The impact of Dobbs v. Jackson on abortion training in obstetrics and gynecology residency programs: A qualitative study

Abstract

Objectives

The Ryan Program collaborates with obstetrics and gynecology (OBGYN) residency programs in the United States (U.S.) to ensure that abortion and contraception care are incorporated into resident curriculum as required. We sought to understand the impact of the Dobbs v. Jackson decision on OBGYN residency abortion training programs from the perspective of Ryan directors and to understand barriers and facilitators to maintaining abortion training in OBGYN residency programs post-Dobbs.

Study design

We conducted qualitative, semi-structured in-depth interviews with Ryan program directors at U.S. academic medical centers. We coded the data iteratively and analyzed the data thematically.

Results

From January to April 2023, we conducted 24 interviews, representing 21% (n = 23) of eligible U.S. Ryan directors. Participants were evenly distributed across four geographic regions of the U.S.; 50% (n = 12) of participants were from programs in abortion-restrictive settings. Two themes emerged: (1) Ryan directors experienced stressors related to the administration of Ryan programs post-Dobbs, including perceived difficulty satisfying requirements for abortion training in restrictive states, burnout, and increased financial needs to support training partnerships. (2) Directors face challenges in recruitment and clinical care post-Dobbs.

Conclusions

Increased state restrictions on abortion place logistical and financial burdens on OBGYN abortion training programs. Dobbs impacted training experiences across the U.S. and made it more difficult for many OBGYN residencies to provide abortion training.

Implications

The research findings will inform strategies for improving the delivery of abortion education post-Dobbs. We anticipate findings will enhance procedures to establish and maintain partnerships post-Dobbs and identify areas where philanthropy and advocacy can be effectively utilized.