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Objective: To study the impact of converting from subscription‐based publishing to open access ("flipping") in three obstetrics and gynecology (OBGYN) journals. Methods: We compared original articles in three OBGYN journals during a matched subscription‐based and open access publishing period. We analyzed citation metrics and country of authorship. Results: Overall, 1522 studies were included; of those, 869 (57.1%) were before flipping and 653 (42.9%) were after flipping. There was a decrease in publications by lower‐middle income countries from 7.7% in subscription‐based publishing to 1.8% in open access (P < 0.001). There was a decrease in the proportion of articles from South Asia (2.5% vs 0.5%), North America (14.4% vs 9.4%), and the Middle East (7.4% vs 2.5%), and an increase in publications from East Asia and Pacific (17.4% vs 30.9%; P < 0.001). The relative citation ratio was higher in the open access period (median 1.65 vs 0.95, P < 0.001). The number of citations per year was higher in the open access period (median 3.0 vs 2.0, P < 0.001). There was an increase in the proportion of funded studies (from 40.2% to 47.8%; P = 0.003). Conclusions: Flipping to open access in OBGYN journals is associated with a citation advantage with major authorship changes, leading to inequity. Synopsis: Transition to open access leads to a citation advantage, coupled with increasing gaps in equity of authorship. [ABSTRACT FROM AUTHOR]