Impact of Dobbs on Evaluation and Treatment of Ectopic Pregnancy: National Survey of Emergency Physicians.

Introduction: Inconsistent and ever-changing state abortion laws across the United States raise the possibility of deviation from established standards of emergency care. Yet the experiences of emergency physicians in this era have not been captured. We sought to examine the experiences of US emergency physicians in the management of presumed ectopic pregnancy since the Dobbs Supreme Court ruling and passage of new abortion restrictions affecting clinical decision-making around pregnancy termination.

Methods: This was a cross-sectional survey of US emergency physicians administered online between April 1-15, 2024. The survey was completed by 150 board-certified US emergency physicians-50 physicians each from states categorized as abortion restrictive, semi-restrictive, or permissive-who were queried about any reported delays in or adaptations to the assessment and/or management of patients with known or suspected ectopic pregnancy.

Results: We found that 24% of physicians in restrictive or semi-restrictive states reported delays in the management of patients with suspected or confirmed ectopic pregnancy, and 54% of physicians reported adaptations to care of these patients including repeat testing and arranging alternative care in cases where they might previously have delivered definitive care in the emergency department.

Conclusion: In a post-Dobbs practice environment, emergency physicians across the United States, practicing in states with various abortion restrictions, reported delays and adaptations of care for patients with presumed or suspected ectopic pregnancy including deviations from standard of care in emergency medicine.