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today, Representative Cindy Axney (IA-03) Xavier Becerra, secretary of the Department of Health and Human Services, and Jennifer Klein, director of the White House Gender Policy Council, wrote a letter to express their concerns about the negative impact of the decision. Dobbs v. Jackson Women’s Health Organization Access to women’s and reproductive health care in states that are considering abortion bans, such as Iowa. Members expressed concern that restrictions on reproductive health would further restrict and reduce the availability of health care providers, particularly in rural areas that lack access to care.
Representative Axon was joined by eight of her colleagues in writing this letter. Together, the group represents several U.S. states that are considering or already implementing abortion and other reproductive health care services.
The letter sheds light on the already dire state of reproductive health care that abortion restrictions pose to the workforce that provides this care in these states.
Many counties in Iowa and other states are represented in this letter as maternity care deserts, meaning there are no maternity care, birth centers, or hospitals with obstetrician-gynecologists (OB-GYNs).) And with no certified nurse midwives, the impact of restricting abortion can be devastating.
For example, the letter A A study from Texas This suggests that earlier state legislative efforts to restrict abortion, such as prohibiting abortion after detection of fetal or fetal heart activity, doubled the risk of health complications for pregnant patients.
“During the long-standing maternal mortality crisis in the United States, which has resulted in American women dying at higher rates than any developed country, these restrictions are life-threatening and have a significant impact on an already overburdened and understaffed reproductive health care workforce.”“ The members continued. “The reproductive health care workforce, which includes obstetrician-gynecologists (OB-GYNs), nurses, midwives, midwives and other professionals, provides services ranging from Pap smears and STD testing to maternal and infant care. . Despite their important services, these providers are few and far between.
According to the letter, doctors are expressing concern about losing their medical licenses and allowing legal recourse to practice in states that have criminalized abortion services, making it more difficult to attract new talent to the profession. In fact, one medical recruiting firm reported that 20 OB-GYNs have turned down positions that restrict abortion, and many others won’t even consider roles in such states.
To address these concerns, this coalition asked Secretary Becerra and Director Klein to respond to six questions about the future of reproductive health care in the United States, particularly in states where abortion bans may be implemented.
The letter was signed by US representatives. Alma Adams (NC-12), Carolyn Bourdeaux (GA-07), Emmanuelle Cleaver (MO-05), Veronica Escobar (TX-16), Ruben Gallego (AZ-07), Brenda Lawrence (MI-14), Kathy Manning. (NC-06), and Tom O’Haleran (AZ-01).
Read the letter in its entirety over here:
Dear Secretary Becerra and Director Klein,
As representatives of the half of states that are considering or implementing restrictions on abortion, we are deeply concerned about the negative impact these measures have on women, pregnant people, their families, and the health care providers who provide them. They think. Most restrictions severely limit abortion to a narrow time frame during pregnancy, with a few exceptions entirely. A growing number of states want to eliminate exceptions for rape or incest, and exceptions for life-threatening/emergencies are confusing, unclear, and interfere with physicians’ ability to provide care based on their best medical judgment.
Various studies have shown that unintended pregnancies, pregnancy-related deaths, complicated pregnancies, miscarriages, and unsafe abortions may increase with these new restrictions.
In fact, a study from Texas found that the state’s past legislative efforts to prohibit abortions and criminalize the delivery of abortion care by doctors after detection of fetal or fetal heart activity doubled the risk of health issues. For pregnant patients. In the U.S.’s long-running maternal mortality crisis, which has caused American women to die faster than any other developed nation, these restrictions are life-threatening and will have a significant impact on an already overburdened and understaffed reproductive health care workforce.
The reproductive health care workforce, including obstetricians and gynecologists (OB-GYNs), nurses, midwives, midwives, and other professionals, provides a variety of services, such as Pap smears and STD testing, to guide maternal and infant care. Despite their important services, these providers are in very low supply. in the past Dobbs According to the decision, the Health Resources and Services Administration expects the number of OB-GYNs to decline to 7% by 2030, leaving a gap of 5,170 providers between the supply and demand for OB-GYNs. Today, these shortages affect 34.9% of US counties as maternity care deserts, meaning there are no maternity care hospitals, birthing centers, OB/GYNs and certified nurse midwives. Most of these counties are located in rural areas where 8 percent of obstetricians practice. post-Dobbs, A large proportion of these counties are located in states that prohibit or practice abortion, presenting additional barriers to health care access and serious challenges to future reproductive health care workforce development in these areas.
For example, several articles document lack of interest among medical students, OB-GYN residents, and providers pursuing training and careers in states that have or are considering abortion restrictions. Some concerned medical students, especially those seeking OB-GYN practice, said they felt discouraged from pursuing residencies in states like ours that could not teach them full reproductive health care and/or limited their scope of practice. As providers are more likely to practice in the same location where they complete their residency, these concerns indicate a potential challenge for physician recruitment in the future.
Even where doctors can be recruited, there are also concerns about the education and preparation of the future reproductive health care workforce. A recent UCLA study found that 44.8% of 286 accredited OB-GYN residency programs are located in states that may or may not prohibit abortion. Thus, of 6,007 current obstetrics and gynecology residents, 2,638 (43.9%) were either definitively or in-state with no access to training in abortion-related procedures and critical to other reproductive services. For example, technical procedures such as abortion and ablation may be used to manage miscarriage, treat heavy bleeding, or take a biopsy from the uterus. Additionally, abortion care training remains critical in the ability to manage life-threatening complications such as placental abruption, infections, and eclampsia, and the same skills are often used in the provision of nonabortion services, such as early pregnancy ultrasonography, pain management, and uterine dilation. This means that in addition to the shortage of medical providers in our regions, those remaining providers are unable to provide comprehensive reproductive care to their patients. This affects people who need care in our regions and our legal cases are higher and more complex care needs are more likely to arise.
The future of reproductive health care is at stake nationwide. We appreciate the steps already taken by the administration for access to reproductive and other health care services. We hope to support efforts to highlight and address workforce challenges that we expect to be exacerbated, particularly in states like ours that are implementing or considering restrictions on abortion and reproductive health care. For these reasons, we respectfully request that the Reproductive Health Care Access Task Force respond to the following questions by October 15, 2022.
- How does the administration plan to follow up on reproductive health and human resources? Dobbs Decision?
- How management can support recruitment efforts in communities facing an increasing need for reproductive health care providers Dobbs Decision?
- How can the administration support efforts to protect access to comprehensive reproductive health care training in OB-GYN residency programs in states that have implemented or are implementing abortion restrictions?
- Similarly, how can administration help medical school students gain adequate exposure to general reproductive health care training and service delivery in their clinical rotations?
- As a result Dobbs Barriers to decision-making and care, including abortion, may be of greater concern in patients with complex pregnancies requiring prompt and higher levels of care. Are there contingency plans to extend care to such individuals, particularly in areas with shortages of OB-GYN providers? What about patients with urgent or follow-up reproductive health care needs, including abortion?
- What additional steps can the administration take in the short and long term to prevent people in states like ours from missing out on essential health care?
We look forward to hearing from you and thank you for your prompt attention to this matter and your service to our country.
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