Targeted Regulations Of Abortion Providers Associated With Significant Decreases In OB-GYN Density, 1993-2021.
Level 2 - randomized trial
Level by design analogy to natural experiment (quasi-experimental staggered difference-in-differences policy evaluation using longitudinal panel data).
PubMed 40758924 · doi:10.1377/hlthaff.2025.00266
What was done
Researchers evaluated the association between state Targeted Regulation of Abortion Providers (TRAP) laws and local OB-GYN physician workforce supply in the United States from 1993 through 2021 (the period between the *Planned Parenthood v. Casey* and *Dobbs v. Jackson Women's Health Organization* rulings). The analysis used a staggered difference-in-differences design applied to longitudinal, county-level data.
What was found
TRAP laws were associated with a 4.67 percent average reduction in the density of OB-GYNs per 100,000 women aged 15–44. Decreases occurred among both general and fellowship-trained OB-GYNs, as well as in counties that lacked abortion facilities. In nonmetropolitan counties, the reduction in physician density associated with TRAP laws persisted for ten years.
Why it matters
This study shows that regulatory restrictions aimed at abortion providers have broader collateral consequences for the general reproductive and obstetric healthcare workforce, exacerbating pre-existing physician shortages in rural and nonmetropolitan communities.
Limits
The abstract does not provide the total number of counties analyzed, clinician sample counts, or confidence intervals and exact p-values for the point estimates. Because the study relies on aggregate administrative data, individual clinician career motivations and relocation choices were not directly measured. The findings reflect the regulatory environment prior to the 2022 *Dobbs* decision and may not capture the dynamics of post-*Dobbs* full abortion bans.
Cited by
- supports Approximately 50% of counties in the United States do not have a practicing OB/GYN.