Residents Navigating Moral Distress After the Dobbs v. Jackson Women's Health Organization Decision

To identify and examine strategies used by obstetrics and gynecology residents in abortion-restricted states to mitigate moral distress.

We analyzed one-on-one, semi-structured interviews with 21 obstetrics and gynecology residents in abortion-restricted states to identify and examine strategies used to mitigate moral distress related to training in abortion-restricted environments.

We identified four themes that summarize the strategies that residents have used to mitigate moral distress experienced while training in abortion-restricted settings: maximizing clinical care, supplementing education, engaging in advocacy, and obtaining emotional support. Across all themes, participants described individual and institutional efforts that helped mitigate moral distress, as well as strengths and limitations of all strategies. Faculty and institutional leaders played a particularly pivotal role in mediating the effect of residents' moral distress.

Strategies used by obstetrics and gynecology residents to combat moral distress from training in abortion-restricted states have varying effectiveness. The role of faculty and institutional leadership appears especially important in mediating the effect of resident moral distress and the success of efforts to combat it.