old Missouri woman, who asked that her real name not be used, vividly remembers what her doctor said next.
But Michelle’s OB-GYN worked at a hospital that didn’t provide D&Es. “It’s perceived as an abortion by the community,” a nurse explained. Why would a lack of abortion skills matter in a state that has outlawed almost all abortions? Because the surgical techniques used for elective abortions are used in other aspects of OB-GYN care, particularly in treating miscarriages. The situation threatens to cut off Texas’ supply of well-trained OB-GYNs equipped to provide both basic and critical care to all Texas women. Experts worry new doctors will leave the state for a higher caliber of training—and that they won’t come back.
Navya Kumar, a fourth-year medical student in Houston, is worried about her own future in the field. She’s currently interviewing with OB-GYN programs inside and outside of Texas. “I’m feeling pretty bad, I would say, just generally,” she said. “It’s going to be really, really hard to be an OB-GYN moving forward. It just… sucks.”
Then in September 2021, Senate Bill 8 restricted abortions to the period before fetal cardiac activity can be detected , effectively banning most elective abortions. Surgical abortions are legal if the mother’s life is at risk or if cardiac activity can no longer be detected. This all but eliminated the ability for medical residents to learn how to perform abortions during routine procedures.
Even before the more restrictive abortion laws, only OB-GYN residents in cities with abortion providers, like Houston and Austin, could commute daily to a clinic within city limits without needing to relocate, said Kristin Simonson, director of programs and operations at the Ryan Residency Training Program, an organization that helps OB-GYN programs integrate abortion training into their curriculum.
When Moayedi was a medical student in Fort Worth, she traveled to San Francisco for a one-month family planning rotation. There wasn’t a way to receive training locally through her school. “It really became my own responsibility to find [abortion] training,” she said. The rotation was elective, so she had to pay for it herself. She ended up taking out additional student loans. “It was burdensome on time. And it was a lot of money I had to borrow to be able to do that. But it was worth it for me.
In states where abortion is legal, residents first learn those surgical skills in a concentrated rotation and continue to practice them for the rest of their four-year residency. Texas OB-GYNs-in-training would only be able to practice during their two-to-four-week rotation. When young doctors lose the opportunity to develop these critical skills, it could translate into a loss of institutional knowledge throughout the field as older doctors retire. Cheng described it as a domino effect: Doctors who stay in Texas for their training won’t be able to train the next generation on how to perform abortions.
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