A war on doctors is underway in Republican-led states, and numerous physicians are fleeing for safer ground.

Thirteen states have criminalized all abortion care. Over 500 bills have been proposed targeting LGBTQ+ care, including many that criminalize gender affirming care. Obstetricians and gynecologists, or OB-GYNs, who routinely perform abortions and provide health care to LGBTQ+ people, have been a particular target of these laws and bills.

Idaho is a case in point. Soon after the US Supreme Court passed the Dobbs decision that ended the constitutional right to an abortion, Idaho passed a law allowing family members of a patient to sue providers who perform an abortion for at least $20,000. Doctors also face suspension of their medical license, felony charges, and prison.

The fallout has been swift: five of the nine maternal fetal medicine specialists in Idaho who deal with high risk pregnancies will leave the state by the end of 2023, several hospitals have closed their labor and delivery units, and 40 percents of Idaho’s OB-GYNs said in a recent survey that they were considering leaving the state.

As doctors leave, maternity care deserts are expanding. According to the March of Dimes, nearly 7 million people who can become pregnant who are of childbearing age now live in a county with either no maternity care services or with limited services. One-third of US counties qualify as a maternity care desert, more than half of them classified as rural, including parts of Vermont.



On this Vermont Conversation, we speak with physicians on the front lines of providing abortions and gender affirming care. In the first part of our program, we talk with three physicians at the UVM Medical Center who are midway through their four-year OB-GYN residency. Along with caring for patients, Drs. Mackenzie Delzer, Gnendy Indig, and Sarah McShane have already been to the Vermont State House to testify in defense of reproductive rights.

In the second part of the program we speak with Dr. Lauren MacAfee, associate professor of Obstetrics and Gynecology and Complex Family Planning at University of Vermont Larner College of Medicine and the UVM Medical Center. She has been an outspoken advocate for reproductive rights.

For young physicians who are deciding where they will practice medicine after completing their residency, they must each decide whether they are willing to go to states with abortion bans. “I feel the pull of patients in those areas and the huge deficits and care that are going to be created,” said Dr. Sarah McShane, who attended medical school in North Carolina, which this week banned abortion after 12 weeks. “Part of the moral pull is to also be a part of still fulfilling care, even despite this horrible legislation.”

Dr. Gnendy Indig plans to specialize in health care for LGBTQ+ people. “My mentors in very progressive liberal institutions and cities have been dealing with death threats and doxing to the point where some of them have had to hire full time security to protect them,” she said. “Watching their bravery and watching them use that fear as a motivating factor and …keep pushing on, and still saying I will treat a population that needs me … is what keeps me on the path.”

“We all are trying to do everything we can …in a safe state like Vermont to be a beacon of light and hope for other states,” said Dr. Lauren MacAfee.