Tennessee

The Human Life Protection Act, restricting reproductive care in Tennessee, was enacted Aug. 25, 2022. This law is in direct conflict with the research-backed guidelines of the American College of Obstetricians and Gynecologists. As future physicians, this policy is a threat to our training. As Tennesseans, this law is harming our community.

Tennessee is already failing its population in terms of reproductive health.  The March of Dimes reports that over a third (35.8%) of our counties are maternity care deserts – meaning they lack an obstetrician-gynecologist or hospital offering obstetric care.  An additional 24.2% of counties have low or moderate access to hospitals or birth centers with preventive, prenatal and postpartum care. This means less than half of the counties in Tennessee have adequate access to necessary reproductive care.

Our state’s inadequate care for pregnant people is reflected in its maternal mortality data. According to the Centers for Disease Control and Prevention, between 2018 and 2020, the Tennessee maternal mortality rate was 1.7 times higher than the national average (34.6 deaths per 100,000 live births as compared to 20.4).

Research also shows that, among those living in our many maternity care deserts, patients are 3.5 times more likely to experience pregnancy-related mortality compared to those living with more access to care. Disturbingly, the 2021 Tennessee Maternal Mortality Report indicated that between 2017 and 2019, 74% of all pregnancy-related deaths were likely preventable.

This problem will worsen as people who would have terminated their pregnancies are now forced to continue them. In 2018, 9,987 pregnancies in Tennessee resulted in abortion while 80,737 ended with live births. With the Human Life Protection Act, our government is demanding an immediate 12% increase in prenatal, labor and delivery, and postpartum care provision from an already-overwhelmed system.

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Investing in comprehensive reproductive and obstetric care in Tennessee will save lives. Tennessee is the proud home to nationally known medical training programs and research institutions. Eight of the country’s 294 OB/GYN residency programs are in Tennessee.

These institutions play vital roles in ensuring we have an adequate and well-trained medical workforce in this state. Nearly half (46.6%) of all doctors graduating from Accreditation Council for Graduate Medical Education  residency programs in the state remain in Tennessee after they complete their specialized training. With our growing population and existing care deserts, we are in critical need for these talented doctors to continue to come to our state – and we need them to stay.

It has become evident to us that our peers – in Tennessee and across the country – are weighing reproductive care access as a factor in identifying locations for training.  Nearly all (91%) of applicants to a Chicago-based program agreed that “abortion is a routine part of OB/GYN care, and this belief impacted how I ranked OB/GYN residency programs.” Further, only 16% said they “were comfortable practicing in a state that restricted abortion training.” Because of our state’s laws, we worry fewer students and doctors will seek training in reproductive health in Tennessee, leaving even more patients without the care they need.

The Human Life Protection Act has already had a devastating impact on Tennesseans. Our state government is forcing doctors to provide substandard care in some instances and to ignore evidence-based medicine in others. We strongly oppose this legislation, its lack of exemptions and all attempts to limit a doctor’s ability to provide necessary care to patients. This legislation additionally limits medical training, reducing the number of physicians serving our patients and causing an increase in bad outcomes in all areas of obstetric and gynecologic care. Tennesseans deserve better.

Contact your elected officials and tell them that Tennesseans and their doctors deserve the right to make personal health care decisions based in evidence, not politics. The Human Life Protection Act, SB 1257, must be overturned – for the safety of all Tennesseans.

Jeewoo Kim, Lena Leszinsky and Hannah Light-Olson are medical students at Vanderbilt University. The views expressed by them authors are personal in nature and are not intended to represent the views of their institution.