Yes, OB-GYNs do perform abortions, but only a minority of them offer the service. A 2023 national survey by KFF found that roughly 18% of office-based OB-GYNs in the United States provide abortion care. Whether a specific OB-GYN performs abortions depends on their training, the state they practice in, the hospital or health system they work for, and their personal choice.
How Many OB-GYNs Actually Provide Abortions
Before the Supreme Court’s 2022 Dobbs decision overturned Roe v. Wade, about 21% of office-based OB-GYNs said they provided some type of abortion. That number dropped slightly to 18% afterward, a change driven largely by state-level bans rather than individual doctors choosing to stop. Among those who do provide abortions, 14% offer in-person medication abortions, 13% perform aspiration procedures (the most common type of surgical abortion in early pregnancy), and 12% perform later surgical procedures. Only 5% offer medication abortion through telehealth.
The gap between training and practice is significant. Nearly all OB-GYN residents receive abortion training during their education, yet about four out of five practicing OB-GYNs do not offer the procedure. Some work in states where it’s now illegal. Others practice in hospital systems that prohibit it. And some simply choose not to include it in their scope of practice.
Training Is Standard, Practice Is Not
Since 1996, the body that accredits medical residency programs has required abortion training as a routine part of OB-GYN education. The structure is opt-out, meaning residents receive the training unless they specifically decline for moral or religious reasons. After Dobbs, the accrediting body updated its guidance to say that residents in states with abortion bans “must receive support to obtain clinical experience in induced abortion in another jurisdiction.” So even in restrictive states, OB-GYN residents are expected to learn abortion procedures somewhere.
This means virtually every OB-GYN who completed residency in the last three decades has the clinical skills to perform an abortion. The question isn’t whether they know how. It’s whether they’re allowed to, and whether they choose to.
State Laws Are the Biggest Barrier
The most significant factor determining whether your OB-GYN can perform an abortion is where they practice. Following the Dobbs decision, more than a dozen states enacted near-total bans, and several others imposed gestational limits as early as six weeks.
Most states with bans include exceptions for medical emergencies, but these exceptions are notoriously vague. Phrases like “serious risk of substantial and irreversible impairment of a major bodily function” appear in many state laws without defining what conditions qualify. In South Carolina, for example, the law mentions severe pre-eclampsia and uterine rupture but gives no further detail, leaving doctors to guess whether other serious complications count. This vagueness forces OB-GYNs to consult hospital lawyers before acting, even when a patient’s health is deteriorating.
Some states go further. Tennessee, Texas, and Missouri don’t offer true exceptions in certain bans. Instead, they provide what’s called an “affirmative defense,” which means the abortion is still technically illegal, and the doctor can only justify the decision after being charged with a crime. The doctor bears the burden of proving in court that the procedure was necessary. Unsurprisingly, this chills willingness to provide care even in emergencies.
Hospital and Health System Restrictions
Even in states where abortion is legal, your OB-GYN’s employer may prohibit it. Catholic hospital systems, which account for a large share of hospital beds in the U.S., prohibit most abortions. Some Protestant-affiliated systems ban procedures they classify as “elective” while allowing them in certain medical situations, usually after an ethics consultation. Research has found that interpretation of these system-wide policies varies from hospital to hospital, and that institutional discomfort with abortion sometimes shapes policy as much as formal religious doctrine does.
For patients, this can mean delays, transfers to other facilities, and added costs. OB-GYNs working in religious health systems who want to help patients access abortion care are generally limited to referring them elsewhere, and even the referral process can be restricted depending on the system. Providers in Protestant hospitals tend to have somewhat more latitude to make direct referrals than those in Catholic systems.
What Abortion Care Looks Like at an OB-GYN Office
When an OB-GYN does offer abortion, the experience depends on the type of procedure and how far along the pregnancy is.
Medication abortion is available up to 70 days (10 weeks) of pregnancy and involves two medications taken in sequence. The first stops the pregnancy from progressing by breaking down the uterine lining and softening the cervix. The second, taken a day or two later, causes cramping and bleeding that empties the uterus. The process typically happens at home after the initial visit. Follow-up is often done by phone about a week later, with a home pregnancy test four weeks after treatment to confirm the abortion was complete. When a patient and their doctor both believe the pregnancy has passed based on symptoms, they’re correct 96 to 99% of the time. An ultrasound at follow-up is an option but isn’t required.
Surgical abortions, typically aspiration in the first trimester, are quick in-office procedures that take about 5 to 10 minutes. They require a private OB-GYN office equipped for the procedure or a clinic setting. Later procedures involve more steps and are less commonly available outside specialized clinics.
Abortion and Miscarriage Use the Same Procedures
One detail that surprises many people: the medical procedures for managing a miscarriage are identical to those used for elective abortion. The same two medications used in medication abortion are also the standard treatment for early pregnancy loss. The same surgical technique, aspiration, is used to complete a miscarriage when the body doesn’t pass the tissue on its own. An OB-GYN trained in miscarriage management is, by definition, trained in abortion procedures. This overlap is why abortion bans have complicated miscarriage care in restrictive states, as doctors worry about legal consequences even when treating a pregnancy that has already failed.
Cost and Insurance Coverage
If your OB-GYN provides abortions, paying for it can be complicated. A first-trimester abortion typically costs between $475 and $575 out of pocket. Private insurance coverage is inconsistent. In one study of patients with private insurance in Illinois, a state where abortion is legal, only about one-third had their abortion covered by their plan. Nearly half of patients with private insurance were denied coverage outright. Some patients chose not to use insurance at all, citing privacy concerns about having the procedure on their records.
Medicaid coverage depends entirely on the state. In states that cover abortion through Medicaid, most patients pay nothing out of pocket. But federal law (the Hyde Amendment) bars federal Medicaid funds from covering most abortions, so coverage only exists in states that use their own money to fill the gap. The billing process itself can be chaotic. In one documented case, a patient received insurance pre-authorization for an abortion, only to have the insurer reverse the approval after the procedure was complete, resulting in a $20,000 charge that took over a month of advocacy to resolve.
Finding an OB-GYN Who Provides Abortions
Because fewer than one in five OB-GYNs offer abortion care, you can’t assume your regular doctor does. If you’re looking for abortion services, dedicated reproductive health clinics are often a more direct path. Organizations like the National Abortion Federation and Planned Parenthood maintain provider directories searchable by location. In states with restrictions, some OB-GYNs can still prescribe medication abortion through telehealth across state lines, though the legality of this varies and is actively being challenged in courts.
If you already have an OB-GYN you trust, calling their office and asking directly is the simplest approach. Even if they don’t provide abortions themselves, they can typically point you to someone who does.