Institutional support for navigating abortion bans in pulmonary and critical care: a multistate qualitative study.

Abstract

Abortion bans enacted by numerous US states between 2022 and 2024 offered little guidance to health care systems on pragmatic implementation. Early studies identified meaningful impacts to obstetric and gynecological patients and clinicians and strategies for institutions to support clinicians in these specialties. There is widespread concern regarding the legal implications of these bans on all specialties, and the impact of institutional responses to abortion bans on clinicians outside of obstetrics and gynecology is unknown. We conducted semi-structured interviews with 29 physicians in pulmonary and/or critical care medicine-another specialty whose patients have acute, life-threatening conditions precipitated or complicated by reduced access to reproductive care-about institutional responses to abortion restrictions. Physicians reported 5 areas in which institutional responses varied: legal interpretation of bans, policy and procedural changes, communication with physicians about changes, public statements about bans, and harm-mitigation strategies. Health care organization responses to abortion bans considered most helpful shared key features, including unambiguous guidance, institutional support for physicians, and demonstrated commitment to patient-first care. Our findings suggest promising potential strategies for health care organizations to minimize impacts of abortion restrictions on clinicians and support them in providing the highest level of patient-centered care possible in the post-Dobbs era.