Study shows moral distress OB/GYNs face in abortion-restrictive states
Dr. Jema Turk speaks to me about the results of her academic paper
A new study shows that doctors who work in abortion-restrictive states are more likely to feel distressed at not being able to provide the care they deem necessary.
The paper, “I Went Into This Field to Empower Other People, and I Feel Like I Failed”: Residents Experience Moral Distress Post-Dobbs,” was published in the Journal of Graduate Medical Education. The authors were Dr. Jema K. Turk, Dr. Emily Claymore, Dr. Nafeesa Dawoodbhoy, and Dr. Jody E. Steinauer.
“It's just the ripple effect of these restrictions ripple far and wide, and it's not just patients who need this care,” Turk said. “We have to consider the physicians and the APCs and the other health professionals that are stymied and in distress because they can't provide the care that they know is the right thing to do.”
In 2023, they invited OB/GYN residents identified by their program directors who were training in states with restricted abortion access to participate in one-on-one, semi-structured interviews via Zoom about their experiences caring for patients post-Dobbs. They used thematic analysis to analyze the interview data. Twenty-one residents described their experiences of moral distress due to restrictions.
Things that bothered doctors included being torn between what hospital policy and state law dictate and doing what medical indicators show is the proper treatment, which can consist of abortions.
As we’ve seen in Texas, doctors are caught in a legal quandary because the state supreme court and the Texas Medical Board have not provided adequate explanations and guidelines of when abortion is permissible. In speaking with people close to the situation, they told me that many doctors feel the way the study proves.
Another aspect that bothered many doctors was where the patients were coming from. Many were disproportionately from communities of color and poorer areas. They knew they could help but were unable to do so. One can conclude that many doctors are additionally bothered by realizing the consequences are exacerbated by the other problems those patients face.
Turk pointed out to me how this has affected the Ryan Program, a national initiative based at the Bixby Center for Global Reproductive Health at the University of California, San Francisco. The program's mission is to formally create dedicated family planning rotations in the departments of obstetrics and gynecology in the U.S.
Since Dobbs, many of the residents have been shifted to locations where they can get the proper medical training, including abortion care and pregnancy management.
“They are really focusing on trying to get those residents to an away rotation in a more protective state,” Turk said. “So that's kind of in a nutshell.”