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THE TEXAS OB-GYN EXODUS  
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Stephania Taladrid
November 25, 2024
The New Yorker
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_ Amid increasingly stringent abortion laws, doctors who provide
maternal care have been fleeing the state. A new reality set in for
ob-gyns in Texas - “The standard of care can now be construed as a
felony.” _

Dr. Tony Ogburn helped build a residency program in an underserved
area. After Roe was overturned, the program collapsed., Photograph by
Christopher Lee for The New Yorker

 

Eight months after the fall of Roe v. Wade, Vanessa Garcia lay on a
hospital table in Texas’s Rio Grande Valley, as a technician
performed an ultrasound. Garcia had given birth to two children with
no complications, but her third pregnancy seemed alarmingly different.
The ultrasound revealed that her placenta was covering her cervix—a
condition, known as placenta previa, that heightened her risk of
hemorrhage or preterm birth.

Garcia was referred to a maternal-fetal expert at D.H.R. Health
Women’s Hospital, in Edinburg, Texas, and began going in for weekly
ultrasounds. She approached the visits as an opportunity to catch a
glimpse of her daughter, whom she had named Vanellope. Before driving
to appointments, she got in the habit of drinking half a gallon of
water, hoping that it would contribute to a clearer image. During
scans, she gazed at the monitor, watching raptly when Vanellope lifted
her hand to her eyes, as if gently rubbing them.

At the start of her second trimester, Garcia returned to the hospital
and followed a now familiar routine, uncovering her belly and resting
on a table. On this visit, though, the technician kept moving the
probe across her skin for an unusually long time, without ever turning
the monitor to face Garcia. Then she rose and left the room, without
saying a word.

Alone, Garcia couldn’t resist examining the images. The baby was
curled into a ball, looking eerily still. Instinctively, Garcia
snapped a photo and texted it to her husband, Erick Escareño, a
manager at a supermarket chain. He was checking inventory as he opened
the text and told himself, “This isn’t real.” Then a doctor
walked in and informed Garcia that her daughter’s heart had stopped.

Garcia was fifteen weeks into her pregnancy, and, in cases of
miscarriage in the second trimester, the safest treatment is a
surgical removal or a medical induction of labor. Instead, she was
“discharged to home self-care,” as her chart notes. All Garcia
could do was wait until she had a natural miscarriage. The thought of
it terrified her. What if she hemorrhaged in the middle of the street?
Or in the car, picking up her children from school? Her doctor’s
only departing instructions were: if you start bleeding or develop a
fever, check into the hospital immediately. (The doctor did not
respond to requests for comment.)

A mournful silence settled in Garcia’s home. Escareño busied
himself, but there were only so many times he could empty the trash or
mow the lawn. Garcia spent most of her days lying in bed. In a corner
of their bedroom sat purchases she had made for Vanellope: diapers, a
snuggly blanket, and now a small urn.

Garcia’s situation was not unique. Across Texas, reports were
surfacing of women being sent home to manage miscarriages on their
own. In 2021, the state had passed a law known as S.B. 8, banning
nearly all abortions after electrical activity is detected in fetal
cells, which typically happens around the sixth week of gestation. The
law encouraged civilians to sue violators, in exchange for the
possibility of a ten-thousand-dollar reward.

From a medical standpoint, the treatment for abortion and miscarriage
was the same—and so, even though miscarriage care remained legal,
physicians began putting it off, or denying it outright. After Roe was
overturned, the laws in Texas tightened further, so that abortion was
banned at any phase of pregnancy, unless the woman was threatened with
death or “substantial impairment of a major bodily function.”
Violations could send practitioners to prison for life.

After a week of increasing pain and anxiety, Garcia noticed that her
belly seemed to be flattening, and she couldn’t help wondering if
Vanellope was still there. Finally, she asked Escareño to drive her
to the hospital. In the emergency room, a nurse advised her just to
keep waiting and “let the tissue pass.” Garcia shot back,
“Tissue or baby? Law-wise, it’s a baby, but now you’re telling
me it’s a tissue?”

Eventually, her family doctor referred her to another physician: Tony
Ogburn, the founding chairman of the ob-gyn department at the nearby
University of Texas Rio Grande Valley. Ogburn, a tall man of
sixty-four, with white hair and rimless glasses, had come to the
Valley eight years before, with a mission to improve health care for
women. When he read Garcia’s file, he was outraged. After carrying
the dead fetus for weeks, she risked needing a full hysterectomy. Why
had she had to wait this long?

