This article includes discussion of abortion that may be challenging for some readers.
February 24, 2025
By Natalie Correa, MD Program Student, Drexel University College of Medicine
The Decision
The Dobbs v. Jackson Women’s Health Organization decision was a 2022 Supreme Court ruling that overturned the fundamental right to abortion before fetal viability. This decision eliminated a nearly 50-year history of federal standards and decided that it was appropriate for access to reproductive health care to vary depending on the state that you reside in. We are now two years post-Dobbs, and while some states have made strides in ensuring their residents’ reproductive health care rights are protected, others have continued to chip away at the efforts of generations of feminists and revolutionaries working toward reproductive justice.
The Impact
Aside from the direct impact on individual health, the Dobbs decision is continuing to negatively impact the overall well-being of marginalized communities. In 2021, prior to Dobbs, the Black maternal mortality rate in the United States was 2.6 times the rate for white women. According to KFF, an independent health policy research source, 60% of Black women of reproductive age live in states with abortion restrictions. One study hypothesizes that women of all races will experience an increase in pregnancy-related mortality as a result of restrictive abortion laws, but Black women would bear the highest burden, with an estimated increase of 33%.
Unfortunately, it’s not just the availability of abortion care that will impact the lives of birthing people in these states. After Dobbs, states with abortion bans in place experienced a decrease in the number of MD applicants for residency programs located in those states, particularly OB/GYN programs. The decrease in available providers worsens an already critical situation by reducing access to reproductive care across the lifespan.
The Elephant in the Room
Being two years post-Dobbs also places me in the peak of my residency application process. I never thought I would have to limit the programs I considered because of the politicization of reproductive health care. My friends going into other specialties spoke freely and passionately about being excited to explore residency programs in new locations, while I (and likely a majority of other OB/GYN applicants) made it a point to consider reproductive legislation prior to submitting applications to programs in new places. Women, practicing OB/GYNs and incoming residents are apprehensive about the state of reproductive justice as the United States prepares to inaugurate the 47th president, who appointed the Supreme Court justices responsible for the Dobbs decision.
So, as residency programs continue to meet their applicants and progress through interview season, I challenge them to also talk about the elephant in the room. How does your program handle the fear that may be building in patients? How will you train your residents in all aspects of reproductive care to support reproductive justice for all? How will your program continue to protect women and their right to health care through its position as an educational institution?
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