For more than a decade, Jonna Quinn fought to keep what she once thought was her perfect life — and job — in Mason City.
Quinn was an OB-GYN at a hospital nearby. She was initially thrilled to work just an hour away from where she grew up.
But little by little, she said the hospital started restricting care, like certain birth control options and fertility treatments, based on its affiliation with the Catholic Church. At the same time, her unit was becoming increasingly short-staffed.
Quinn said at one point she was seeing up to 50 patients a day.
“That is twice what a normal OB-GYN will see in a day,” she said. “I was just trying to take really good care of my patients. I knew I was going to miss something because there's no way somebody can function at that level.”
Quinn decided to leave last year — not just Mason City, but Iowa entirely.
Quinn said she saw the Iowa Supreme Court at the time was on the verge of enacting a law banning abortion as early as six weeks of pregnancy, with some exceptions, so she moved her family to Minnesota, which has constitutional protections for the procedure.
"I could either stay and ruin myself and my career and my mental health and my relationship with my children, or I could go and continue to practice OB, which had always been my dream,” she said.
'There just simply isn't enough people'
Iowa has one of the lowest rates of OB-GYNs in the country. Increasing, that number has been a hot topic for the state’s lawmakers.
Rural hospitals, like the Grinnell Regional Medical Center, are especially struggling to recruit much-needed OB-GYNs.
The rural hospital has seen deliveries jump since nearby Newton Medical Center closed their obstetrics department last year, said David-Paul Cavazos, rural president of the Grinnell Regional Medical Center.
It delivered 249 babies last year and was close to already surpassing that number by the beginning of August.
“I imagine we're probably going to be set to break 400 by the end of the year,” he said.
At the same time, the 49-bed hospital has been recruiting an OB-GYN and a family practice doctor with obstetrics for more than a year.
“There just simply isn't enough people in the market to satisfy all the need. And it's not just us who's recruiting, right? We're competing with the other rural hospitals out there,” Cavazos said.
The hospital has been using locum doctors and doctors from affiliated UnityPoint hospitals in Des Moines to fill in shifts, but Cavazos said the increased workload has been challenging for the hospital’s two doctors who work in its maternity unit.
“It's one thing when your volume is lower and a weekend on call you just kind of had to hang out at home, [and] be by the phone,” he said. "But when that same weekend on call, volume goes up, and now it turns into, you're delivering five babies on Saturday, six babies on Sunday. It becomes more stressful.”
“They understandably do not want to put their licenses and their livelihood at risk when it comes to taking care of patients.”Karla Solheim, chair of the Iowa section of the American College of Obstetricians and Gynecologists
Last session, the Iowa Legislature passed a bill that increased Medicaid provider reimbursement rates for maternity care and directed millions in federal funding to create new residency slots.
These moves help address some of these issues, but the state’s abortion restrictions are also giving some OB-GYNs pause when considering practicing in Iowa, said Karla Solheim, chair of the Iowa section of the American College of Obstetricians and Gynecologists.
“They understandably do not want to put their licenses and their livelihood at risk when it comes to taking care of patients,” she said.
Solheim, who works in Waterloo, said she recently performed an abortion on someone who had life-threatening complications. It spurred many questions from hospital administrators, which made her very uncomfortable.
“I got so many phone calls about why I had done what I'd done,” she said. “Did I have enough evidence? Was her blood count low enough that her life was in danger? Should we have waited until her blood pressure got lower to proceed with terminating the pregnancy?”
The stress of working in understaffed delivery units has taken its toll on Solheim, who said she plans to stop delivering babies and focus on outpatient care.
She said if that plan doesn’t work out, she’s considering being a locum doctor and traveling to help out hospitals in neighboring Minnesota and Wisconsin for short stints.
“It just feels like our job is impossible,” she said. “We are expected to keep our patients alive. We are expected to provide excellent medical care. We are expected to remain calm and pleasant, and yet we are subjected to all of these forces just constantly beating against us at all times.”
Mixed results in the aftermath of abortion bans
It's still unclear whether abortion bans are driving doctors out of state.
A recent study found Idaho lost 35% of its OB-GYNs practicing obstetrics two years after enacting its highly-restrictive abortion law.
But another study analyzed federal data from January 2018 to September 2024 and found OB-GYNs aren’t leaving states with abortion bans two years after the Dobbs decision by the U.S. Supreme Court.
“We were surprised, and we cut the data in every possible way that we could,” said Becky Staiger, an assistant professor at the University of California, Berkeley’s School of Public Health, and the lead author on the study.
While numbers don’t show a systemic exit, she said she’s speculated it's possible some of these OB-GYNs could be “sheltering in place” for now.
“They're identifying ways that they can alter the practice that they have been doing for many years in order to stay with their patient population,” Staiger said. “We've heard anecdotally and through qualitative research that they're really highly committed to those patients.”
She said their analysis also doesn’t capture how OB-GYNs feel working in states with abortion restrictions.
“What we can't observe is anything about the quality of care that the providers are able to provide, about provider satisfaction with [the] job, about provider safety,” Staiger said.
A study published last year found Texas OB-GYNs reported feeling increased stress working under the state’s abortion ban.
But data suggests abortion laws like Iowa’s are influencing where another highly sought after group goes — medical students.
An analysis of data from the Association of American Medical Colleges found fewer students apply to OB-GYN residency programs in states that restrict or ban abortion.
“Any kind of disruption in that pipeline of getting physicians back into Iowa communities is a potential problem, and something I think policymakers need to think about,” said Atul Grover, a clinical professor of medicine at George Washington University who worked on the analysis.
E, a fourth year medical student in Iowa, said the law is weighing heavily into her decision of where to go for residency — and ultimately practice. IPR is using her middle initial because she is concerned about impacting her career.
“I really worry about the effect that abortion bans will have on my future patients and on my ability to provide evidence-based care for my patients,” she said. “I'm seriously questioning whether Iowa is a state that I want to practice in in the long term, and it breaks my heart because I know that there is such a need.”
