Caring for Pregnancy-Related Emergencies after Dobbs

Background: Almost immediately after the landmark 2022 Dobbs decision overturning the legal right to abortion established under Roe v. Wade, important questions emerged about the possible effects of the state-level bans and severe restrictions on abortion that Dobbs allowed, including denial or dangerous delay in providing care that had been available pre-Dobbs. Theoretically, these new state-level abortion restrictions permit exceptions for what is variably described as a "threat to the life" of the pregnant woman. In practice, however, the actual determination of when a pregnant person has reached the threshold of this legal language is often vague and subjective. How clinicians have navigated patient care, including obstetric emergencies, in this context, and what it means for their experiences of work is an important area of study. Methods: Drawing on in-depth interviews with clinicians (n = 29), we document how the Dobbs-driven changes in pregnancy care have impacted clinicians both in states in which abortion is banned or severely restricted and those where it remains largely unrestricted. Results: It is not just clinicians in states that have severely restricted abortion who have been impacted; clinicians in states where abortion remains broadly legal are central to protecting patients' lives and health when they experience the dangers of pregnancy. Conclusions: We close by speculating on the consequences of this rising awareness of the importance of access to abortion care for obstetric patients and possibilities for shifts in public support for clinicians who provide abortion care.