Maternity care likely to be harder to find in some states

July 17, 2023

Decrease in Residency Match, 2023

Source: Grover, JAMA Network Open, June 15, 2023

2023 was a bad year for “matching” graduating medical students into training programs in obstetrics and gynecology. The American Association of Medical Colleges published data in JAMA Network Open showing that the drop in medical school graduates going into OB-GYN was especially steep in states that have banned or severely restricted access to abortion. Many of these states (OK, MS, WY, AR) already have only half as many physicians per 100,000 population as some states without restrictions (NY, MA, VT, MD).

Newly trained physicians often establish practices in the state where they did their residency, so reductions in new OB/GYN placement will exacerbate the already significant and growing shortage of doctors in rural areas. Physicians tend to cluster in urban and suburban areas, and many rural hospitals have already shuttered their maternity units. This lack of access to nearby maternity care could worsen our problem of preventable severe maternal morbidity and death. A decrease in maternity units might also lead to higher unit costs at those maternity units that remain open.

Implications for employers:

• The shortage of rural maternity care is already a serious problem, and we can expect this to worsen in coming years.

• Some prenatal care can be done virtually and can be covered through the employer sponsored insurance plan.

• In the future travel benefits might be beneficial for those who live too far from a maternity facility.

Tomorrow:   An economist weighs in on how artificial intelligence will affect health care.

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