Access to obstetrics and gynecology (OBGYN) and reproductive health care is essential for women’s overall health and well-being.
Where does a woman go for care in the state of Missouri? Where does a woman go who has postmenopausal bleeding and abdominal pain? Where does a woman go if she has choriocarcinoma, a cancer associated with a nonviable pregnancy that is curable but can be fatal, if not recognized and treated in time? Where does a woman go if she is pregnant and is also diagnosed with breast cancer?
In Missouri, women face significant challenges in obtaining the care they need for a range of health issues, including reproductive services, cancer screening, and timely treatment.
Crisis of women’s healthcare
Missouri currently enforces some of the strictest abortion limitations in the United States. These restrictions have eliminated access to safe and legal abortions and led to the closure of clinics that provide vital services such as family planning, contraception, primary care, and cancer screenings. Tragically, women are now left with fewer options for care, and mortality rates are rising.
OBGYNs are essential for comprehensive health care. They are often the primary healthcare providers for women ages 18-49…
Missouri has witnessed a severe shortage of OBGYN physicians for years. With approximately 42% of Missouri counties classified as OBGYN deserts (March of Dimes’ Report), many women lack access to essential reproductive health services. This shortage adversely affects maternal and infant health outcomes and hinders early detection and treatment of various cancers. OBGYNs are essential for comprehensive health care. They are often the primary healthcare providers for women ages 18-49, providing risk assessments and facilitating timely screenings for common cancers such as breast, cervical, and colon cancer. Without adequate access to these specialists, cancers will go undetected until they reach advanced, less treatable stages.
Making matters worse
The restrictive abortion laws have consequences beyond limiting termination services. The impact of these health care restrictions negatively affect care for miscarriage management, ectopic pregnancies, in vitro fertilization, and access to contraception. The dwindling OBGYN workforce raises pressing questions about who will provide comprehensive care for women throughout their lives and how many families will be devastated by this shortage.
Missouri’s healthcare deficiencies are reflected in the persistently higher than national cancer mortality rates. Missouri ranks 42nd out of 50 in deaths related to breast and cervical cancers, according to a report from the Commonwealth Fund.
Unintended consequences
Disproportionate effects on Black women
As two cancer specialists who are also Black women in Missouri, we witness firsthand the impact of inadequate healthcare access on communities of color. Black women in Missouri have higher mortality rates of breast, endometrial, cervical, and colon cancers and often face worse outcomes due to delayed diagnoses and treatments. The disparity in mortality rates is greatest for younger Black women, who select more often OBGYN specialists as their only primary health care provider.
A call to action
We need a collective effort to address Missouri’s healthcare crisis. We must amplify the message that reproductive health care is intrinsically linked to cancer care and overall health. We urge everyone to use their voice and join us in spreading awareness about the essential role of reproductive healthcare and OBGYNs in providing comprehensive healthcare. Together, we can work towards a healthcare system that supports and sustains the health of all women in Missouri.
Dineo Khabele MD is a board certified gynecologic oncologist and Lannis Hall MD, MPH is board certified radiation oncologist. Both practice in the St. Louis area.
For additional information, please visit https://www.marchofdimes.org/