When they met, though, Ogburn reassured Garcia that she had options:
his team could induce delivery, or perform a dilation and
evacuation—a D. & E., as it’s known. The latter option was
“emotionally better for most patients,” Ogburn told me. In his
experience, it was traumatic enough for a mother to lose a child,
without having to go through labor to deliver a corpse. “For a lot
of people, the tipping point is, ‘You mean I can go to sleep, and
when I wake up it’ll be done?’ ”

Garcia was torn. For weeks, she had sustained the hope of holding
Vanellope at least once. But she couldn’t summon the resolve to go
through labor and return home without her child. Ultimately, she opted
for surgery, and the procedure was scheduled for the next day.
“I’m sorry,” Ogburn told her. “You should never have gone
through this alone at home.”

In the recovery room, when the anesthesia wore off after the surgery,
Garcia’s eyes filled with tears. “My first thought was, She’s
gone,” she said. But Ogburn had provided a memento: with her
permission, he had recorded Vanellope’s hand- and footprints on a
sheet of paper. “I didn’t get to carry her, but I have that part
of her,” Garcia said. Back home, she put the diapers, the blanket,
and the urn in storage, and replaced them with Vanellope’s prints,
set in a wooden frame.

Garcia felt grateful to have been referred to Ogburn, but there were
few other choices: hardly any physicians in the Valley were trained to
perform a D. & E. Amid the tightening restrictions on maternal care,
doctors had started leaving Texas; others were contemplating early
retirement. Within a few months, Ogburn would leave the Valley, too,
and the program he’d started would be shut down.

In the summer of 2016, Ogburn looked on as fifty-five student
physicians lifted their right hands to recite the Hippocratic oath.
They were the inaugural class at the University of Texas Rio Grande
Valley’s medical school—a new facility that, in the words of
university officials, promised to “forever transform the lives of
our children and grandchildren.”

For years, aspiring medical students in the Valley had moved to San
Antonio, or farther north to Houston, Austin, or Dallas. They rarely
returned home. The United States averaged almost three hundred
practicing doctors for every hundred thousand people; even in the most
populous county of the Rio Grande Valley, the ratio was less than a
third of that. Though the Valley included some of the poorest cities
in the nation, there wasn’t a single public hospital. The school
intended to turn things around. To attract residents, the
administrators called in Ogburn, who had spent a career providing care
in underserved places.

Ogburn had begun thinking about what doctors owed their patients
before he finished medical training. As a student, in the
nineteen-eighties, he served for a month at Kayenta Health Center, in
Arizona. Situated on the Navajo reservation, the center served a
community of about twenty thousand people. Some patients rode horses
to appointments. Others—who didn’t have running water at home,
much less a phone—hailed rides from strangers.

Each week, Ogburn was sent into the countryside with a translator and
a nurse, who carried a list of people who had missed appointments.
“We would drive twenty miles down a washboard creek bed to get to a
hogan out in the middle of nowhere,” Ogburn said. “Nobody was
there to make a lot of money. They were there to provide good health
care.”

After finishing his residency, Ogburn moved to Gallup, New Mexico,
with his wife, Jane, planning to stay a year or two. Instead, they
spent six years there, and had two children. Ogburn’s next job, at
the University of New Mexico, lasted almost two decades. Early on, he
worked part time at a clinic on the Kirtland Air Force Base, east of
Albuquerque. It was a “socialized-medicine environment,” he said.
Neither he nor his patients had to worry about whether they could
afford imaging tests or prescriptions—the government bore all
medical costs. The university, too, used a portion of its public
funding to care for the indigent. “It was a place where the social
determinants of health, which we didn’t have vocabulary for back
then, came into play,” Eve Espey, a longtime colleague of Ogburn’s
there, said.

Ogburn conducted studies on how to improve health outcomes for women,
and advocated for abortion care to be a part of every medical
student’s education. He eventually became a leader of the
university’s obstetrics-and-gynecology practice. In 2015, a
recruiter called to tell him about the effort to build a medical
school in the Rio Grande Valley. The region faced needs that were
similar to New Mexico’s, but it had never had an ob-gyn residency
program. Would he want to start one?

The idea was to create a practice staffed by doctors who would also
teach at the med school and oversee residents at the hospital. Ogburn
visited medical facilities around the country, seeking talent. His
pitch was meant to counteract the stereotype of the Valley as a region
defined by clashes between smugglers and Border Patrol agents—what
Ogburn described as “people with machine guns driving around in
pickup trucks.” But what stood out most was the moral urgency of his
message. “He was the only person that talked about human rights,”
Zoe Kornberg, one of the residents he recruited, said. She emerged
with a galvanizing idea: “It’s a radical act to make somebody feel
cared for and empower them, if they’ve never had that before.”

Most of the Valley’s population occupies a string of cities
connected by Highway 83, known locally as the world’s longest main
street. The region is bordered by vast ranches and fields of mesquite,
as well as _colonias_, where thousands of agricultural workers live
in trailer homes. The area is defined less by violence than by
poverty: the per-capita income hovers around twenty thousand dollars a
year.

Even in Texas, which has the largest share of uninsured residents in
the nation, the Valley had unusually high numbers. Women suffered and
died from cervical cancer at inordinate rates. One ob-gyn routinely
performed surgeries on cancer patients without being board-certified
in oncology. “You’re talking about a huge chunk of Texas where you
didn’t have a place for physicians to pursue a medical
education—nothing,” Adela Valdez, a respected doctor in the
Valley, said. “It was an area that was forgotten.”

Residents and physicians around the country signed on to Ogburn’s
program, convinced that he would instill a higher standard. In the
fall of 2015, Ogburn and his team began working at D.H.R. Health
Women’s Hospital, a sand-colored building with a colonnaded
entrance. They focussed on starting the residency program and building
a series of practices, including one in complex family planning,
designed to treat some of the most delicate complications that arise
in pregnancy. The consensus, according to Valdez, was that Ogburn
would institute “the kind of health care for women that they
deserved.”

At the hospital, Ogburn was a calm, observant presence. One night
during my visit, he stopped by a glass-panelled room, known as the
fishbowl. Inside was a wall lined with screens showing the heartbeats
of mothers about to deliver. One of the lines was peaking
constantly—a sign, Ogburn said, that the mother was in the middle of
contractions. Right above it was the baby’s heartbeat. “If it’s
wiggly and has what are called accelerations, it’s fine,” he said.
“When it’s straight, or low, it might not be.” Near the center
of the wall, one mother’s monitor flashed a dipping line. It was a
variable deceleration, Ogburn explained, meaning that the baby was
likely in the birth canal, where heart rates tend to slow. It was, in
a way, a prelude to the first breath.

When Ogburn and his team started working at D.H.R., they quickly
discovered that it was “practicing how most hospitals did twenty
years ago,” he said. They found that episiotomies, or perineal
incisions, which were regarded as an outdated practice, were not
unusual there. C-section rates were high—exceptionally so among some
doctors. Ogburn said that women who came to the E.R. with heavy
bleeding were typically given a transfusion and then sent home, only
to return later with even more severe hemorrhages. When he performed
pelvic exams on a group of these women, he determined that they all
had cervical cancer. (D.H.R. declined to comment on specific patient
encounters but stated that it was “committed to providing prompt,
compassionate care in accordance with Texas state law, maintaining
evidence-based practices.”)

Ogburn’s colleagues noticed similarly troubling patterns. Jennifer
Salcedo, an ob-gyn who left a practice in Honolulu to move to the
Valley, recalled that early on she was rushed into an operating room
where a physician had attempted to perform a D. & E. but hadn’t
fully dilated the woman’s cervix—a mandatory first step. “He was
just kind of standing beside the patient,” Salcedo said. “There
was over a thousand millilitres of hemorrhage.” (Women hemorrhage in
less than six per cent of D. & E. procedures, and when they do they
generally lose only half that much blood.) Salcedo realized that the
doctor had used tools reserved for an early pregnancy, even though the
patient was well past the twentieth week.

 
When Vanessa Garcia was fifteen weeks pregnant, tests found that her
baby’s heart had stopped. A nurse advised her to go home and “let
the tissue pass.”  (Photograph by Christopher Lee for The New
Yorker)
Like many other hospitals in the Valley, D.H.R. was a for-profit
institution. It was also physician-owned, which meant that doctors
took a cut of the proceeds—giving them an incentive to bring in
patients. “Volume means money,” Ogburn said. When he began working
with D.H.R., the hospital was averaging about eight thousand annual
deliveries, making its maternity ward one of the busiest in Texas.

