US Physicians' Perceived Impacts of Abortion Bans in Pulmonary and Critical Care Medicine.

Abstract

Background: 18 U.S. states implemented abortion bans between 2022-2024. Although emerging evidence shows bans have impacted obstetrics and gynecology, little is known about their impact on other specialties. We hypothesize that pulmonary and critical care medicine may be adversely impacted due to the time-sensitive, high-acuity needs of their patients.

Research question: How have abortion bans impacted pulmonary and critical care medicine clinical practice and/or physicians' wellbeing and careers?

Study design and methods: Between October 2022 and July 2024, we conducted semi-structured interviews via videoconferencing with pulmonary and critical care medicine physicians (N=29) working in 15 US states about the impacts of abortion bans. We used an abductive approach to analyze interview transcripts.

Results: Physicians had a median 7 years in practice and 16 were women. Physicians described varied impacts for patients and physicians, such as repeated experiences of restricted and delayed treatment, physician moral distress, and impacts to training. Institutional guidance for physicians was often experienced as variable and vague. Concerns about disparate impacts across social groups were pervasive. Physicians also described novel forms of harm mitigation and increased political activation resulting from abortion bans' implementation.

Interpretation: Abortion bans are impacting patients and physicians in medical specialties outside of obstetrics and gynecology. Additional research is needed to better understand harm mitigation approaches, which may provide policymakers and health care systems with strategies to minimize patient and workforce harms.