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Obstetricians and gynecologists have experienced heightened distress due to their inability to administer necessary interventions to patients following the overturning of Roe v. Wade, according to research presented by Harvard Center for Work, Health and Wellbeing director Erika L. Sabbath.
Sabbath discussed her work on the increased moral distress that physicians have faced in the wake of the 2022 ruling at an event at the Harvard Center for Population and Development Studies on Thursday. Previous research has studied the impact of the Supreme Court ruling on individuals seeking abortions, but less focus has been placed on the effects of the decision on healthcare providers — a gap that Sabbath’s analysis helps fill.
The research entailed interviewing more than 50 OB-GYNs about their experience providing abortion care in the 13 states that have instituted near-complete abortion bans since 2022. Sabbath and her team found that these physicians reported heightened guilt and anxiety when interacting with their patients.
One interviewed OB-GYN described how her patients were “sobbing and crying and begging,” Sabbath said. “You have the chills because you’ve got the procedure room just down the hall. You’ve got medications right next door. You could fix this person’s problem, and you’re not.”
A number of states with abortion bans have exceptions for when maternal life is threatened, but not maternal health, according to Sabbath. Some of the interviewed clinicians reported withholding treatment until their patients’ conditions worsened — and they would be legally allowed to undergo certain procedures.
“The person’s life had to be in danger before the hospital said that the physician could proceed,” Sabbath said.
Several state-level abortion laws often use non-medical language, which Sabbath said has made clinicians unsure about what medical decisions are legal or not. That ambiguity has increased fear among physicians trying to provide life-saving care. Some OB-GYNs reported being paranoid that their patients, or their patients’ partners, record their interactions to implicate them, according to Sabbath.
Legal consultations can ease physicians’ concerns, but many medical emergencies occur outside of lawyers’ working hours, Sabbath added.
This moral distress has driven many OB-GYNs out of their home states. More than 10 percent of clinicians interviewed by Sabbath’s team moved to states with more relaxed abortion laws, and an additional 60 percent reported considering doing so. Moral concerns compel others to stay.
“I thought so many times about leaving, but I’m one of only three people left in the state who can take care of a patient who is possibly dying from their pregnancy,” one of the interviewed clinicians said.
Sabbath’s team — composed of researchers at Boston College and the University of North Carolina, Chapel Hill— have expanded their research sample in an ongoing study to include clinicians in all 50 states. So far, they have found that OB-GYNs overall have experienced heightened distress, not just those in states with highly-restrictive abortion laws.
Sabbath gave a number of potential explanations for this unexpected finding, including the fact that significant time has elapsed since Roe v. Wade was overturned. Her team is currently conducting additional research to pinpoint the exact reason.
