Oregon health care workers see rise in abortion 2 years post-Roe

PORTLAND, Ore. (KOIN) – Two years after the Supreme Court overturned Roe v. Wade, Oregon healthcare providers say there's been an increase in abortions in the state and they have ramped up support for both patients and out-of-state providers.

“While most states that have retained access [to abortion] have seen a significant increase in the number of patients that they're serving, certain states are really absorbing more of those patients because of your capacity; Oregon is one of them," said Dr. Alyssa Colwill, Oregon Health & Science University assistant professor of obstetrics and gynecology.

According to OHSU, Oregon and the rest of the nation have seen an uptick in abortions since the Supreme Court's June 24, 2022, decision in Dobbs v. Jackson Women's Health Organization. The Dobbs ruling overturned Roe v. Wade, which provided constitutional protections for abortions for nearly 50 years.

The university said since the Dobbs decision, several states have passed restrictions on abortion care and 14 states have imposed bans, "yet the number of abortions in the United States has risen and remains consistently elevated compared with pre-Dobbs levels."

At OHSU, the Dobbs decision meant doubling their clinical services to support that increase with help from their telehealth program.

Oregon saw an increase in the volume of abortions from 2022 to 2023, including a nearly 40% increase since 2020, OHSU said, citing the Guttmacher Institute -- an organization that supports reproductive health care rights.

The increase includes a rise in out-of-state patients seeking abortion care at OHSU's Center for Women's Health.

“What the numbers continue to tell us is that restrictions don’t eliminate the need for abortion care, they make care unsafe and inaccessible. This is especially true for people who already face barriers to the health care system, including people of color, immigrants, low-income individuals and LGBTQ+ people,” said Dr. Maria Rodriguez, OHSU professor of obstetrics and gynecology and director of the OHSU Center for Reproductive Health Equity. “It’s heartbreaking to see the obstacles patients face to receive what should be basic health care.”

Ahead of the Dobbs decision, OHSU developed a contingency plan to support both patients seeking an abortion and training for hospital residents by launching a family planning elective for out-of-state residents.

“Providers want to learn in an environment where they’re able to offer comprehensive, evidence-based care, but in many places, providers now fear legal retribution for offering basic and essential health care,” Colwill said. “Without those skills, they won’t be able to properly care for patients, which is a threat to women’s health care everywhere.”

The move to support out-of-state residents comes as the Association of American Medical Colleges reports that fewer medical school graduates applied to residency programs in states that restricted or banned abortion compared to states where abortion remained legal.

“There's a lot of reasons for this. I think, after medical school, these are pivotal reproductive years not only for residents themselves, but also for potentially their partners or their families," Colwill said. "It's people thinking about 'Where do I want to raise my family?' 'Are we going to be safe in this community that that we're working in?' And I think these are the workforce issues that the states really have to think about.”

To bridge gaps in training, OHSU continues to offer abortion training for medical residents who do not have access to clinical experience. OHSU's visiting resident program has trained two fellows and 13 residents since the Dobbs decision and will host another 10 residents in the next academic year.

Katie Hansen, a fourth-year OBGYN resident at OHSU, was among medical school graduates who sought residency in a state with abortion protections.

“I went to medical school in Austin, Texas, and for me, choosing to go to OBGYN residency training in a state that I knew it'd be protected from restrictions against abortion felt really important. Abortion is a central part of healthcare and being able to provide abortion services is central to being an OBGYN," Hansen said.

“I think that the Dobbs decision and all of the bans that we're seeing, has not only impacted people's decision to go into this specialty in general, but people who do choose to pursue OBGYN, I think, are being really thoughtful about where they choose to train. I've definitely seen and spoken with medical students who have rearranged their residency rank list to reflect that -- preferentially ranking programs in sanctuary states,” she added.

The OHSU resident furthered that the skills she's learned during abortion training are essential.

“Abortion care's really routine health care, and to remove it from our training is incredibly detrimental to our patients, and to us, as providers," Hansen added. "Those skills are also really important when we are managing complications related to just normal childbirth or managing complications related to miscarriage."

Similar to OHSU, Planned Parenthood Columbia Willamette has also seen an increase in abortion services since Dobbs, noting a roughly 29% increase. A spokesperson for PPCW told KOIN 6 News that a majority of their patients travel to their clinics from Idaho.

Since Dobbs, PPCW has expanded abortion services at their Northeast Portland health center and built a new health center in Ontario, Ore. to serve the surrounding Morrow, Grant, Umatilla, Harney, and Malheur counties and residents from Idaho.

At the state level, the Oregon Health Authority said the Dobbs decision is a "stark reminder" of challenges to protecting reproductive health care, but the agency "remains committed" to ensuring access across the state.

“OHA will continue to ensure that people in Oregon have access to safe, effective reproductive care – including abortion services – when and where they need it," OHA Director Sejal Hathi said.

In light of the Supreme Court's recent decision rejecting a challenge to the abortion pill Mifepristone, OHA said the state has a plan in place if future litigation seeks to restrict access to the medication -- adding the state secured a three-year supply and has a plan to equitably distribute the medication to eligible prescribers.