Medical professionals describe a world of uncertainty a year after the Roe v. Wade reversal

It’s been over a year since Roe v. Wade was overturned by the U.S. Supreme Court, eliminating the constitutional right to abortion nationwide. The opinion was one of the most consequential Supreme Court decisions in decades and paved the way for states to pass laws to limit or ban access to the procedure. Abortion has already become one of the defining issues of the 2024 campaign and is expected to continue to be a key topic as candidates face questions about whether they support banning the procedure on the local and national level. CNN spoke with doctors and medical professionals who responded to a request for stories about how people’s lives have changed in the wake of the ruling. Those who responded all shared stories of their professional lives being disrupted by abortion bans and severe restrictions — including in Idaho and Arizona. Some no longer want to practice in states with limitations on the procedure. Others worry about the safety of their patients as more bans loom in the future. Below we share the stories of three medical professionals who agreed to give us full interviews about their experiences. Katie A., MichiganIdaho native Katie A. had plans of returning to her home state to practice as an obstetrician/gynecologist, but after Roe v. Wade was reversed and the state passed a near-total abortion ban, she is unsure of where she will go when she completes her residency in Michigan. Katie, who asked CNN not to use her full name due to safety concerns, was born and raised in Boise, Idaho, and went to medical school in Washington state to specialize in rural patient care. “As I was doing my clinical rotations in Idaho, I could really see myself working with the population there,” she told CNN. “Idaho is a state that for a long time has had a shortage of physicians. There’s a huge centralization of medicine in Idaho, most of the hospitals and specialists are in Boise.” Because of this, Katie said many people outside of the city do not have easy access to care. The medical resident told CNN that she envisioned making a difference in the state, especially by specializing in gynecological and obstetrics care. “I was really excited about the idea that I get to move home with this population that I grew up with — I could make a difference,” she said. When Roe v. Wade was overturned, Katie’s plans to practice in her native state quickly changed as she witnessed the medical landscape transform there. “I really felt called, like I felt that was where I could still make the most difference and it was really important to me to continue to pursue obstetrics and gynecology — whatever that might look like,” she said. “But for my safety and for my ability to really treat my patients, I knew as soon as Idaho started passing laws, criminalizing transportation across state lines and all that sort of thing that it would not be a hospitable place for me to practice medicine. And that you know is sort of heartbreaking, right?” the medical resident added. Idaho made abortions illegal last August — with only two exceptions: if the mother’s life is in danger, and in the case of rape or incest, but only after a police report has been filed and provided to the doctor. Since then, doctors who care for pregnant people and perform abortions have been fleeing the state due to new abortion restrictions. In April, health care providers sued the state’s attorney general after he wrote in a legal opinion that the state’s abortion ban prohibits medical providers from referring patients out-of-state for abortion services. Gov. Brad Little, a Republican, also approved legislation that makes it much harder for minors in the state to obtain out-of-state abortions without parental consent. The law creates an “abortion trafficking” crime that makes it illegal for adults in the state to assist a minor with obtaining an abortion without informing the pregnant person’s parents or guardians. Katie hopes that once she finishes her residency in four years, the situation will have evolved, helping her to more easily decide where she could eventually practice. “I think wherever I practice; it might be Michigan, it might be Washington — I don’t know, it could be anywhere — will really depend on what local politics are and what protections are in place for physicians and patients,” she told CNN. For the time being, she feels a sense of relief for matching with a program in a state without restrictive abortion laws. Katie’s decision is on trend with new data which suggests that these restrictions are having an impact on where — and what — future doctors plan to practice. The number of medical school seniors who applied to residency training programs went down by nearly 2% last year, and applications to programs in states with abortion bans dropped the most, dipping by 3%, according to an analysis in April from the Association of American Medical Colleges. Interest in the ob/gyn specialty took a notable dip, according to the analysis, with applications dropping 5% nationwide and twice as much in states where abortion is banned. Dr. Robert Andrews, Washington state Dr. Robert Andrews, a doctor specializing in interventional radiology in Washington state, told CNN that he has turned down job offers in states with abortion bans and restrictions. Andrews explained that his work involves image-guided surgery, including