UH Law Colloquium Event Highlights Post-Dobbs Challenges for OB/GYN Residency Programs

April 20, 2026 — The U.S. Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, has reshaped abortion policy and access to reproductive health care across the nation. That decision, a legal scholar visiting the University of Houston Law Center said, is also transforming the education of the doctors who provide obstetric and gynecological care.

“The reversal of Roe v. Wade has set in motion a slow-building crisis in medical education, one that will eventually compromise the quality of patient care across the country,” said Rachel Rebouchè, a leading U.S. scholar in reproductive rights and health. “This concern about patient care is not only about elective abortion, but also about the full spectrum of pregnancy-related emergencies that every OB-GYN must be prepared to manage.”

Rebouchè, a professor at the University of Texas Law School and former dean of Temple University Beasley School of Law, explored post-Dobbs changes and their implications during a recent presentation as part of UH Law’s 2026 Colloquium/External Speaker Series. The talk was based on her upcoming paper “Training By Travel: Medical Education for OB/GYN Residents After Dobbs,” which examines how these restrictions and abortion bans are forcing medical residency programs to rethink how and where medical training takes place.

“The legal landscape is not just restrictive, it is confusing, and the confusion itself generates harms,” she said. “That harm reverberates directly into how positions are trained to navigate [medical] exceptions [to the law]."

Accreditation standards still require OB/GYN residents to receive abortion training, Rebouchè said. But in states where most abortions are illegal, residency programs must send trainees out of state, often to California and New York, to meet that requirement.

While travel-based training programs allow residents to gain legally required experience, Rebouchè said, they also create logistical and financial burdens. Many residents opt out of abortion-related training for a variety of reasons, she said, including religious objections, personal beliefs and, now, challenges of the out-of-state educational requirement.

“It’s increasingly residents, people training in just the scenario that you described, that are opting out,” she said in response to a question from an audience member who shared a personal story about his wife’s traumatic emergency delivery and asked how physicians are taught to handle such complex procedures when their training is limited.

According to Rebouchè, the resulting gaps in training can affect an OB/GYN’s ability to provide informed and needed medical care.

The rippled effects extend beyond training, worsening skilled workforce shortages in states with abortion bans, she noted.

"This [decrease in applicants] accelerates an existing crisis and connects to the broader legal issue,” Rebouchè said. “Fewer OB/GYNs in banned states means fewer physicians available to exercise the medical judgment that life and health exceptions require."

At the same time, the nature of abortion health care is changing. Rebouchè noted that the number of abortions nationally has not declined as dramatically as expected after the Dobbs decision, in part because of the rise of medication abortions provided through telehealth.

"The average number of abortions is actually higher than before Dobbs, and mailed medication abortion helps account for that figure,” she said. “Most residency programs have not yet developed protocols for teaching telehealth-based medical abortions, even as it becomes a predominant form of care."

This shift towards telehealth raises new questions about physicians training, including whether telehealth can off-set the need for in-person clinical training.

"Arguably, providers need training in both [in-person and tele-healthcare],” she said. “The tension that I want to look at is that even with mailed medication abortion, the need for clinical space is not going to disappear."

However, she added, there is mounting legal pressure, from interstate lawsuits to calls for enforcing the 1873 Comstock Act, to restrict the telehealth models.

Although the number of patients who require emergency medical abortions is relatively small, Rebouchè emphasized that the consequences can be severe when care is unavailable or delayed.

“The problem is that it's a dire outcome when you need it and cannot get it,” she said.

As abortion laws continue to change and vary widely across the U.S., Rebouchè’s research highlights how the effects of Dobbs and other decisions extend beyond access to care today, but the training of the next generation of medical physicians and patients’ access to care in the future.

The UH Law Center 2026 Colloquium/External Speaker Series brings together leading legal scholars from across the country to present their works in progress that foster scholarly dialogue. This year’s series is unique in that it features all law deans, including, in Rebouchè’s case, former law deans. To keep up with the Colloquium Series, click here.