REASONS CLINICIANS CONSIDERED LEAVING AND STAYING IN STATES WITH ABORTION BANS

Abstract

Objectives

We aimed to examine clinicians’ decisions about whether to leave or continue to practice in states with abortion restrictions.

Methods

We conducted semi-structured interviews with clinicians providing care in Louisiana, Idaho, and Florida, after severely restrictive abortion policies went into effect from 2023 to 2024. In this secondary thematic analysis, we examined how these restrictions impacted clinicians’ thoughts about leaving states with bans.

Results

The interview sample comprised 57 clinicians and trainees. The majority (n=32) had considered leaving the state, and 12 had plans to leave, including all of the trainees. Twenty-eight said they would more seriously consider leaving if the laws became more restrictive, or would never have moved to the state given the current laws. Cited reasons for leaving included: not being able to use their full range of skills, criminal charges, and moral distress of providing care under laws. However, nine who considered leaving had since committed to staying. Primary cited reasons for staying were: to not abandon patients or concern about what kind of care would be provided if they were not there, to advocate to change the laws, to maintain established family ties in the state, or having moved there intentionally to provide abortions.

Conclusions

Participants’ responses highlighted that decision-points like residency or a more restrictive law might be catalysts to decide to leave. Clinicians who worked in practices that experienced fewer impacts from abortion restrictions, had stronger family ties, or had more advocacy-focused goals were more likely to consider staying in states with restrictions.