The Biggest Threat to Women’s Health That No One Talks About

There’s a massive shortage of obstetricians and gynecologists.

<a href="http://www.istockphoto.com/portfolio/Jovanmandic?facets=%7B%22pageNumber%22:1,%22perPage%22:100,%22abstractType%22:%5B%22photos%22,%22illustrations%22,%22video%22,%22audio%22%5D,%22order%22:%22bestMatch%22,%22filterContent%22:%22false%22,%22portfolioID%22:%5B9871321%5D,%22additionalAudio%22:%22true%22,%22f%22:true%7D">Jovanmandic</a>/iStock

Fight disinformation. Get a daily recap of the facts that matter. Sign up for the free Mother Jones newsletter.

The lady doctors are disappearing, right when women need them the most.

According to the American College of Nurse-Midwives, nearly half of all counties in the United States don’t have a single OB-GYN. That’s a problem because, as Pew Charitable Trusts reports, the overall population is expected to boom by 18 percent between 2010 and 2030, and that means more women and babies who need health care. Maternal deaths are already high in the United States compared with other developed countries—there are 18.5 deaths for every 100,000 live births, compared with 8.2 in Canada and 6.1 in Japan and the United Kingdom.

And while the number of births increases, the number of practicing OB-GYNs is projected to decrease even more. The American Congress of Obstetricians and Gynecologists (ACOG) estimates that the United States will face a shortage of OB-GYNs—6,000 to 8,800 fewer of them than necessary—by 2020. By 2050, that shortage will grow to 22,000.

Why? A few reasons. First, the number of medical students choosing to specialize in obstetrics and gynecology has remained relatively steady since 1980, but in the past couple of years, more than four out of five first-year OB-GYNs were women. That’s a change—like most medical specialties, the field used to be dominated by men. Thomas Gellhaus, president of ACOG, said female OB-GYNs tend to retire about a decade earlier than male OB-GYNs and tend to prefer part-time schedules.

Another factor: While OB-GYNs were once expected to be available around the clock, few doctors today will put up with such a demanding schedule. This change has given way to “laborists,” providers who work only in hospitals and focus strictly on labor and deliveries.

Finally, students going into obstetrics and gynecology today are choosing more lucrative subspecialties like gynecologic oncology and reproductive endocrinology and fertility, leaving a gap in routine gynecological care providers. Opting for a subspecialty over a general OB-GYN practice could mean up to a $100,000 annual difference in salary.

One potential solution: Let certified nurse-midwives pick up the slack. A California bill introduced by state Assemblywoman Autumn Burke would remove the requirement that nurse-midwives—registered nurses who have also completed an accredited nurse-widwifery program and passed an exam given by the American Midwifery Certification Board—practice under the supervision of doctors. Pew reports that the number of nurse-midwives in the United States has risen as states have relaxed restrictions—the profession has grown by 30 percent since 2012.

HERE ARE THE FACTS:

Our fall fundraising drive is off to a rough start, and we very much need to raise $250,000 in the next couple of weeks. If you value the journalism you get from Mother Jones, please help us do it with a donation today.

As we wrote over the summer, traffic has been down at Mother Jones and a lot of sites with many people thinking news is less important now that Donald Trump is no longer president. But if you're reading this, you're not one of those people, and we're hoping we can rally support from folks like you who really get why our reporting matters right now. And that's how it's always worked: For 45 years now, a relatively small group of readers (compared to everyone we reach) who pitch in from time to time has allowed Mother Jones to do the type of journalism the moment demands and keep it free for everyone else.

Please pitch in with a donation during our fall fundraising drive if you can. We can't afford to come up short, and there's still a long way to go by November 5.

payment methods

ONE MORE QUICK THING:

Our fall fundraising drive is off to a rough start, and we very much need to raise $250,000 in the next couple of weeks. If you value the journalism you get from Mother Jones, please help us do it with a donation today.

As we wrote over the summer, traffic has been down at Mother Jones and a lot of sites with many people thinking news is less important now that Donald Trump is no longer president. But if you're reading this, you're not one of those people, and we're hoping we can rally support from folks like you who really get why our reporting matters right now. And that's how it's always worked: For 45 years now, a relatively small group of readers (compared to everyone we reach) who pitch in from time to time has allowed Mother Jones to do the type of journalism the moment demands and keep it free for everyone else.

Please pitch in with a donation during our fall fundraising drive if you can. We can't afford to come up short, and there's still a long way to go by November 5.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate