"I Feel Like there's a Politician in the Room": Provider Perceptions of the Impacts of State Abortion Bans on Physician-Patient Relationships.

Abstract

State-level abortion bans enacted after Dobbs v. Jackson may have a deleterious impact on the health of women and may increase maternal morbidity and mortality. In obstetrics-gynecology, strong patient-physician relationships, which are built via patient-centered care strategies, are associated with better pregnancy-related outcomes. Abortion bans may limit physicians' ability to utilize these strategies by restricting care that can legally be provided. Further, all members of the care team, including social workers, may face legal and professional consequences for engaging in options counseling, altering how providers engage with patients. This study assessed OB-GYNs' perceptions of how patient relationships have been impacted by Dobbs, using semi-structured interviews with 54 OB-GYNs from 13 US abortion-restrictive states. Four themes emerged: mistrust and fear of legal consequences; governmental intrusion into the patient-physician relationship; patients assigning blame; and strategies for strengthening relationships post-Dobbs. These findings indicate that abortion bans may have a substantial impact on patient-physician relationships. Knowledge of this dynamic provides context for social workers related to identifying gaps in patients' education about care options and intervention targets.