Exploring how California obstetrician-gynecologists interpret the fetal viability concept.

Area of Science:

• Medical Law
• Reproductive Health
• Obstetrics & Gynecology

Background:

• California has viability-based abortion legislation.
• Fetal viability is a complex medico-legal concept.
• Understanding provider interpretation is crucial for equitable care.

Purpose of the Study:

• To explore how OBGYNs in California define and interpret fetal viability.
• To examine the influence of hospital and state policy on these interpretations.
• To assess the impact on clinical practice regarding abortion care.

Main Methods:

• Qualitative audio-only interviews were conducted with OBGYNs in California.
• Participants included generalist and Complex Family Planning (CFP) fellowship-trained physicians.
• Interviews were transcribed and analyzed for thematic content.

Main Results:

• Understanding of state viability laws varied among OBGYNs.
• Many generalist OBGYNs equated viability with 24 weeks, often due to institutional policies.
• Physicians' approaches to peri-viable care included fetus-centered, institution-centered, and rarely person-centered frameworks.

Conclusions:

• Many OBGYNs are unaware of specific state abortion legislation.
• Institutional policies often dictate peri-viable care, sometimes more conservatively than state law.
• Differing interpretations of fetal viability create inequitable access to abortion care past 24 weeks in California.