I’ll never forget that sweltering July morning in 2022 when I woke up to find my world turned upside down. As I scrolled through my phone, bleary-eyed and still half-asleep, the headlines hit me like a punch to the gut: “Roe v. Wade Overturned.” In an instant, I knew my life as an OBGYN in rural Texas was about to change dramatically.
My name is Dr. Johnson, and for the past 15 years, I’ve dedicated my career to providing compassionate reproductive healthcare to women in a small town outside of Amarillo.
From routine check-ups to delivering babies to performing life-saving procedures, I’ve seen it all. But nothing could have prepared me for the seismic shift that was about to rock the medical community in Texas.
The Immediate Aftermath: Confusion and Fear
In those first few weeks after the Supreme Court decision, my office was flooded with panicked calls from patients. Women with scheduled procedures were terrified their appointments would be canceled.
Expectant mothers worried about how this might impact their prenatal care. Even those just coming in for annual exams had questions and concerns.
My staff and I worked overtime trying to reassure patients while also grappling with our own uncertainty about what exactly was and wasn’t legal anymore.
The new Texas “trigger law” set to go into effect would make performing an abortion a felony, punishable by up to life in prison. But what about ectopic pregnancies? Or management of inevitable miscarriages? The law’s language was frustratingly vague.
I remember sitting in my office late one night, poring over legal documents and medical guidelines, trying to make sense of it all. My heart raced as I imagined worst-case scenarios – being hauled off to jail for providing what I knew to be necessary medical care. It was the first time in my career I felt genuinely afraid to do my job.
The Exodus Begins: Colleagues Fleeing the State
Within months, I started noticing a troubling trend. Colleagues – fellow OBGYNs I’d known and worked alongside for years – were leaving Texas in droves. Dr. Martinez, who ran a practice in a neighboring town, packed up and moved to New Mexico.
My old medical school friend Dr. Chen accepted a position at a hospital in Colorado. Even some of the nurses and support staff at my own clinic were talking about relocating.
I couldn’t blame them. The stress of practicing under such restrictive laws, coupled with the fear of potential legal consequences, was taking a toll on all of us.
But as I watched more and more providers leave, I couldn’t help but worry about the patients left behind. Who would care for all these women if we all abandoned ship?
The Growing Crisis: Healthcare Deserts and Maternal Mortality
As the months wore on, the impact of the provider exodus became impossible to ignore. Clinics in neighboring counties shut down, unable to staff their facilities.
Women were having to drive hours just for routine prenatal check-ups. And for those facing pregnancy complications or in need of specialized care, the situation was even more dire.
I’ll never forget Maria, a patient of mine who was 20 weeks pregnant when we discovered her fetus had severe abnormalities incompatible with life. In the past, we would have discussed all her options, including termination.
But now, my hands were tied. I had to watch helplessly as Maria was forced to continue a doomed pregnancy for weeks, suffering both physically and emotionally.
Stories like Maria’s became all too common. And as access to care dwindled, especially in rural areas, maternal mortality rates began to climb. Texas already had one of the highest maternal death rates in the developed world, and now it was getting even worse. I felt like I was watching a slow-motion tragedy unfold before my eyes.
The Impossible Choice: Stay or Go?
As the situation in Texas deteriorated, I found myself facing the same agonizing decision my colleagues had grappled with: should I stay or should I go? On one hand, I felt a deep responsibility to my patients and my community. These were women I’d cared for through some of the most intimate and vulnerable moments of their lives. How could I abandon them now?
But on the other hand, the constant stress and fear were taking their toll. I wasn’t sleeping well, my blood pressure was through the roof, and I found myself second-guessing every medical decision.
Was I really providing the best care possible under these circumstances? Or was I putting myself and my patients at risk by trying to navigate this legal minefield?
I spent countless nights debating the pros and cons, talking it over with my family and closest friends. In the end, it came down to a question of whether I could do more good by staying and fighting or by leaving and advocating for change from afar.
