March 24, 2026 

Abortion Restrictions and the Physician Workforce Pipeline

WASHINGTON, D.C. – Doctors for America strongly condemns abortion bans and criminalization of reproductive healthcare, as these policies not only restrict patient access, but are actively destabilizing the physician workforce pipeline at a national level.

Abortions bans directly contribute to required reproductive health training mandated by the Accreditation Council for Graduate Medical Education (ACGME). An estimated 43.9% of OB/GYN residents trained in states have or are predicted to outlaw abortion access. As a result, the proportion of residents receiving comprehensive reproductive training may drop from 92% to only 56%, and this number does not fully account for additional affected residencies like Family Medicine. The loss of training opportunities undermines trainees’ confidence in procedural and counseling skills, including uterine evacuation, ultrasonography, and miscarriage management. Inadequate preparation in these competencies jeopardizes trainees and future attending’s ability to manage pregnancy complications safely, while also raising concerns about achieving ACGME milestones relevant to their field. 

The criminalization of reproductive healthcare in abortion-restrictive states also leads to clinical and legal uncertainty. Providers in these environments often face ethical conflicts, especially in complicated clinical scenarios, which contribute to heightened moral distress in an already extremely stressful clinical environment. Physicians also report concerns about not being able to provide evidence-based care due to the complex legalities and fear of repercussions, even during standard-of-care conditions, such as termination of an ectopic pregnancy or early pregnancy loss. This extends into the subspecialized fields of Maternal Fetal Medicine and Complex Family Planning, where providers are morally distressed and express anger, exhaustion, and strain to not deliver the care necessary. 

These dynamics increasingly impact residency decision making. Medical students are likely to avoid training in states where they cannot safely and comprehensively learn evidence-based reproductive care, especially when considering one’s own family planning needs. Medical students may also choose programs that are similar politically and ethically, which can lead to strained training capacity, especially with students attending away rotations from restrictive states. 

Collectively, these can combine and lead to “training deserts” - regions where physicians cannot obtain comprehensive, evidence-based education in pregnancy and gynecologic care - which can develop into maternal care deserts, as trainees and attendings choose to practice in more protective states. These can lead to workplace shortages and exacerbation of disparities, especially among disadvantaged communities.  

Madison Whitekiller, a recently matched fourth-year medical student, shared,: “As I built my rank list, I had to think not just about the program itself, but about the environment that I would be training in. As future OB/GYNs, our training depends on exposure to the full spectrum of reproductive health care. When I built my rank list, I ultimately ranked some programs in more restrictive states lower because I was concerned about whether I would receive comprehensive reproductive health training. It’s a difficult position for applicants, but it’s a reality that policy is shaping where many of us choose to train and may have real consequences for where the next generations of OB/GYNs choose to practice.”

Patient care consequences have already been evident. Patients in restricted states not only face lack of access to abortion care, but also delays in necessary emergency pregnancy care and miscarriage management. These delays in care severely increase maternal morbidity and mortality. For example, in restrictive states, like Texas, maternal mortality rates are significantly higher compared to permissive states, with increased risks of maternal sepsis and congenital abnormalities in infants. Evidence further shows that abortion restrictions are associated with poorer birth outcomes and exacerbating social disparities in women’s health. 

Reproductive healthcare training is core medical education, not a niche political issue. The protection of comprehensive reproductive healthcare training is essential to maintaining a stable, well-distributed physician workforce.

Doctors for America calls on policymakers to:

• Protect comprehensive reproductive health training
• Support federal/state protections for evidence-based care
• Oppose criminalization of pregnancy care
• Support policies that safeguard physician education environments

Doctors for America affirms that protecting comprehensive reproductive healthcare training and access is essential to maintaining a stable physician workforce, reducing health disparities, and ensuring patient-centered care across the United States.

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About Doctors for America:

Doctors for America (DFA) is a national nonprofit that mobilizes over 40,000 physicians and medical trainees to advocate for policies that improve the health of patients and communities. Through advocacy training and action at the state and federal levels, DFA works to expand access to affordable care, strengthen community health and prevention, and advance health justice and equity. We do not accept funding from pharmaceutical, insurance, or for-profit health care entities, ensuring our work remains fiercely independent and patient-centered. DFA puts patients over politics–and over profits. Find out more at doctorsforamerica.org and on X @drsforamerica or Bluesky drsforamerica.bsky.social.

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