Wisconsin’s abortion restrictions may have role in decline in applications to OB-GYN programs

Planned Parenthood of Wisconsin leaders made waves in mid-September when they announced that the organization would resume abortion services. 

Abortions had been unavailable in Wisconsin since the U.S. Supreme Court overturned Roe v. Wade in June 2022, reverting the state back to an 1849 law that was widely interpreted as banning the procedure in nearly all cases. 

This past July, a Dane County judge signaled that she did not believe the 1849 law referred to consensual abortions, but instead to feticide, in which a nonconsensual act causes a fetus to die. Planned Parenthood, which provides a variety of sexual and reproductive health care services, pointed to that as evidence that Wisconsin does not have an enforceable abortion ban. 

Groups that support abortion rights were quick to praise Planned Parenthood’s decision. That included Opportunity Wisconsin, which describes itself as a coalition of Wisconsin residents fighting for economic equity. 

In a Sept. 14 press release, the group applauded the access Wisconsinites will once again have to abortion and focused on the health impacts of the past year-plus, when that access was limited. 

"The repeal of Roe v. Wade has exacerbated the state’s OB-GYN shortage as residency programs report a decline in enrollment due to the inability of residents to receive training in-state," the release stated. 

Is the decline in enrollment a direct consequence of Wisconsin’s abortion restrictions? And has it exacerbated the shortage?

We’ll break things down step by step, starting with the first portion of the claim. 

First, Wisconsin does have a documented shortage of doctors that specialize in obstetrics and gynecology, particularly in rural areas — a trend that existed before Roe’s overturning. Forty-four percent of the state’s rural hospitals don’t provide obstetric services, according to a 2019 report from the Wisconsin Office of Rural Health. 

And the state’s OB-GYN residency programs did report a recent decline in enrollment. An April 13 report from the Association of American Medical Colleges’ Research and Action Institute found that Wisconsin’s OB-GYN residency programs saw a 7.8% decrease in 2022-23 from the previous application cycle. 

The report found that the decrease in OB-GYN applicants was highest in states with complete abortion bans (a decline of 10.5%) and lowest in states without abortion restrictions (a decline of about 5.3%). 

There are three places in Wisconsin that have OB-GYN residencies: UW Health in Madison, and Aurora Sinai Medical Center and the Medical College of Wisconsin in Milwaukee. 

A UW Health spokesperson reported a 2.5% decline in applicants to UW Health’s program in 2023. An Aurora spokesperson declined to share their applicant trend, and spokespeople for the residencies at the Medical College of Wisconsin did not respond to a request for the information.

What’s the connection between OB-GYN residency programs and abortion? Those programs are required to teach students how to perform a procedure commonly known as a D&C, which is used to diagnose and treat certain uterine conditions or to clear the uterine lining after a miscarriage or an abortion. Not providing that training could cause the programs to lose accreditation.

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Last year, the Journal Sentinel reported that OB-GYN residents at the Medical College of Wisconsin and Aurora Sinai Medical Center would travel out of state to receive training on the procedure because Wisconsin had halted abortions. 

But can we explicitly draw the connection between the state’s abortion ban and a decline in applicants to its OB-GYN residency programs? That’s where things get murky. 

Fears from OB-GYNs and residency program directors nationwide on this issue are well-documented — when asked for evidence of the claim, an Opportunity Wisconsin spokesperson sent a litany of examples. 

On Wisconsin Public Radio last October, an associate professor of obstetrics and gynecology at the University of Wisconsin-Madison said it was "a real worry" to not be able to recruit and retain physicians in a state that doesn’t provide abortions. 

A Medical College of Wisconsin doctor told PBS Wisconsin in August that "it’s nearly impossible to find doctors who are willing to go to states that have such hostile bans," and that Wisconsin’s physician shortage could get worse because of that. 

And a study published in the Journal of General Internal Medicine in February surveyed more than 2,000 current and future physicians on social media and found that more than three-quarters of respondents "would not even apply to states with legal consequences for providing abortion care." 

Although signs point to the claim being accurate, causation is harder to tease out — that is, that the decline in residency applications is a direct consequence of Wisconsin’s abortion rules. 

The UW Health spokesperson said the hospital isn’t certain whether its decrease in applications signals a trend — though she noted that some applicants have asked about the 1849 law in their interviews. 

Dr. Ellen Hartenbach, chair of the OB-GYN department at the University of Wisconsin School of Medicine and Public Health, also told Wisconsin Health News in May that the university is uncertain if abortion restrictions caused this year’s decrease in applicants. 

It’s worth noting that the report from the Association of American Medical Colleges’ think tank report found that the number of medical school graduates who applied to residency positions during the 2022-23 application cycle decreased by about 2% from the previous year. So, there was a small overall decrease, regardless of what states’ laws were regarding abortion.

And since Roe’s overturning happened just over a year ago, there may need to be more years of documented decreases in residency applications to suss out a trend that can be explicitly linked to abortion restrictions, or one that directly results in worsening Wisconsin’s OB-GYN shortage.

Opportunity Wisconsin claimed that Roe’s overturning — and the subsequent halt of abortions in Wisconsin — exacerbated the state’s OB-GYN shortage by driving medical school graduates away from residencies in the state. 

Though the number of OB-GYN residents did decline, and there’s been significant speculation that abortion restrictions could have caused it, it doesn’t appear that the direct link is settled yet like Opportunity Wisconsin framed it. 

And if there could be other reasons for the dip, that means it’s not yet clear whether Roe’s repeal exacerbated the shortage. It’s likely that more years of data will be needed to draw a conclusion. 

Our definition of Half True is a statement that is partially accurate but leaves out important details or takes things out of context. 

That fits here.