The volume of patients presented an opportunity for the new residents:
the more conditions they were exposed to, the more they learned.
Ogburn insured that anyone who walked in, irrespective of her ability
to pay, could see a resident. “It was a win for the patient, it was
a win for the residents, and it was a win for the hospital,” he
said. Soon after he arrived at D.H.R., it became the first institution
in the Valley to have ob-gyns on-site around the clock. In the past,
doctors were hardly ever at the hospital at night, so they had to be
called in for after-hours emergencies; often, they ended up just
giving nurses instructions over the phone. Now if a woman’s uterus
ruptured halfway through labor, there would be someone to treat her.
Eventually, the hospital qualified for Level IV status, signifying
that it was equipped to handle the highest-risk pregnancies.

Part of Ogburn’s goal was for residents to “serve beyond the walls
of the hospital.” That included holding community health clinics and
working with institutions connected with underserved populations.
Among the uninsured patients who turned up at D.H.R. were referrals
from Holy Family, one of the oldest birthing centers in Texas.
Previously, physicians had rarely wanted to collaborate with Holy
Family—midwifery was viewed in the Valley as a pseudoscience.
According to Sandra de la Cruz-Yarrison, the center’s executive
director, if a patient faced a life-threatening complication or
received a midpregnancy diagnosis of cancer, and couldn’t afford
care, there was nowhere to refer her to. “They all went
untreated,” she told me. After Ogburn arrived, she said, “his
support got us through that door.”

Not everyone at D.H.R. was happy about the university’s influence.
According to Efraim Vela, the hospital’s chief medical officer, some
saw residents as “ten-year-olds with sharp knives in their hands,
running around the house.” Others rolled their eyes whenever a Holy
Family patient walked through the door. “I didn’t join D.H.R. to
practice at an indigent hospital,” Ogburn was repeatedly told.

The staff tried to contain these tensions, but they became harder to
ignore with the passage of S.B. 8, which had the controversial
provision that encouraged anyone suspecting a person of “aiding or
abetting” an abortion to file a lawsuit. In some instances, nurses
openly challenged doctors, invoking their right to sue. “People were
so hair-triggered to be looking for a crime,” Zoe Kornberg, the
resident, said.

Ogburn began meeting with patients behind closed doors and instructing
his residents not to offer counselling over the phone. “You never
know who’s on the other end listening,” he told them. By then,
“nobody felt comfortable talking about anything,” Elissa Serapio,
one of the ob-gyns, said.

The list of conditions that could be treated narrowed substantially.
If a woman came to the hospital with a lethal fetal anomaly, she had
no option but to carry the pregnancy to term. The outcome was
traumatic for both the mother and her doctors. “Several people had
babies die in their arms,” Ogburn said. Doctors were even reluctant
to treat life-threatening complications such as ectopic pregnancies.
“It’s the standard of care everywhere in the world,” Ogburn
remembers telling an anesthesiologist. “And you’re telling me you
can’t treat an ectopic?”

A majority of women didn’t know that the laws had changed, and many
of those who did know were not in a position to seek care out of
state. A somewhat simpler solution was to cross the border into Mexico
and buy abortion pills over the counter. Misoprostol, which causes
uterine contractions, often comes in blister packs of twenty-eight.
Women would call the hospital to ask if the twenty-eight pills should
all be taken at once. The answer was no—four was typically the
recommended dosage. But even such vital counsel could now be construed
as aiding and abetting.

Ogburn referred patients to his former colleague Eve Espey, who had
gone on to lead the University of New Mexico’s ob-gyn department.
She, too, was feeling the effects of S.B. 8: the majority of her
patients now came from out of state. But it took weeks, if not months,
for many women to secure the money and the free time to travel
hundreds of miles for care. When patients made it to Albuquerque,
Espey said, the most vulnerable of them presented hemorrhages so
severe that only a hysterectomy could keep them alive.

In the coming months, a new reality set in for ob-gyns in Texas. As
Ogburn told his colleagues, “The standard of care can now be
construed as a felony.” Many of the doctors had moved cross-country
to join him at the university, but now the law complicated their work.
“I see horrible things go wrong all the time in people’s
pregnancies, and the law has made it so that there’s no guarantee
that the right thing can be done,” Serapio told me. Even after
getting all the mandatory clearances from lawyers and administrators,
she added, “you still don’t know if you’re going to have an
anesthesiologist who will agree to do it. By that time, the person has
bled out and could die.”

