Jonna Quinn was initially thrilled when she got her first job after her medical residency, working as an OB-GYN in Mason City, Iowa. It was less than two hours down the road from West Bend, where she grew up on a farm.<\/p>\n
But the hospital started restricting certain birth control options and fertility treatments based on its affiliation<\/a> with the Roman Catholic Church, she said. At the same time, her unit was increasingly short-staffed<\/a> as other obstetricians left and retired.<\/p>\n At one point, Quinn said, she was seeing up to 50 patients a day.<\/p>\n \u201cThat is twice what a normal OB-GYN will see in a day,\u201d she said. \u201cI knew I was going to miss something, because there\u2019s no way somebody can function at that level.\u201d<\/p>\n In spring 2024, Quinn decided to leave \u2014 not just Mason City, but Iowa entirely.<\/p>\n At the time, the state Supreme Court was on the verge of approving a law<\/a> banning abortion as early as six weeks of pregnancy, with very few exceptions.<\/p>\n It was the last straw for Quinn, who got a job<\/a> in Minnesota and moved her family there. Minnesota has constitutional protections<\/a> for abortion.<\/p>\n \u201cI could either stay and ruin myself and my career and my mental health and my relationship with my children, or I could go and continue to practice OB, which had always been my dream,\u201d she said.<\/p>\n A few months after Quinn moved away, Iowa\u2019s abortion ban went into effect on July 29, 2024.<\/p>\n A Severe Shortage<\/strong><\/p>\n After the Supreme Court overturned Roe v. Wade<\/em> in 2022, multiple states, including Iowa, enacted abortion bans<\/a>.<\/p>\n Coupled with existing OB-GYN shortages, the laws have put doctors under increasing strain and surveillance, complicating the standard medical treatments<\/a> for miscarriage, ectopic pregnancy, premature membrane rupture, and other pregnancy problems. Some physicians fear these laws could drive these much-needed doctors from certain states and dissuade other OB-GYNs from moving in and establishing a practice.<\/p>\n Iowa has the lowest number of OB-GYNs per capita<\/a> among states, according to a KFF analysis of 2021-22 federal data<\/a> from the Health Resources and Services Administration<\/a>.<\/p>\n Studies show that insufficient maternity care is linked to low birthweight<\/a> and increased infant and maternal mortality<\/a>.<\/p>\n Stress on Those Who Remain<\/strong><\/p>\n Rural hospitals in Iowa have been struggling to find more OB-GYNs.<\/p>\n The Grinnell Regional Medical Center<\/a>, a 49-bed hospital in a rural college town, has been trying to recruit an OB-GYN, and a family practice doctor with obstetrical training, for more than a year.<\/p>\n The hospital has seen a dramatic jump in deliveries after a neighboring hospital shuttered its labor and delivery unit<\/a> in 2024. The additional deliveries have been stressful for its two existing obstetrical-unit doctors, said David-Paul Cavazos<\/a>, an executive with the center.<\/p>\n Back when patient volume was lower, it was easier for doctors to be on call over the weekend, he explained.<\/p>\n \u201cYou just kind of had to hang out at home, be by the phone,\u201d he said. But recently, the on-call doctors have been delivering \u201cfive babies on Saturday, six babies on Sunday,\u201d Cavazos said. \u201cIt becomes more stressful.\u201d<\/p>\n An Iowa law<\/a> enacted last May increased Medicaid reimbursement rates for maternity care, so OB-GYNs could be paid more for caring for pregnant patients. The new law also directs federal funding toward a project to set up additional medical residency slots, including OB-GYN residency slots, in the state. Medical residents tend to stay and establish practices<\/a> in states where they complete their residency.<\/p>\n These things could help, said Karla Solheim<\/a>, chair of the Iowa section of the American College of Obstetricians and Gynecologists. But the state\u2019s abortion restrictions are still a red flag for some OB-GYNs when deciding whether to practice in Iowa, she said.<\/p>\n \u201cThey understandably do not want to put their licenses and their livelihood at risk when it comes to taking care of patients,\u201d Solheim said.<\/p>\n At her previous job in Quad Cities, Solheim performed an abortion on a patient who had life-threatening complications, she said. It spurred many phone calls from hospital administrators<\/p>\n They peppered her with questions about her decision, Solheim recalled. \u201cDid I have enough evidence? Was her blood count low enough that her life was in danger? Should we have waited until her blood pressure got lower?\u201d<\/p>\n Solheim recently stopped delivering babies to focus on gynecology and outpatient care, saying she had become exhausted working in Iowa hospital units that didn\u2019t have enough obstetricians.<\/p>\n Recent data on residency applications shows that state abortion bans may be influencing the next generation of doctors.<\/p>\n Fewer medical students are applying<\/a> to OB-GYN residency programs in states that restrict or ban abortion, according to a data analysis<\/a> from the Association of American Medical Colleges.<\/p>\n For E., a fourth-year medical student in Iowa, the law weighs heavily on her decision of where to apply for OB-GYN residency, and, ultimately, practice. She worries about how Iowa\u2019s law will affect her ability to practice evidence-based care.<\/p>\n E. is her middle initial \u2014 KFF Health News and NPR are identifying her that way to prevent her comments from jeopardizing future job opportunities.<\/p>\n \u201c<\/strong>I\u2019m seriously questioning whether Iowa is a state that I want to practice in, in the long term, and it breaks my heart because I know that there is such a need,\u201d she said.<\/p>\n A Mixed Picture<\/strong><\/p>\n It\u2019s still unclear whether abortion bans are driving doctors out of state.<\/p>\n One recent study<\/a> in Idaho found that two years after the state enacted its highly restrictive abortion law, 35% of the state\u2019s 268 OB-GYNs had stopped practicing obstetrics.<\/p>\n But another study<\/a>, analyzing federal data two years after the 2022 Dobbs <\/em>decision, failed to find significant departures of OB-GYNs from states with abortion bans.<\/p>\n \u201cWe were surprised, and we cut the data in every possible way that we could,\u201d said Becky Staiger<\/a>, an assistant professor at the University of California-Berkeley\u2019s School of Public Health, and the study\u2019s lead author.<\/p>\n While numbers don\u2019t show a systemic exit, it\u2019s possible some OB-GYNs are adapting how they practice so they can stay with their patients, she said.<\/p>\n \u201cWe\u2019ve heard anecdotally, and through qualitative research, that they\u2019re really highly committed to those patients,\u201d Staiger said.<\/p>\n She said the analysis also doesn\u2019t capture<\/a> how OB-GYNs feel about working in states with abortion restrictions<\/a>.<\/p>\n \u201cWhat we can\u2019t observe is anything about the quality of care that the providers are able to provide, about provider satisfaction with job, about provider safety,\u201d Staiger said.<\/p>\n This article is from a partnership with <\/em>Iowa Public Radio<\/em><\/a> and <\/em>NPR<\/em><\/a>.<\/em><\/p>\n\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n