When the Arizona Supreme Court ruled on April 9, 2024, that the state’s Civil War-era law banning nearly all abortions was enforceable, it brought into stark reality the potential impacts of leaving reproductive rights up to the states to regulate, and the related consequences for women’s health.

The ruling, set to go into effect in late June 2024, will only remain active for a few months because Arizona lawmakers repealed the law on April 30. Starting in the fall, a previous state law banning abortion after 15 weeks will be reinstated.

The rapidly changing legal landscape and conflicting information has fueled fear and confusion for women, families, hospitals, physicians and other health care providers, and had a chilling effect on abortion services.

We are a health policy expert who studies how laws and policies affect health outcomes, especially for women and children, and a soon-to-be health care lawyer who is focused on health law and policy.

After having studied how reproductive health care has been affected by the 2022 Dobbs decision that overturned Roe v. Wade, it’s clear to us that the implications of bans like those in Arizona and dozens of other states go well beyond abortions. They include reduced availability of safe birthing services, pre- and postnatal care, pap smears, testing for sexually transmitted diseases, family planning, gynecological conditions and miscarriage management.

These downstream effects are not just predicted: They are already playing out in real time in states with the most restrictive reproductive rights laws across the nation.

Policies restricting abortion affect much more than access to abortion.

For one, these laws limit the supply of women’s health specialists like obstetricians and gynecologists, or OB-GYNs. Medical students are less inclined to enter the specialty and more likely to avoid training positions, employment or both in states with restrictive or near-total bans. These states also have difficulty retaining existing OB-GYNs.

This impact on the availability and locations of future women’s health specialists further exacerbates physician shortages, financial strains on families and racial and ethnic health disparities. The dampening effect on the workforce can also worsen the already dismal maternal mortality rates in rural and low-income communities of color.

Having a well-trained and adequate number of OB-GYNs is critical to promoting women’s health. One survey of third- and fourth-year medical students found that 60% were unlikely to apply for residencies in states where abortion is illegal or heavily restricted.

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