POSITIONALITY AND PRIVILEGE POST-DOBBS: A QUALITATIVE ANALYSIS OF OB-GYN GRADUATES’ DECISION-MAKING

Abstract

Objectives

We aimed to understand the impact of the Dobbs v Jackson Women’s Health Organization decision on recent obstetrician gynecologist (Ob-Gyn) graduates with an emphasis on career decisions.

Methods

We performed 30 semi-structured interviews of residents who graduated from residencies with Ryan Abortion training Programs in July 2023. Interviewees were invited from a list of those who had previously completed a national survey. Interview questions addressed the professional and personal impact of the Dobbs decision as well as its impact on decision-making for fellowship ranking or attending positions. We analyzed interview transcripts using the Template Analysis Method.

Results

Our template analysis resulted in the overarching theme of positionality and privilege. Participants experienced abortion restrictions distinctly in relation to opposing positionalities: being physically located in restrictive vs non-restrictive states, being an abortion vs non-abortion provider, being a healthcare provider vs a patient, and identifying as female vs male. Those of less impacted positionalities commonly cited feeling “privileged,” “fortunate,” or “lucky” when describing the lack of impact of Dobbs on their lives, both personally and professionally. When asked what they desire from lawmakers, the theme of positionality and privilege persisted. Respondents want lawmakers to check their privilege and empathize with the patients who seek abortion care by shadowing clinicians in the office or listening to their stories.

Conclusions

Recently graduated Ob-Gyns are navigating through different decision-making realities post-Dobbs. Sharing the experiences of these opposing positionalities can be used to inform shared action and advocacy nationally in abortion care.