INDIANAPOLIS — Indiana doctors are sharing their concerns about the impact of the state's upcoming abortion restrictions on women who already have limited access to care.
"We are worried how this is going to affect patients, we are worried on how this is going to affect providers of OB/GYN care now and in the future,” said Dr. Caroline Rouse, a maternal fetal medicine physician at IU Health.
Thousands of Hoosier women are living in obstetric care deserts.
Data from the Indiana Department of Health's Maternal Mortality Review Committee found around one-third of Indiana counties don't have a delivery hospital in county. Data from March of Dimes shows the lack of care for expectant mothers often hits rural counties the hardest.
Rouse said for pregnant people living in maternal care deserts, it often makes it hard to access adequate care, especially if something unexpected comes up.
“If you’re in an OB desert county, there may not be healthcare providers that are familiar with people who are pregnant and the problems that are common to that population," Rouse said. "Furthermore, in high-risk pregnancies, we’re often having to see people as frequently as twice a week, sometimes more. And the burden of travel, time away from work, potentially needing to arrange childcare in order to travel long distances to get to an appointment is a really big deal for a lot of patients."
But Rouse said she's concerned that when the state's new law banning most abortion takes effect in a few weeks, it will make Indiana's OB deserts grow with fewer providers willing to move to rural areas.
“We knew that there was a healthcare provider crisis, even before SB1 happened. And we are worried that it’s going to get worse, you know, it became particularly apparent during COVID too, that the lack of care that just care deserts generally exist in our state," Rouse said. "And the situation is similarly dire for obstetric care. The additional restrictions of this abortion ban and the threat that providers feel they are under as a result, we fear is going to make it worse."
Dr. Nicole Scott, director of IU Health's OB/GYN residency program, said initial data from surveys found that the state's new abortion laws may also keep doctors from moving to or staying in Indiana after they finish their training, expanding those care deserts even further.
“I think that’s our biggest fear. In addition to providing comprehensive care for people, is that we’re going to make our disparities worse. Right now, we’re number three for maternal mortality and with our obstetric deserts, we expect that only to get worse and only time will tell,” Scott said.
Indiana's maternal mortality rate is one of the worst in the nation. According to the state's MMRC report from 2020, 87% of pregnancy-associated deaths were preventable.
To turn that trend around, Scott said Indiana needs to focus on bringing in, supporting, and keeping quality physicians instead of driving them out of state.
“I think really talking about recruitment and retention is very important. There are plenty of initiatives that help support providers, both obstetrics and gynecology providers, as well as other specialties going to more rural areas such as student loan repayment. But with the current climate and with potential abortion restrictions, we worry that may affect the people’s likelihood of coming to Indiana or staying in Indiana, particularly if they trained for their residency or fellowship here," Scott said.
But resources for women and new mothers needs to increase, too, according to Scott, and that's where the state can step up.
"We can't change the legislation. But what we can do is improve funding for support for maternal health," Scott said. "We can improve our access to contraception. And so these are two key areas that hopefully are bipartisan and that we can get continued support for."