The Impact of Shrinking OB-GYN Numbers on the Women's Health Movement

It's crazy to realize that it's been 5 years since COVID turned the world upside down. The tsunami-style ripple effect felt by healthcare workers during COVID and since has been profound. In the first 2 years post-COVID, the focus for most systems was on nursing shortages and trying to get back to normal without needing travel nurses to supplement staffing. It created safety issues for nurses and patients alike while further depleting the finances of health systems around the country so the focus was necessary.

But 5 years post-COVID, the reversal of Roe v. Wade and a wave of interest in women's healthcare later, we face an entirely new landscape–and a whole new set of issues. The lack of funding and investment in women's health is well documented and has been covered extensively so I won't focus on that.

There has been an amazing surge of women's health companies and offerings to try to close the gap, but there is one major issue that hasn't been addressed. And it's one that can't be fixed easily. The ongoing decline in the number of OB-GYNs (Obstetricians and Gynecologists) across the US creates an additional set of hurdles for women to get quality healthcare–as if we need to make it any harder on women than it's already become thanks to the Supreme Court's landmark (and might I add totally ignorant, short-sighted and solely religious persecution-based) decision to overturn Roe v. Wade.

The Current State of OB-GYN Availability

Reports from the American College of Obstetricians and Gynecologists (ACOG) highlight a significant shortage of OB-GYN professionals, with a 7% decrease in practicing physicians expected by 2030. ACOG projects that 2025, this year, the demand for OB-GYN services will officially surpass supply which further puts women's health on the line.

A lethal combination of current OB-GYNs retiring and more than 100 hospitals shuttering their obstetric units since 2022 means fewer places for OB-GYN residents to train to even try to fill that gap.

Implications for Women’s Healthcare Access

The drop in practicing OB-GYNs has serious implications for women's healthcare access. There are some obvious consequences like extended wait times and limited appointment availability. I know I have struggled to get an appointment not just with my OB-GYN, but with any OB-GYN without at least a 6-8 month wait. And I live in Chicago, a large city with a vast amount of resources!

To be clear, this isn't about abortion care which tends to be a common refrain or focus when we speak of women's health. Women are struggling to access essential services, such as preventive screenings or prenatal care. And this is especially difficult for women in rural and/or low-income areas. In fact, according to a 2024 March of Dimes report, a staggering 35% of all US counties are now considered to be maternity care deserts, meaning they lack birthing facilities or obstetric clinicians. They don't have a single OB-GYN available for patients.

Impact on Maternal Health

Reducing the availability of OB-GYNs directly threatens maternal health. And according to the CDC, the US has a maternal mortality rate that is 2-4x higher than any other high-income country, with the risk of maternal mortality increasing significantly where OB-GYNs are in short supply. And that rate is obviously significantly higher for BIPOC, especially black women. So I'd say we have a multi-faceted big ass problem on our hands.

Gaps in Preventative Care

While many of our lovely representatives in Washington DC don't feel like women's health is a problem for the country to deal with and women are on our own (as per usual), the reality is that this lack of OB-GYN care will actually cost our already struggling healthcare systems even more money than if we increased access.

For example, the cost of diminished access to preventative care has long term physical and financial implications. Regular gynecological check-ups are essential for early detection of serious conditions like cervical and ovarian cancers.

One study found that women who lack access to regular gynecological care have a 40% greater risk of late-stage cancer diagnoses. As fewer OB-GYNs become available, the possibility of missed diagnoses rises, threatening overall women’s health outcomes. And considering uterine and ovarian cancer treatment cost the US a whopping $12.2B in 2020 alone, the cost of human lives and the finance implications are massive.

Addressing the Shortage

At the end of the day, we need more focus on OB-GYN beyond just polarizing opinions on abortion care. We need healthcare systems to stop shuttering obstetrics units and start re-opening them to meet the needs of women. And we need medical students to enter obstetrics and gynecology because the specialty is vital for women's healthcare moving forward. Some institutions have started offering scholarships and mentorship programs to incentivize students.

While systems and medical schools work to address the shortage, there are boatloads of insanely smart folks out there attacking this issue from various other angles. According to Advisory Board's newest guide on the topic, the biggest theme for how to address these issues is creative adaptation.

From PCPs, NPs and PAs increasing responsibility to manage various aspects of women's healthcare needs, to Payers expanding reimbursement for doulas and midwives to Femtech point-of-care solutions identifying partnerships and integrations, the gap is being addressed.

I don't know that you can say these initiatives are truly closing the gap, but I think you can say they are at least buying some time by figuring out how to keep it afloat.

Conclusions

As the healthcare landscape changes, the rapid decrease in the number of OB-GYNs represents yet another significant challenge for women’s health to overcome. We have a long way to go in terms of addressing this shortage, but joining forces and working together to find creative solutions is vital.

To me, one of the biggest ways we can address this is to move our focus on women's health beyond just conversations of abortion rights. Yes it is a vital topic and one that I have a feeling we will be debating for the rest of time (despite it being medical care and absolutely nothing that should be controlled by extremist religious groups). But women's healthcare is so much more than just our capability and/or willingness to grow and birth another human being.

Women's health is equally as important as if not more important than men's health (you know, since we're the ones who actually re-populate the earth by birthing other humans and all). It is nuanced–different anatomy, hormonal cycles, chemical makeups, etc. Those aspects of women's health deserve to be honored, researched and treated. It is essential to keep women’s health at the forefront of healthcare initiatives, ensuring everyone has the opportunity to receive the care they need and deserve.