These days, it is not uncommon for people to tell me that I am "brave" for pursuing a career in OB-GYN, given the current state of reproductive rights in America.
When people say this, I immediately think about a patient -- let's call her Claire. The stretcher rolls by on labor and delivery, and I see a young woman lying on her side crying in pain and scared. She was traveling through Virginia from another state when she broke her water and started bleeding. Now, she is actively miscarrying, bleeding and in danger. Despite several blood transfusions, the blood loss is not controlled. Claire takes my hand, the medical student, and thanks the team for taking care of her; she is so grateful that she can get the care she needs. We don't talk long before she goes to the operating room and the providers save her life.
If Virginia restricted abortion or required extradition of patients or providers, this patient may have experienced delays in care that could have been fatal.
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Patients like Claire deserve the standard of care -- which sometimes requires medical interventions to end a pregnancy. Since the Supreme Court's Dobbs decision in 2022, 22 states have enacted abortion laws stricter than the Roe v. Wade standard. Virginia remains the only state in the Southeast that provides abortions into the second trimester, not only for Virginians, but also for patients who travel from other states to receive care here. Providing this care requires not only supportive laws, but also trained providers.
Like other medical students, when I applied to residency I carefully considered the states in which I would continue my medical training. The Virginia state election in 2023 was a very important outcome in my decision to include Virginia programs in my residency application because abortion remained accessible in Virginia. Southern states are seeing record low numbers of applicants for obstetrics and gynecology, and Virginia could be next if abortion care isn't protected.
In 2022-2023, applications to OB-GYN residencies in states with complete abortion bans decreased by almost 11% and a nationwide survey found that almost 60% of medical students, regardless of specialty, were unlikely or very unlikely to apply to states with abortion restrictions.
Since over 50% of physicians practice in the state where they complete residency, this is directly relevant to Virginia's workforce. Currently, a third of Virginia counties are maternal care deserts and Virginia's primary care provider demands will exceed service availability by 2030. Further restrictions and interference in the practice of medicine will only worsen this workforce shortage. Virginia's future medical workforce will depend on electing legislators who protect access to reproductive health care.
Seeing patients like Claire reaffirmed my desire not only to pursue an obstetrics-gynecology residency, but to seek training only in states that preserve access to abortion care.
Last November, Virginians made their beliefs on reproductive rights clear by showing up at the polls and electing legislators who support access to care. But there is still work to be done. Voting in this year's election will be crucial. I urge you to register to vote, find your polling place, or vote by absentee ballot.
Katie Kolb is a third-year medical student who is currently training in Virginia. She has experienced seeking pregnancy care in a maternity care desert county and plans to provide obstetrical care here upon completing her education. She can be reached at [email protected].
Sarah Sebastian, MD, PGY-1 in OB/ GYN residency, is an alumna of the University of Virginia School of Medicine (2024). Opinions expressed are solely her own and do not express the views or opinions of her employer or alma mater. Contact her at sarah. [email protected].
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