OBGYN resident experiences in an abortion-ban state post-Dobbs.

Abstract

Objective: To explore the impact of the June 24, 2022 anti-abortion legislation (Dobbs) on trainees, we examined the experiences of OBGYN residents within a single program in a state with a complete abortion ban with rare exceptions.

Study design: We conducted semi-structured interviews with OBGYN residents at an institution in an abortion ban state. Domains of inquiry included: residency selection process, experiences with/attitudes toward abortion training, perspectives on legislation and advocacy, and career plans. We conducted thematic analysis of transcribed interviews, which were coded by two independent coders using Dedoose.

Results: We enrolled 19 participants from May-December 2023, representing trainees from all years who entered the program between 2018-2023. We identified four main themes: 1) Abortion restrictions increased residents' moral distress and frustration due to strain on the patient-physician relationship, increased barriers to care, and decreased quality of care; 2) Residents receiving abortion training post-Dobbs reported concerns about clinical competence due to decreased volume at their institution and away rotation. 3) Residents considered availability of abortion training in residency program choice more highly after the Dobbs decision. 4) Practicing in an abortion-restricted state reinforces residents' desires to receive abortion training and informs where they choose to practice after graduation.

Conclusions: In a residency program where post-Dobbs legislation resulted in one of the most restrictive abortion bans, OBGYN residents reported an impact on their well-being amid increasing patient care challenges, concerns of competence due to limited abortion training, and a desire for future abortion provision.

Implications: This study highlights the significant impact of the Dobbs decision on OBGYN trainees in abortion-restricted states. By revealing how these restrictions affect residents' training, well-being, and career choices, our findings underscore the urgent need for adaptive strategies to ensure comprehensive abortion education in a rapidly evolving legal landscape.