As published by JAMA Network-Open: Original Investigation
Key Points
Question To what extent do obstetrician-gynecologists (OB-GYNs) experience clinical constraints associated with their state’s abortion laws, and are those constraints associated with moral distress?
Findings In a cross-sectional study surveying 864 OB-GYNs, those in abortion-restrictive states endorsed higher levels of 3 specific clinical constraints (counseling, care provision, and care for patients with potentially life-threatening pregnancy complications) compared with OB-GYNs in protective states. Greater levels of each clinical constraint were associated with higher moral distress scores in restrictive and protective states.
Meaning These findings suggest that OB-GYN moral distress, associated with inability to provide certain forms of care to pregnant patients, transcends abortion policy context; institution-level policies and practices to support OB-GYNs are indicated nationally, not only in states with the most restrictive abortion laws.
Abstract
Importance Moral distress can occur when clinicians cannot provide clinically appropriate care due to external constraints. In the wake of Dobbs v Jackson Women’s Health Organization, moral distress has been reported among subsets of obstetrician-gynecologists (OB-GYNs), yet little is known about how moral distress manifests among OB-GYNs nationally.
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