Dr. R. Todd Ivey, a practicing OBGYN in Houston, Texas, opened his Sunday paper last weekend to find a letter from New Mexico Gov. Michelle Lujan Grisham – directed at him.

“It must be distressing that a draconian abortion ban has restricted your right to practice and turned it into a political weapon,” Lujan Grisham wrote.

“I certainly respect those of you who remain committed to caring for patients in Texas, but I also invite those of you who can no longer tolerate these restrictions to consider practicing next door in New Mexico,” she added. “We’re fiercely committed to protecting medical freedoms here and we’re taking steps to ensure that what happened in Texas never happens in New Mexico.”

The letter, addressed to health care providers in Texas, appeared in five full-page ads in major newspapers across Texas.

It’s part of New Mexico’s $400,000 campaign dubbed “Free to Provide,” aimed at recruiting doctors from neighboring Texas who feel restricted by their state’s strict abortion ban. Ahead of the letter’s publishing, the campaign strategically placed six “Free to Provide” billboards around the Houston Medical Center.

Why specifically target doctors from Texas?

“We have to start somewhere,” Dr. Miranda Durham, chief medical officer for New Mexico’s health department, told CNN. “We are looking to improve the health care of New Mexicans and recruiting providers, wherever they want to move from, is part of that strategy.”

Like many states across the US, New Mexico is facing a health care provider shortage, across specialties, Durham said. As states in the region have implemented restrictive abortion policies, out-of-state patients are increasingly seeking abortion care in New Mexico, she noted.

“It’s bringing more patients to a state that’s already somewhat stressed by a provider shortage,” Durham said.

Abortion is legal without restrictions on pregnancy length in New Mexico, and the state has a shield law that protects its abortion providers caring for out-of-state residents.

Texas, on the other hand, adopted a near-total abortion ban in 2022, without exceptions for rape or incest.

Texas law does allow for exceptions in medical emergencies that threaten the life of the pregnant person, but the law does not outline exactly what constitutes a medical emergency. Doctors who violate the law risk up to $100,000 in penalties – not to mention the loss of their medical licenses and prison time.

“It’s gut-wrenching to look at a patient who you know is going to lose her pregnancy, and then say, ‘Oh, I’m sorry. We have to wait until something more severe happens,’” Ivey said. “It’s gut-wrenching, it’s – it’s not right.”

Ivey said he personally knows several doctors who made the decision to retire or practice in another state, in part because of the restrictions placed on them by Texas’ abortion law.

Rather than leaving, Ivey has encouraged his peers to stay and fight for a change in policy.

“We should be able to practice medicine – good, evidence-based, quality care – without fear of going to jail or losing our license,” he said. “Relocation is never going to be an answer for me.”

Texas Gov. Greg Abbott’s office called New Mexico’s campaign a stunt.

“People and businesses vote with their feet, and continually they are choosing to move to Texas more than any other state in the country. Governor Lujan Grisham should focus on her state’s rapidly declining population instead of political stunts,” Abbott’s press secretary Andrew Mahaleris told CNN in a statement.

About 116 health centers, hospitals and other providers have posted open jobs to the campaign’s webpage where interested applicants can apply, according to New Mexico’s health department.

Democratic Texas state Rep. Vikki Goodwin, who voted against her state’s abortion ban, told CNN that the law has left some doctors in Texas concerned for their livelihood.

“Hopefully we can retain good OBGYNs here in the state, because we do have a growing population, but I want our state leaders to be aware of what’s happening and the fact that we may lose good doctors to nearby states who do allow their doctors to practice as they see appropriate,” Goodwin said.

Doctors are leaving states with abortion bans

Researchers with the Association of American Medical Colleges examined applications from the 2023-2024 residency cycle and found that states with abortion bans, including Texas, had larger decreases in residency applications than states where abortion remained legal. That trend is likely to continue, the researchers noted.

New Mexico has two medical schools, while Texas has more than a dozen – granted, the Lone Star state has a much larger population.

In New Mexico, 33.3% of counties are considered maternity care deserts, where access to services is limited or absent, compared to 46.5% in Texas, according to a March of Dimes report.

Texas’ medical emergency exception was tested in a high-profile case last December, when a woman who was told her life and future fertility could be at risk without an abortion was denied one by the state supreme court. Texas Attorney General Ken Paxton publicly named the patient’s doctor in an open letter threatening first-degree felony prosecutions and civil penalties of $100,000.

Ivey and other physicians in the state took notice.

“As a physician, when you’re in that position, you want to make a reasonable medical judgment, but you’ve got the looming fear of these really severe penalties,” Ivey said. “If the law is unclear and physicians don’t have protection, how can they feel comfortable moving forward?”

Dr. Kimberly Pilkinton, president of the Texas Association of Obstetricians and Gynecologists, told CNN Wednesday that she was saddened by Lujan Grisham’s letter.

“The thought of losing current and/or future physicians to another state primarily based on politicized medical issues is unfortunate,” Pilkinton said in a statement.

The Texas Association of Obstetricians and Gynecologists says it opposes policies that “interfere with the patient-physician relationship, especially under the threat of felony,” and has called for state policymakers to revise and create new laws related to the care of women and their families.

The “majority of physicians are servant leaders who want to concentrate on caring for their patients, and all states need to offer support in doing so and stop interfering with the ability to counsel and care for patients to the best of our ability to do so,” Pilkinton added. “Hopefully, our Texas governing body will offer a response and encourage current and future physicians to remain in our great state of Texas.”

Ivey is a member of the American College of Obstetricians and Gynecologists, and he and his peers have called on state leaders to work towards revising abortion policy in Texas.

He said he hopes doctors join them in pushing back on restrictive abortion bans, as opposed to relocating.

“My heart is in Texas, and I want to stay here,” Ivey said. “I can’t speak for everyone, but I certainly hope that people realize that the women of Texas need us. They need good care.”