One of the consequences of the U.S. Supreme Court’s Dobbs decision is the lack of abortion care training for medical residents training to become OB-GYN doctors in states where abortion care is banned.

A recent congressional report focused on the consequences of the lack of training in university medical schools in states with abortion bans. Some worry that this lack of training will lead to a future where OB-GYN providers will lack skills and knowledge that is not only important for abortion care, but also in the event of a miscarriage or a complex pregnancy.

Dr. Eve Espey, professor and chair of the Department of OB-GYN and Family Planning fellowship director at the University of New Mexico, told NM Political Report that  University of New Mexico does not offer much training to medical residents who are attending medical school out of state. She said they’ve had a few visiting medical residents, but not many. 

She said the UNM team reviews every three-to-six months to see if they can accommodate medical residents training in states with bans to receive training on abortion care. But she said there are several challenges, including logistical hurdles and the question of how to maintain patient-centered care with a large group of learners in the exam room. 

The UNM program is considered a center of excellence in family planning in the southwest, Espey said. She said the UNM program receives applications every year from about 600 applicants for six spots.

“I will say we attract a group of applicants who are extremely motivated in family planning in abortion care training,” she said. 

But she said, overall, the numbers of applicants for OB-GYN medical training dipped due to the Dobbs decision.

“People read stories about how challenging it is to provide care in certain states and feel criminalized to provide miscarriage care. That has dissuaded people from going into the field,” Espey said.

Espey said that UNM is committed to trying to encourage graduates to work, after graduation, in rural communities in New Mexico. She said UNM is planning to have its medical students, residents and fellows incorporated into the operations at the new Las Cruces reproductive healthcare clinic. 

She said while Las Cruces is not rural, many travel from surrounding areas for healthcare.

Last week, Espey attended a groundbreaking ceremony for the new full-spectrum reproductive healthcare facility, along with Gov. Michelle Lujan Grisham and many advocates and elected officials. Espey told NM Political Report that the new clinic could also be a place where medical residents could receive training, though that is not currently planned. The University of New Mexico is partnering with Planned Parenthood of the Rocky Mountains to operate the clinic and reproductive rights groups, Bold Futures and Strong Families New Mexico are also partners in the clinic to provide the community’s perspective on what services are needed.

Related: Guv: Las Cruces groundbreaking of new reproductive healthcare clinic ‘the beginning’

“This center will expand our ability to train,” Espey said.

Espey said that where medical residents begin work after graduation has become “a real issue for students” since the Dobbs decision created a situation where providers in some states provide reproductive healthcare and some provide limited reproductive services due to state bans and legal liability fears.

“People are leaving Idaho; they’re leaving Iowa because they feel like their practice is constrained and they have to practice in the shadow of litigation. Or they’re concerned over their license. It’s not just a legal concern but a concern to practice the evidence-based care they learn in residency,” she said. 

Lujan Grisham recently paid for an advertising campaign in Texas, targeting medical providers in that state to encourage them to relocate to New Mexico where reproductive healthcare is safe and legal. 

Espey said New Mexico’s status as a reproductive healthcare haven is “a huge selling point for us” and that it could help alleviate the provider shortage in New Mexico. 

“Even people who don’t provide abortion care want to be in a state where the governor backs them up to provide evidence-based care,” she said. 

Espey said UNM’s volume in abortion care for individuals who require procedural abortion due to gestation, “has just about doubled” since before the Dobbs decision.

She told NM Political Report that one of the challenges UNM is seeing, post Dobbs, are complex care needs. 

“We get a lot of patients from Texas who have had multiple obstacles. They are young and medically very unsophisticated or they have fetal anomalies or maternal conditions not compatible with the health of the pregnant person diagnosed later in pregnancy,” she said. 

She said that general practitioners or family medicine providers could offer abortion care but the biggest barrier is the stigma. But, she said the Dobbs decision has led many to realize that even if they have moral objections to abortion, they don’t like having civil rights taken away. 

“We have a real reckoning here. I do think the stigma around abortion care is changing a bit which I hope is an opportunity for providers to push through the stigma,” she said.