Some of Ogburn’s colleagues were applying for their board
certifications in complex family planning. What if they didn’t meet
the requirements after operating in such a constrained environment?
Residents who were interested in family-planning programs had similar
concerns. To minimize the damage for them, Ogburn reached out to
colleagues around the country and found rotations in states that
offered clinical abortion training, like California or Connecticut.

But the new laws were already having an effect on the health-care
system. Across Texas, residency applications in ob-gyn dropped
significantly. Data from the Gender Equity Policy Institute revealed a
fifty-six-per-cent spike in maternal deaths in the state between 2019
and 2022. When the Supreme Court overturned Roe v. Wade, Texas was no
longer an outlier; in the weeks after the ruling, thirteen states
moved to ban abortion. By then, Serapio and Salcedo had already left
Texas. Another ob-gyn at the practice, Pam Parker, would follow soon.

Ayear after the fall of Roe, Ogburn sat in his office surrounded by
empty cardboard boxes, which he was filling with the records of his
work in the Valley. D.H.R. was ending its partnership with the medical
school. The hospital didn’t offer an official explanation, but the
motives weren’t hard to guess. “Our healthcare mission no longer
aligns with a for-profit, physician-owned health system like DHR
Health,” the university’s president, Guy Bailey, declared at the
time. The residents were dismayed. Many had purchased homes there;
some had signed mortgages shortly before the decision was announced.
Ogburn convened an all-hands meeting to discuss what to do.

No other hospital in the region had as high a volume of patients as
D.H.R., so the program couldn’t simply be transferred elsewhere.
Besides, Ogburn had already lost half his full-time faculty to S.B. 8.
He spent weeks making a new round of calls to medical leaders outside
the Valley, to find hospitals where his residents could finish their
training. Nearly all of them would end up leaving Texas.

The clinic was uncharacteristically quiet when I visited; Ogburn had
stopped seeing new patients. No one was comparing notes in the hallway
or hustling from one examination room to another. The offices adjacent
to Ogburn’s, which had belonged to three ob-gyns who had followed
him to the Valley, were all empty. The doctors had relocated to New
York, California, and Arizona. On a shelf facing Ogburn’s desk was a
pile of unopened dilators, which are used to perform D. & E.s. He
arranged them in a box and taped it shut.

Down the corridor, in a room ringed with computers, two residents were
typing in the records of their last patients. Martha Chapa, a
thirty-year-old with long brown hair, was the only member of her class
to pursue a practice in Texas. Chapa had been born in the border town
of Laredo, and remained committed to improving health care in the
Valley.

During her youth, Chapa explained, whenever there was a family medical
emergency, her parents would drive across the border into Nuevo
Laredo. That’s what they had done when, as a toddler, she dropped
her father’s machete on her foot, and when, years later, she
developed an ovarian cyst. “I ended up having surgery in Mexico, as
a medical student in the United States,” she told me. Now her
parents had insurance, but it was still cheaper for them to see a
doctor across the border, she said. They were the reason why her
reaction to D.H.R.’s decision wasn’t “Fuck Texas, I’m out.”

That night was Ogburn’s last time on call at D.H.R. He put on scrubs
and toured the hospital’s corridors. At the fishbowl, he waved to
the residents, who would also be gone the next day. He and his wife
had just put their house on the market. He planned to take a yearlong
break, then move to San Antonio, where his daughter was doing a
residency in orthopedics. He would work at a hospital there part time,
caring for women who came to deliver—his version of an easy
schedule.

His cell phone rang: it was Kornberg, who was also on call. A patient
had come in through the E.R. with severe bleeding and cramping, but,
when Kornberg asked a nurse what her cervical check had shown, she got
a blank stare. The nurse admitted that she hadn’t examined the
woman. Did she feel comfortable doing so? Kornberg asked. The answer
was no—so Kornberg took over the patient’s care. Ogburn thanked
her warmly. Neither mentioned that in twenty-four hours they would
both be gone.

Close to midnight, I caught up with Kornberg. There were three women
in the antepartum unit whose amniotic sacs had ruptured before the
fetuses were viable, she told me. Their babies had little chance of
surviving, and elsewhere the women would have been given the option to
terminate their pregnancies. “I can’t do that in this state,”
Kornberg said. Instead, the women were all told, “We’re going to
give you these medications, to give the baby the best chance, though
it may not survive.” The reality, Kornberg added, was even bleaker:
“You have a baby that’s probably not going to survive, and we’re
going to keep you here. And you’re going to sit alone in this room
for three, four months, and maybe you’ll die of sepsis.”

