The national supply of ob/gyns met most of the demand in the US last year, but all except six states are projected to fall far short of the ob/gyns they will need over the next decade, according to findings from analysis of a national workforce database. The hardest hit areas will be nonmetro regions but planning and investment in mitigation strategies can help alleviate the severity of the shortage.

“Mitigation strategies include expanding the ob/gyn pipeline, retaining the existing workforce, integrating advanced-practice clinicians, using technology to extend reach, and optimizing care-delivery models,” William Rayburn, MD, MBA, of the University of New Mexico (UNM) School of Medicine in Albuquerque, New Mexico, and Imam M. Xierali, PhD, of the US Health Resources & Services Administration (HRSA) in Rockville, Maryland, wrote in the January 2026 issue of Obstetrics & Gynecology.

The article is “a kind of wake-up call that we’ve all known that ob/gyns alone cannot take care of women’s health issues entirely,” Rayburn, a maternal-fetal medicine specialist and emeritus chair of obstetrics and gynecology at UNM, told Medscape Medical News. “There needs to be help.”

Rayburn said it’s challenging to be accurate about projections like these considering all the variables that play a role, but the use of the HRSA database makes the data fairly robust. He and Xierali conducted a secondary analysis of data from HRSA’s Health Workforce Simulation Model that considers population data, healthcare utilization patterns, current workforce data, educational pipeline data, and supply and demand to estimate how adequately the number of projected healthcare professionals will meet projected needs.

The ob/gyn workforce in 2025, a total of 40,975 full-time equivalents, met 93.4% of the demand, with the highest levels of inadequacy in the central Midwest and Intermountain West states. Among the most populous states, New York, had adequate supply of ob/gyns last year, but California, Texas, Florida, and Pennsylvania did not.

A projected 9.3% decline in the national ob/gyn workforce by 2035 will leave only Hawaii, New York, Connecticut, Maryland, Rhode Island, and Louisiana with enough ob/gyns. A decade from now, the ob/gyn workforce will be 11.7% smaller in metro areas and 5.3% smaller in nonmetro areas than it was in 2022.

The states that will have the worst shortages include Nevada, Arizona, Arkansas, Oklahoma, Iowa, Idaho, and Utah; all of whose workforce is projected to meet < 70% of demand. The analysis suggests that (33 states will experience severe inadequacy, which means the available ob/gyns would meet < 85% of the demand.

“We knew that supply was a concern, but as we project it out, it looks even worse,” Rayburn told Medscape Medical News. “The supply of ob/gyns is becoming progressively inadequate to handle women’s healthcare needs.”

These predictions corroborate those of the the Association of American Medical Colleges, noted Amy E. Young, MD, of the Department of Women’s Health at Dell Medical School at the University of Texas at Austin and the American Board of Obstetrics & Gynecology (ABOG), and colleagues in an accompanying editorial.

Rayburn highlighted the robustness of this dataset while also acknowledging several limitations that should be considered in interpreting the findings. A strength of the dataset was the ability to consider both part-time and full-time clinicians since it was reported in full-time equivalents of 40-hour workweeks.

However, two limitations include the pandemic-era year of data collection — the most current data come from 2022 — and the fact that the data did not distinguish between general practice ob/gyns and subspecialists, such as maternal-fetal medicine physicians, “who invariably practice in metropolitan communities,” the authors wrote. Some of the changes occurring during the pandemic may have included more retirements and clinicians cutting back on hours or giving up obstetrics.

Young and colleagues noted that approximately 20% of the physicians participating in the ABOG’s Continuing Certification program in 2024 were subspecialists, and current enrollment data suggest that number will grow to 30%.

“Further, based on results from the 2024 Continuing Certification Survey, approximately half of subspecialists in maternal-fetal medicine, gynecologic oncology, reproductive endocrinology and infertility, and urogynecology and reproductive pelvic surgery indicated that they spend zero time dedicated to specialist practice,” Young and colleagues wrote. “This information highlights the problematic nature of subspecialty inclusion in the model, which may obscure critical nuances in workforce planning.”

They also noted that the full-time equivalency model, defined as more than 20 hours/wk, may overestimate actual clinical capacity. These limitations, combined with data collection during a pandemic era with “significant aberrations in care delivery,” may together “lead to erroneous estimates of the overall physician deficit and maldistribution and must be accounted for in interpretation.”

At the same time, however, there are separate models for midwives, women’s health physician assistants, and women’s health nurse practitioners, which prevent a full picture of team-based care projections. In fact, the HRSA model for advanced practice practitioners shows an oversupply of 135%-201% adequacy by 2035.

Rayburn and Xierali noted that the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, may have a negative effect on the ob/gyn workforce, though it’s currently too early to tell the extent to which it may ultimately influence workforce patterns across the country.

“So far, the Dobbs decision has not made a difference in the workforce, but there’s the fear that there are going to be ob/gyns leaving the states that either have bans or have severe restrictions,” Rayburn said.

“This issue, along with the decline in births and closing of rural hospitals, will be important for the HRSA in defining workforce scenarios for future investigations,” he and Xierali wrote. More resident training would be one solution to offset these predictions, but Rayburn was not optimistic about that because of funding.

Other ways to counteract future workforce inadequacy include encouraging ob/gyns not to retire early, extending their geographic reach with telehealth, optimizing care delivery models by engaging more primary care physicians, and adding more advanced practice providers to groups, Rayburn said. He also suggested that loan repayment programs that encourage practice in rural and other underserved areas could help. He acknowledged the challenges of the ob/gyn specialty, however, particularly burnout and long work hours.

“The aging female population will alter demand for gynecologic services such as cancer care, pelvic floor disorders, and menopause management,” the editorial authors wrote. “These evolving clinical needs necessitate strategic workforce planning to inform specialty and subspecialty training and evolution of competencies in the existing workforce.”

The authors of the research letter and of the editorial had no disclosures, and no external funding source was noted.

Tara Haelle is a science/health journalist based in Dallas.