Obstetrician and Gynecologist Physicians’ Practice Locations Before and After the <i>Dobbs</i> Decision
Bibliographic record
Abstract
Importance: State abortion policies may influence the practice locations of obstetricians and gynecologists (OBGYNs), having potentially significant implications for access to and quality of reproductive health care. Objective: To explore changes in OBGYN practice locations from before to after the Dobbs v Jackson Women's Health Organization US Supreme Court decision in June 2022. Design, Setting, and Participants: National Plan & Provider Enumeration System data files were used in a descriptive cohort study assessing the association between state abortion policy environments and OBGYN practice locations in the US from January 1, 2018, to September 30, 2024, for all OBGYNs listed in the data files during the study period. Main Outcome and Measures: The number of OBGYNs practicing in states with differing abortion laws and the movement of OBGYNs between these states before and after the Dobbs decision. Results: The sample included 60 085 OBGYNs (59.7% women), of whom 3.8% were maternal-fetal medicine specialists and 12.9% were recent residency graduates. The mean increase in the per-quarter number of OBGYNs from before to after Dobbs was 8.3% (95% CI, 6.6%-10.1%) in states with total abortion bans, 10.5% (95% CI, 8.1%-13.0%) in states with gestational age limits or threatened bans, and 7.7% (95% CI, 5.9%-9.4%) in states with abortion protections. From the quarter immediately before Dobbs to the end of the study period, 95.8% of OBGYNs remained in protected states, 94.8% (95% CI, 94.3%-95.2%) remained in states threatening bans, and 94.2% (95% CI, 93.7%-94.7%) remained in states with abortion bans. Conclusions and Relevance: In this descriptive cohort study, there were no significant differences in trends in OBGYNs' practice locations across states with different abortion-related policy environments after the Dobbs decision. Although these findings do not provide insight into changes in the quality of care provided, they suggest that there are no major changes in the supply of OBGYNs associated with the Dobbs decision.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".