The Impact of Restrictive Abortion Laws on Medical Residency Applications and Healthcare Access: Implications for Maternal Health Equity.

The 2022 Supreme Court ruling in Dobbs v. Jackson Women's Health Organization returned regulatory authority over abortion to the states and precipitated a wave of restrictive state-level legislation. This narrative review examines how these state responses have influenced medical residency applications, physician training, and maternal health equity. Existing research indicates that restrictive state laws have contributed to a decline in residency applications to programs in jurisdictions with near-total abortion bans. A growing body of evidence suggests that many medical students, particularly those seeking OBGYN training, prioritize programs in states with fewer restrictions to ensure comprehensive clinical education. These trends may exacerbate existing maternity care deserts by contributing to physician shortages, particularly in underserved and rural areas. The review further explores how the post-Dobbs regulatory environment impacts physician training. Many OBGYN residency programs in restrictive states struggle to provide abortion training, often requiring residents to travel out of state, which creates significant financial and logistical burdens. Additionally, a lack of transparency regarding training availability in these states complicates the ability of prospective residents to assess program offerings. Beyond residency applications, these state-level restrictions have affected practicing physicians, contributing to burnout, legal uncertainties, and ethical dilemmas. Many providers in restrictive jurisdictions report moral distress and legal risks when making clinical decisions, leading some to relocate to states with greater reproductive freedoms. The compounded effects of these laws may widen healthcare disparities, disproportionately affecting marginalized communities, particularly low-income individuals and people of color. Given the limited longitudinal evidence since Dobbs, continued monitoring of OBGYN residency applications, training availability, workforce distribution, and maternal health outcomes is needed to determine the persistence and magnitude of these effects.