How Texas’ abortion laws are driving doctors out of the state
Texas’ strict abortion laws have hampered doctors in the state, preventing them from providing comprehensive maternity care to pregnant women, said Dr. Emily Briggs, an obstetrician and family physician who practices in central Texas.
So far, no doctor has been prosecuted for violating the ban, which is now a criminal offense, but the confusing and inconsistent law has doctors concerned about how they treat their patients. Briggs considers it a “dangerous situation.”
“Because personally, as a primary care physician, I could face losing my license, a life sentence and enormous fines just for having a conversation with my patient about evidence-based care,” she said.
How Texas Abortion Laws Have Affected Medical Care
Twenty states, including Texas, have banned or severely restricted abortion after the Supreme Court overturned Roe v. Wade in 2022. Violating Texas abortion law is considered a misdemeanor.
Before the 2022 decision, Texas, under SB-8, had banned abortion after six weeks, with no exceptions for rape, incest or serious fetal abnormalities. There was an exception for medical emergencies, but the bill did not define what those were.
In 2022, Texas passed another, more restrictive law, banning all abortions from conception unless the mother’s life was in immediate danger.
The prospect of prosecution has created such fear that most Texas hospitals now require doctors to consult with staff attorneys when treating complicated pregnancies and miscarriages.
I’m leaving Texas to train and practice elsewhere
Dr. Briggs said she has heard from colleagues, both obstetricians and primary care physicians, who no longer want to practice in Texas. Last year, the number of OB-GYN applicants in Texas dropped 16%.
“Future obstetricians recognize the complexity of the rules in Texas,” Briggs said. “Not only do they not want to practice here, but that also means they don’t want to practice here.”
Dr. Adrianne Smith was 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 seriously ill after trying to end her own pregnancy with an unknown drug she bought in Mexico.
Smith spoke with a supervising physician about the case.
“He looked at me and said, ‘The attorney general wants to make someone an example. And you don’t want to be that,'” Smith said.
She said it made her realize that there were people who wanted to criminalize her professional actions and send her to prison.
OB-GYN training affected by Texas law
In Texas, residents are now missing the opportunity to learn about different types of care for pregnant women, according to Dr. Eve Espey, chair of the University of New Mexico’s department of gynecology.
“They’re missing the opportunity to learn trauma-informed care…diagnosing pregnancy complications in the first trimester and in the second trimester,” she said. “They’re missing out on learning… care for a miscarriage, care for an ectopic pregnancy, pregnancy in an unknown location. I mean, the list goes on.”
These things are part of the training needed to become a certified gynecologist anywhere in the US, but in Texas some training is no longer offered due to the new laws. That means OB-GYN residents now have to travel out of state for two- to four-week rotations to receive the required training.
According to Espey, that is not enough time.
“Our residents have a special rotation in the first year, in the fourth year. But they work with us for the four years they are in residency,” she said.
Back in Texas, Briggs is urging lawmakers to work with doctors. She worries about what she thinks will happen if nothing changes.
“We’re losing doctors in Texas, we’re losing healthy mothers, we’re losing families in general. It’s scary just to decide to get pregnant,” she said. “Please note that if something medically complex were to happen, you could lose your life and not receive the care you deserve. Why would anyone stay for that?’