The Decision to Stay: Finding Purpose in the Struggle
After months of soul-searching, I made the difficult decision to stay in Texas. It wasn’t an easy choice, and there are still days when I question whether it was the right one. But ultimately, I realized that my patients needed me now more than ever.
I’ve had to adapt my practice in significant ways. I’ve beefed up my legal team, implemented even stricter documentation protocols, and spent hours educating myself on the nuances of the new laws. I’ve also become more involved in advocacy work, speaking out about the real-world impacts of these restrictions on women’s health.
But perhaps the most important change has been in my approach to patient care. I’ve doubled down on preventative services, contraceptive counseling, and education.
I’ve worked to build stronger networks with providers in neighboring states for patients who need services I can no longer offer. And I’ve focused on providing emotional support and resources for women navigating this new landscape.
The Broader Impact: A Changing Medical Landscape
As one of the few OBGYNs left in my area, I’ve had a front-row seat to the transformation of the medical landscape in rural Texas. The ripple effects of the abortion restrictions and subsequent provider shortage have touched every aspect of women’s healthcare:
- 1. Longer wait times: With fewer providers available, women are facing increasingly long waits for appointments. What used to be a same-week visit might now take months.
- 2. Increased travel: Many women are forced to travel long distances for care, which can be especially challenging for those with limited resources or childcare responsibilities.
- 3. Delayed diagnoses: With less access to routine care, we’re seeing more cases of advanced cervical cancer and other conditions that could have been caught earlier.
- 4. Mental health crisis: The stress and uncertainty surrounding reproductive healthcare has led to increased rates of anxiety and depression among patients.
- 5. Training pipeline disruption: Medical students and residents are choosing to train elsewhere, leading to concerns about the future pipeline of providers in Texas.
- 6. Economic impact: The closure of clinics and exodus of providers has had a significant economic impact on many small towns, leading to job losses and reduced local tax revenue.
- The Ongoing Fight: Advocacy and Resistance
Despite the challenges, I’ve been inspired by the resilience and determination I’ve seen in my community. Grassroots organizations have sprung up to help women access care, whether that means providing transportation to out-of-state clinics or raising funds for those who can’t afford treatment.
I’ve also connected with a network of providers across the state who are committed to staying and fighting for change. We share resources, offer each other support, and work together to navigate the complex legal landscape.
On a personal level, I’ve become more politically active than ever before. I’ve testified at state legislative hearings, written op-eds for local newspapers, and even considered running for local office. I believe that change is possible, but it will require sustained effort and engagement from those of us on the front lines.
Looking to the Future: Hope Amidst Uncertainty
As I reflect on the past two years, it’s hard not to feel a sense of loss for what once was. The practice of obstetrics and gynecology in Texas has been fundamentally altered, and the full ramifications of these changes are still unfolding.
But amidst the uncertainty and challenges, I also see glimmers of hope. I see it in the fierce determination of my patients, who refuse to be silenced or pushed aside. I see it in the innovative solutions healthcare providers are developing to work within the constraints of the law while still prioritizing patient care. And I see it in the growing awareness and activism around reproductive rights issues.
I don’t know what the future holds for OBGYNs in rural Texas. The legal landscape continues to shift, and we may yet see further restrictions or, hopefully, a loosening of the current laws. What I do know is that as long as there are women in need of care, there will be providers like me fighting to ensure they receive it.
To my colleagues who have left, I understand and respect your decision. To those considering coming to practice in Texas, I won’t sugarcoat the challenges, but I can assure you that the work is vital and deeply meaningful. And to the women of Texas, I want you to know that you are not forgotten or abandoned. We are here, we are fighting for you, and we will continue to do so for as long as it takes.
The battle for reproductive healthcare access in Texas is far from over. But as I look out my office window at the vast Texas sky, I’m reminded of the strength and resilience that runs deep in the women of this state. And I know that together, we can weather this storm and emerge stronger on the other side.
