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Reproductive Healthcare After Dobbs: Rethinking Obstetric Harm in the United States
Mara Buchbinder1, Erika L Sabbath2,3
1Department of Social Medicine and Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Medical Anthropology
|December 20, 2024
Summary
Clinicians in states with abortion bans may inflict obstetric harm not only through direct mistreatment but also via state actions. This reframing reveals how obstetrician-gynecologists experience harm from legislative presence.
Area of Science:
- Medical Ethics
- Public Health Policy
- Reproductive Health
Background:
- The obstetric violence framework defines harm as physical, psychological mistreatment, and autonomy violations by clinicians.
- Clinicians' actions within the obstetric setting are increasingly influenced by external factors.
Purpose of the Study:
- To analyze how state actions, particularly abortion bans, contribute to obstetric harm.
- To reframe the understanding of obstetric harm by including the influence of state legislators on clinical encounters.
Main Methods:
- Qualitative analysis of interviews with 54 obstetrician-gynecologists (OB-GYNs).
- Focus on OB-GYNs practicing in US states with near-total abortion bans.
Main Results:
- Obstetric harm can be perpetrated through state actions, not solely clinician behavior.
- OB-GYNs experience harm due to the looming presence of state legislators in clinical settings.
- This perspective shifts the understanding of OB-GYNs' role from perpetuators to experiencers of obstetric harm.
Conclusions:
- State legislative actions, especially abortion bans, are a significant source of obstetric harm.
- Recognizing the state's role expands the definition of obstetric violence.
- OB-GYNs navigate and experience harm within a politically charged clinical environment.
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