MICHEL MARTIN, HOST:
Iowa needs more OB-GYNs. Lawmakers are trying to attract more, but critics blame a state abortion ban for the country’s lowest OB-GYN rate per capita. Natalie Krebs of Iowa Public Radio has this report.
NATALIE KREBS, BYLINE: Dr. Karla Solheim leads the Iowa chapter of the American College of Obstetricians and Gynecologists. She says practicing got harder after Iowa’s abortion ban started in 2024.
KARLA SOLHEIM: It just feels like our job is impossible.
KREBS: Solheim says a recent pregnant patient developed life-threatening complications, so Solheim ended the pregnancy. She says afterwards she was grilled by hospital administrators to make sure the abortion qualified for an exception under the law.
SOLHEIM: Did 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 to proceed with terminating the pregnancy?
KREBS: Another OB-GYN, Jonna Quinn, ended up leaving Iowa. Quinn grew up here and really wanted to stay, but the problems and stresses kept building at her job. For one thing, she worked at a Catholic hospital that did not allow her to offer all the birth control options or fertility treatments, and the staffing shortages kept getting worse. Quinn says at one point, she was seeing up to 50 patients a day.
JONNA QUINN: That is twice what a normal OB-GYN will see in a day. I knew I was going to miss something because there’s no way somebody can function at that level.
KREBS: But the final straw came when Iowa lawmakers banned most abortions after six weeks. Quinn says she felt like she was working under too many restrictions to provide the best medical care.
QUINN: I 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.
KREBS: Last year, Quinn took a job in Minnesota, where the state Constitution protects abortion. In Iowa, lawmakers are trying to keep OBs and attract even more. They raised the amount that Medicaid pays doctors for maternity care. They also used $150 million to create more residency training slots across Iowa. Solheim says these things help, but the state’s abortion law is an issue for OB-GYNs.
SOLHEIM: They understandably do not want to put their licenses and their livelihood at risk when it comes to taking care of patients.
KREBS: It’s still unclear how state abortion bans affect OBs. A national study of federal data didn’t find OB-GYNs are leaving abortion-banned states in significant numbers. Some researchers say the laws are so new, it’s too soon to see an effect. But when it comes to medical students – the future doctors – these laws do seem to be having an impact. Applications for medical residencies have dropped in states with abortion bans. That’s especially true for OB-GYN residencies. That’s according to the Association of American Medical Colleges. E is in her final year of medical school in Iowa, and she wants to be an OB-GYN.
E: I really worry about effect that abortion bans will have on my future patients and on my ability to provide evidence-based care for my patients.
KREBS: E asked to be identified by her middle initial because she’s concerned her comments could negatively affect her future career.
E: The idea of leaving Iowa possibly forever breaks my heart, but it is something I’m seriously considering at this point.
KREBS: For NPR News, I’m Natalie Krebs in Des Moines.
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MARTIN: This story comes from NPR’s partnership with Iowa Public Radio and KFF Health News.
(SOUNDBITE OF MARK HOLLIS SONG, “THE WATERSHED”) Transcript provided by NPR, Copyright NPR.
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