Abortion-Providing Clinicians Are Shifting Careers and Locations to Meet Needs
October 1, 2025 4 minutes read
By Melinda Young
A new and growing trend among OB/GYNs and other reproductive healthcare clinicians in the post-Dobbs era has shifted healthcare resources for women out of Southern states and into states with laws that do not have abortion bans, research shows.1 “We did this study the year after Dobbs, from June 2022 to December 2023, and about 74% of the respondents were practicing in no-restriction states, and 20% were in abortion-ban states after Dobbs,” says Dana Howard, PhD, MS, an assistant professor in the division of bioethics, department of biomedical education and anatomy, department of philosophy at The Ohio State University in Columbus.
“Of the respondents, 16% moved in that year from their state of primary practice, and that percentage is much higher than other rates of relocation found amongst OB/GYNs before Dobbs,” Howard says. “When we looked at where they were moving from and where to, we found that 42% of providers who were practicing in a state that imposed a ban relocated their primary care practice — compared with 9% moving from unrestricted abortion states.”
Nine in 10 of the doctors who moved their practice ended up in a state that did not impose an abortion ban. And 6% of respondents stopped providing any abortion care after Dobbs, and they were mostly in abortion-ban states.1
“Early evidence shows there are these really significant changes that are happening with clinician relocation,” Howard says. “Our respondents were all clinicians providing abortion. So, this was a more specialized group that we’re studying, in comparison to OB/GYNs more broadly.”
The study’s findings gave an early look at workforce changes in reproductive healthcare. Investigators noted that broader reproductive healthcare workforce patterns can take years to develop, but their findings provide early insight into a pattern that may expand in coming years and decades.1 Clinicians in the study included nurses, advanced practice practitioners, and clinicians in family medicine.1
“The study has a broader understanding of who are the clinicians providing abortion,” Howard says. “Our study looked at a larger section of the reproductive health workforce.” Of these clinicians who provided abortion care, 92% provided other healthcare services, including a full spectrum of reproductive healthcare, such as contraception counseling, contraceptives, Pap smears, and more, she notes. “These are clinicians in these communities providing the full spectrum of reproductive healthcare,” Howard adds. Their places of practice included academic hospitals, Planned Parenthood facilities, independent clinics, and community hospitals.1
Relocations of highly trained healthcare clinicians can have a ripple effect on the communities they are leaving behind, and this could place more burden on clinicians who remain and make access to reproductive healthcare more challenging for patients.1 “When clinicians can’t provide the standard of care, they may leave, and we’re starting to see a large proportion of clinicians moving to places where they can provide the full spectrum of care,” Howard explains. “When they leave, they leave patients with a lack of access to maternal health and reproductive healthcare.”
The clinicians who provided abortions before the U.S. Supreme Court overturned Roe v. Wade and made it possible for states to enact total abortion bans are committed to providing healthcare for their patients. But practicing medicine in states with highly restrictive laws creates too much uncertainty and stress for many of them, Howard says.
“For example, what constitutes a medical emergency? Given the new administration changing federal guidance related to requirements for EMTALA, there is a lot of uncertainty among clinicians and hospitals of what to do, and patients are suffering,” she says. “Patients may have to wait until their condition worsens, which can have long-term effects on their fertility, their health, and their ability to have children in the future.”
For some clinicians, the moral distress and stakes may be too high, so relocation seems like their best option. “One thing I find interesting is the fact that in these restrictive states, emergency hospitalists are now responsible for providing abortions, and lot of these folks didn’t sign up to do that,” Howard says. “So, there could be misalignment of who is the abortion provider and whether it is the hospitalist or the clinician who was trained for it and wants to be engaged in this kind of healthcare.”
Emergency department physicians might have their own ethical concerns related to abortion care, and that could be different from what OB/GYNs are doing, she adds. “It puts people in positions where they’re expected to provide care that isn’t necessarily what they signed up for,” Howard says.
Howard’s other recent study looks at moral distress among reproductive healthcare providers in the post-Dobbs era, and she found that uncertainty of what is legal and what could result in civil or criminal penalties elevated clinicians’ moral distress. Researchers found that clinicians who practiced in restrictive states had more than twice the amount of moral distress as those who practiced in protective states.2
“Even if they know what the law is now, the fact that it could change and there might be potential legislation elevates their level of moral distress and makes it harder for people to do their jobs,” Howard says. “The question of change is a really huge concern.”
For instance, Howard does research in Ohio, a midwestern state that has changed its laws about abortion access several times since mid-2022. “The people of Ohio were very clear about enshrining reproductive rights into the Ohio constitution,” she says. But Ohio’s legislative body has tried to reduce access to abortion care, which creates uncertainty and moral distress among clinicians who provide abortions, she adds.
“Moral distress is this idea in bioethics that it’s not just feeling stressed out; it’s this specific suffering or experience where you feel you know what the right thing to do is for your patients, and institutional or legal barriers are stopping you from providing that care,” Howard explains. “The question of change is a really big concern.”
Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.
References
1. Howard D, Bornstein M, Wascher J, et al. Relocation post-Dobbs among clinicians providing abortions. JAMA Netw Open. 2025;8(6):e2514884.
2. Rivlin K, Bornstein M, Wascher J, et al. State abortion policy and moral distress among clinicians providing abortion after the Dobbs decision. JAMA Netw Open. 2024;7(8):e2426248.
Clinicians in the study included nurses, advanced practice practitioners, and clinicians in family medicine.
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