Legal issues impacting women's access to care in the United States-the malpractice insurance crisis.

Professional liability insurance costs have increased rapidly in the last 10 years in the United States, while availability of companies offering professional liability insurance has decreased. The result is that ob-gyn physicians are changing their practice patterns. Many are no longer performing difficult or complex surgical procedures while others have stopped caring for obstetrical patients. Some physicians are retiring early or moving to other localities where there are less liability concerns. These changes all impact on the availability of health care for women. In addition, these problems have become a concern of medical students, and this is reducing the numbers considering a career in ob-gyn. Even where ob-gyns are available, hospitals and insurance carriers are limiting their ability to practice the wide range of procedures for which they were trained. Although legislative efforts to correct the problems are proposed, very few have been enacted. The end result is that women's health care has been threatened and will continue to face shortages and restrictions.