Kornberg was moving to Los Angeles to finish her residency. Like the
doctors who had left before her, Kornberg had come to see herself as
“part of the problem,” she said. “I have the knowledge, all the
support staff, everything to be able to help this person avoid one of
these horrible outcomes—and they’re begging me to do it, but I’m
not allowed to.” The bans felt like a personal attack, she said:
“The state sees you as a felon.” When the act of caring for
pregnant women in Texas could carry the same penalty as murder, the
inevitable conclusion for Kornberg was “You don’t want me here?
Fine, I’ll leave.”

Texas authorities are not keeping track of the exodus of doctors, at
least not officially. Yet among practitioners there is a quiet sense
of doom. “The pipeline is drying up,” Charles Brown, a
maternal-fetal expert and a former Texas regional chair of the
American College of Obstetricians and Gynecologists, said. A growing
number of residents who trained in the state were leaving, Brown told
me, and many established doctors were contemplating it, too.
“We’re just not going to have enough people to take care of women
in this state,” he said.

A report released last month by Manatt Health, a health-care
consultancy based in Los Angeles, confirmed Brown’s fears. Manatt
surveyed hundreds of ob-gyns in Texas to examine the impact of
abortion bans. Seventy-six per cent of respondents said that they
could no longer treat patients in accordance with evidence-based
medicine. Twenty-one per cent said that they were either considering
leaving the state or already planning to do so; thirteen per cent had
decided to retire early. The report found “historic and worsening
shortages” of ob-gyns, which “disproportionately impact rural and
economically disadvantaged communities.” As in the Rio Grande
Valley, the bans were shrinking the field’s future workforce:
residency programs across Texas have seen a sixteen-per-cent drop in
applications.

Texas is among the twenty-one states where abortion is banned or
severely restricted. In Idaho, nearly a quarter of the state’s
ob-gyns have left since the ban went into effect, and rural hospitals
have stopped providing labor and delivery services. In Louisiana,
three-quarters of rural hospitals no longer offer maternity care. Half
a year after Ogburn left the Valley, another doctor submitted her
resignation. The school’s Department of Obstetrics and Gynecology
was folded into a new unit: the Division of Women’s and Children’s
Health. By then, the department had shrunk to three doctors, one of
whom plans to leave next spring.

After the departures, I sat down with Efraim Vela, the chief medical
officer, to talk about D.H.R.’s future. A burly, clean-shaven man of
seventy, with graying hair and a slight limp, Vela compared the
severed relations between his hospital and the school to a tumultuous
divorce. “The kids will obviously suffer,” he said.

Patients had shown up at Ogburn’s clinic only to find a closed door.
Others had come for appointments and learned that the residents they
knew had moved on. “They’re going to be an asset to someone else,
somewhere else,” Vela said, fighting tears.

After more than four decades of practicing in the Valley, Vela
understood that it was singularly difficult to draw people there.
Ogburn had managed to do it, and, Vela said, doggedly, “I’m hoping
to rebuild.” D.H.R. had attempted to start its own ob-gyn residency
program twice since Ogburn’s departure, and on the second attempt
the organization that accredits such programs had approved the
application. Even so, it would be five years before the residents
could graduate and start a practice in the Valley.

Until then, with the residents gone and so many specialists departed,
it was unclear how high-risk pregnancies would be handled at D.H.R.
Vela had initially asked seven doctors to take turns covering night
shifts, and then brought in a hospitalist to work full time.
D.H.R.’s Level IV status is set to expire next year, but Vela was
adamant that the hospital would not lose it—“as long as I sit
here,” he said, gripping the sides of his chair. Where, I wondered,
would uninsured patients turn now? Vela said that D.H.R. was still
accommodating those with Medicaid, and doing what it could for the
rest. But, he concluded, echoing the most skeptical voices at D.H.R.,
“we can’t run a charity hospital.”

_[STEPHANIA TALADRID
[[link removed]] is a
contributing writer. She was named a Pulitzer Prize finalist in 2023
for her reporting on the fall of Roe v. Wade.]_

Published in the print edition of the December 2, 2024
[[link removed]], issue, with the
headline “The Texas Exodus.”

* women's health
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* Women's health care
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* maternal health care
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* reproductive health
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* Reproductive rights
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* abortion
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* abortion rights
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* anti-abortion
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* Women
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* war on women
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* Ob Gyn doctors
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* post-Dobbs
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* Dobbs v. Jackson
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* Donald Trump
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