using ultrasounds and computerized tomography (CT) scans for lesions and balloons and catheters to treat blocked blood vessels. He said he became involved in pregnancy-related cases when treating bleeding in ectopic pregnancies. The doctor said the procedure to handle the ectopic pregnancy complication would “get the bleeding under control and allow the patient to have definitive treatment, but it would also kill the embryo.” Ectopic pregnancies are not viable and if left untreated can be life-threatening. According to the American College of Obstetricians and Gynecologists, these types of pregnancies occur when a fertilized egg grows outside of the uterus. The organization says most ectopic pregnancies occur in a fallopian tube and when the pregnancy progresses, it can cause the tube to rupture, leading to major internal bleeding that “can be a life-threatening emergency that needs immediate surgery.” Video below: Doctor talks impact of SCOTUS Roe v. Wade decision on health careAndrews told CNN he has declined opportunities to assist in practices in states with abortion limitations — despite there being a shortage of doctors nationwide in his specialty. “When I’ve been contacted about opportunities in other places, I’ve flatly rejected them, I wouldn’t even consider doing moonlighting in Idaho, even though I could drive there. Just wouldn’t consider it,” he said. “But I just flat out told the recruiters, you know, just look at the map, figure out whether the state has restrictions against abortion, and if so, don’t, don’t contact me because I wouldn’t consider it,” he added. Asked what states he specifically would not consider practicing in, Andrews said most states in the southeast and Texas. “I wouldn’t go to any place really in the southeast… I wouldn’t even go to Florida on vacation right now,” he said. Andrews has two teenage daughters and said that he refuses to pay for tuition if they decide to go to college in a state with abortion restrictions or bans. He fears for their reproductive safety, especially in the states he mentioned. He said that the risk of not being treated for miscarriages and other pregnancy-related complications is too high. “My older daughter is 18, and you know, you go somewhere on vacation, and you find out, you’re having a miscarriage, and you could potentially die, because they won’t treat it and they won’t let you leave because you might treat it,” he said. “My daughter is getting ready to go to college and thank goodness she doesn’t want to go to Idaho or Texas, or any of those places,” he said. Dr. Pratima Gupta, CaliforniaDr. Pratima Gupta, an ob/gyn who provides abortions in San Diego, California, said that the Roe v. Wade reversal has caused a lot of confusion for patients who now must travel for care. The doctor, who allowed CNN to use her full name, said she has had to take steps to ensure her patients’ protection after providing care, despite practicing in a state with protective laws surrounding abortion and contraception. “What we’re still seeing is a lot of patients who are traveling for care. And there’s a lot of confusion and chaos out there. And that’s really, exactly what was intended when the Dobbs (decision) came down,” she said. She added that while the reversal was devastating, “It was not a surprise, and abortion care was already under attack.” The doctor said that because she practices in one of the major cities closest to Arizona — which implemented a 15-week abortion ban — she’s seen the state’s laws leave many gray areas and patients are unclear about where they can go. Several patients that Gupta sees are going through not only the hurdles of bypassing their home state laws, but also having to figure out travel and post-care plans. Trying to help patients deal with the uncertainty of care and helping them navigate a flurry of laws and restrictions has left some clinic workers exhausted, she said. Gupta told CNN that patients are scared about their data being monitored when they return to their home state. “Now, we have people who are worried about their medical records being subpoenaed or anybody having access to their electronic medical record too… So it’s, you know, kind of created this culture of fear as well,” she added. On a personal level, Gupta said that she has had to deal with people questioning her choices given that she provides abortions. “I have had to, you know cross many picket lines going to work simply just to do my job,” she said. “Because of that, I have had to make personal choices for my safety.” These measures include protecting the identity of family members, checking her car before driving home and taking different routes home. “And I think almost every one of my colleagues has some level of, you know, other things that they have had to endure — personal attacks, attacks on their home,” she said. “But we all deserve better.” Gupta said these challenges have not lessened her determination. She told CNN that if doctors like her stop providing abortion care, “then the anti-abortion community, they’ve won.” “It’s not the care that any of us would ever want for ourselves, or our sisters, our family members,” she said. “So, I will continue — I do continue and will continue to provide care to support patients during some of their most vulnerable moments in their life,” the doctor added. CNN’s Christina Zdanowicz, Devan Cole, Deidre McPhillips and Kyla Russell contributed to this story.