• Posted April 23, 2025

Some OB/GYNS Stay in States With Abortion Bans, Despite Legal Risks

WEDNESDAY, April 23, 2025 — Three years after the U.S. Supreme Court ended the federal right to abortion, doctors who specialize in obstetrics and gynecology are still dealing with tough decisions about where to live and work.

A new study published in JAMA Network Open shows that most OB/GYNS didn’t immediately leave states where abortion was banned after the 2022 Dobbs ruling. 

In fact, the number of OB/GYNS in those states rose by about 8% in the months after the decision, similar to the growth in states where abortion remains legal.

But doctors say their decisions are personal and pretty complex, CNN reported.

“The tone of the conversation is, ‘How do I do the best job I can for my patients, and how do I stay out of legal trouble at the same time, and how do I reconcile those?’ ” said Lori Freedman, a sociologist and bioethicist at the University of California, San Francisco.

She said each doctor weighs their own tolerance for risk.

Dr. Nikki Zite, an OB/GYN in Tennessee, chose to stay despite her state’s abortion ban. She works at a large academic center that she says has helped support her and train future doctors. 

“When it came down to it, I feel like being in an academic center in a banned state trying to continue to both provide care and educate students and residents and fellows on why abortion care is health care and part of what all OB/GYNs should be trained to take care of is important,” Zite told CNN.

“I was very privileged to be in a family situation and an institutional situation where I felt like I could do that without too much risk to my personal liberties and freedom,” she added.

Other doctors have left. Dr. Leilah Zahedi-Spun moved from Tennessee to Colorado, where abortion is now protected by state law. 

She said her high-risk patients made her work more vulnerable to legal restrictions. 

"I had a target on my back," she said.

Though only about 4% of the new study’s data came from maternal-fetal medicine specialists like Zahedi-Spun, their departure can still have major impacts. She was one of just eight abortion providers in Tennessee. Now, only five remain, CNN said.

“It’s less about the sheer volume of providers and more about what that care actually looks like,” Zahedi-Spun said. “I was the only person who trained residents to do procedures in the second trimester. So now they’re graduating multiple classes of residents that have never done that care before, and they’re going to go into communities and not be able to provide that care.”

While most OB/GYNs haven’t moved, some say the legal risks have changed how they practice.

“Doctors are definitely very uncomfortable, very scared. They’re doing a lot of things differently. They’re punting a lot of things that they could have handled before to other people who are more comfortable taking on that sort of risk or the intensity,” Freedman said.

Zite said she’s sometimes doubted whether her decisions might be second-guessed by others — even while her patient was on the operating table.

It wasn’t about the clinical decision, Zite added. It was about the prospect that she might have to defend herself to people with less medical knowledge.

In 2024, more 155,000 people traveled out of state for an abortion, according to the Guttmacher Institute. Illinois alone provided care to more than 20% of those people.

Zahedi-Spun told CNN she still feels guilty about leaving her patients and community behind in Tennessee. She felt a sense of pride that she had only practiced in states with abortion restrictions.

"When it came time to be like, ‘Am I willing to go to jail for that, or lose my license, or not be able to practice medicine anymore?’ That’s when the rubber hit the road for me,” she said. “I was like, ‘I can’t take care of anybody if I don’t have my license, and I do a lot of good for a lot of people in banned states here in Colorado now, and that feels like the fight I need to fight.”

More information

The Center for Reproductive Rights has more on abortion laws by state. 

SOURCE: CNN, April 22, 2025