How Texas's abortion laws are driving doctors out of the state
Texas' strict abortion laws have hindered doctors in the state, leaving them unable to offer comprehensive maternity care to pregnant women, according to Dr. Emily Briggs, an obstetrician and family physician who works in central Texas.
To date, no doctor has been prosecuted for violating the ban, which is now a felony, but the confusing and inconsistent law has doctors worried about how they interact with their patients. Briggs considers it a "dangerous situation."
"Because I personally, as a family physician, could face losing my license, I could face life in prison, I could face huge fines, just for having a conversation with my patient about evidence-based care," she said.
How Texas' abortion laws have impacted medical care
Twenty states, including Texas, banned or severely restricted abortion after the Supreme Court overturned Roe v. Wade in 2022. Violating the Texas' abortion law is considered a felony.
Before the 2022 decision, Texas, under SB-8, had banned abortion at six weeks with no exceptions for rape, incest or severe fetal abnormalities. There was an exception for medical emergencies, but the bill didn't define what those were.
In 2022, Texas enacted another, more restrictive law, banning all abortion from conception, except when the mother's life was in immediate danger.
The prospect of facing prosecution has created such fear that today, most Texas hospitals require physicians to consult with staff attorneys when they treat complicated pregnancies and miscarriages.
Leaving Texas to train, practice elsewhere
Dr. Briggs said she's heard from colleagues, both obstetricians and family physicians, who no longer want to practice in Texas. Last year, the number of OB-GYN resident applicants in Texas dropped 16%.
"Future obstetricians are acknowledging the complexity of the rules in Texas," Briggs said. "Not only do they not want to train here, but that also means that they won't want to practice here."
Dr. Adrianne Smith transferred from Texas to the University of New Mexico Hospital last year.
One of her last cases in Texas still haunts her: a young woman who became extremely ill after she tried to end her own pregnancy with an unknown medication she bought in Mexico.
Smith spoke with a supervising physician about the case.
"He looked at me and said, 'The attorney general is looking to make an example out of somebody. And you don't want to be that case,'" Smith said.
She said it made her realize there were people looking to criminalize her professional actions and send her to jail.
OB-GYN training impacted by Texas law
In Texas, residents now miss out on the opportunity to learn about several forms of care for pregnant women, according to Dr. Eve Espey, the chair of the OB-GYN department at the University of New Mexico.
"They lack an opportunity to learn trauma-informed care…diagnosing pregnancy complications in the first trimester and in the second trimester," she said. "They miss learning…miscarriage care, ectopic pregnancy care, pregnancy of unknown location. I mean, the list goes on and on."
These things are part of the training required to become a certified OB-GYN anywhere in the U.S., but in Texas, some training is no longer offered because of the new laws. That means OB-GYN residents now have to leave the state for two to four week rotations to get the required training.
That's not enough time, according to Espey.
"Our residents have a dedicated rotation in the first year, in the fourth year. But they are working alongside us throughout their four years of residency," she said.
Back in Texas, Briggs is urging lawmakers to work with doctors. She worries about what she believes will happen if nothing changes.
"We lose physicians in Texas, we lose healthy mothers, we lose families in general. It's already scary to decide to become pregnant," she said. "Throw on top of that that if something medically complex happened, you could lose your life and not have the care that you deserve. Why would anybody stay for that?"
