Ohio Abortion Regulations and Ethical Dilemmas for Obstetrician-Gynecologists.


Journal

Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101

Informations de publication

Date de publication:
01 08 2022
Historique:
received: 17 12 2021
accepted: 12 05 2022
entrez: 19 7 2022
pubmed: 20 7 2022
medline: 22 7 2022
Statut: ppublish

Résumé

To analyze obstetrician-gynecologists' (ob-gyns') experiences with, and perspectives on, how Ohio's abortion-restrictive regulatory landscape affects their health care practices. Between 2019 and 2020, we conducted qualitative interviews and focus groups with ob-gyns (N=35) who had practiced in Ohio for at least 6 months between 2010 and 2020. Discussions were recorded, transcribed, coded, and analyzed thematically using ATLAS.ti software. Participants perceived Ohio abortion regulations affecting their practice in three key ways: abortion regulations framed abortion and physicians who provide abortion as separate and distinct from other medical practices and physicians; many institutional interpretations of abortion regulations undermined physician expertise and professional autonomy; and the constellation of abortion regulations, institutional interpretations, physicians' trepidation, and their perceived inability to exercise clinical judgment worked together to limit abortion access and increase risks to patients' lives and health. The combined factors left participants feeling distraught that they were unable to practice medicine in an ethical and compassionate manner. Ohio abortion regulations limit ob-gyns' ability to provide comprehensive reproductive health care, creating ethical dilemmas for these physicians as they attempt to care for their patients. As Ohio's abortion laws increase in number and restrictiveness, they further undermine obstetric and gynecologic ethical practice guidelines. However, medical institutions play a key role in determining abortion provision in Ohio; through their interpretation of the law, institutions can demonstrate support or further limit ob-gyns' ability to exercise clinical judgment and provide ethical, compassionate care to their patients. Considerable work remains to bring Ohio's abortion regulations, institutional interpretations, and physician practices into alignment with professional clinical practice and ethics guidelines.

Identifiants

pubmed: 35852276
doi: 10.1097/AOG.0000000000004870
pii: 00006250-202208000-00018
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

253-261

Informations de copyright

Copyright © 2022 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Financial Disclosure Hillary Gyuras disclosed that she received a grant from the AAUW to cover living expenses as a graduate student (2019–2020). She previously worked for Planned Parenthood of Greater Ohio (2013–2018). Danielle Bessett disclosed that money was paid to her institution from the National Science Foundation/American Sociological Association and Society of Family Planning. The other authors did not report any potential conflicts of interest.

Références

Blake VK, McGowan ML. Filling a federal void: promises and perils of state law in addressing women's health disparities. J L Med Ethics 2020;48:485–90. doi: 10.1177/1073110520958873
doi: 10.1177/1073110520958873
Norris A, Chakraborty P, Lang K, Hood R, Hayford S, Keder L, et al. Abortion access in Ohio’s changing legislative context, 2010-2018. Am J Public Health 2020:e1–7. doi: 10.2105/AJPH.2020.305706
doi: 10.2105/AJPH.2020.305706
Catholic Health Association of the United States. Catholic health care serving Ohio. Accessed July 8, 2020. https://www.chausa.org/docs/default-source/advocacy/state-fact-sheets/oh-2021-state-fact-sheet.pdf?sfvrsn=d05e04f2_16
Freedman L. Willing and unable: doctors' constraints in abortion care. Vanderbilt University Press; 2010.
Fuentes L, Lebenkoff S, White K, Gerdts C, Hopkins K, Potter JE, et al. Women's experiences seeking abortion care shortly after the closure of clinics due to a restrictive law in Texas. Contraception 2016;93:292–97. doi: 10.1016/j.contraception.2015.12.017
doi: 10.1016/j.contraception.2015.12.017
Jerman J, Frohwirth LF, Kavanaugh ML, Blades N. Barriers to abortion care and their consequences for patients traveling for services: qualitative findings from two states. Perspect Sex Reprod Health 2017;49:95–102. doi: 10.1363/psrh.12024
doi: 10.1363/psrh.12024
Roberts SCM, Fuentes L, Kriz R, Williams V, Upadhyay UD. Implications for women of Louisiana's law requiring abortion providers to have hospital admitting privileges. Contraception 2015;91:368–72. doi: 10.1016/j.contraception.2015.02.001
doi: 10.1016/j.contraception.2015.02.001
White K, deMartelly V, Grossman D, Turan JM. Experiences accessing abortion care in Alabama among women traveling for services. Women’s Health Issues 2016;26:298–304. doi: 10.1016/j.whi.2016.01.003
doi: 10.1016/j.whi.2016.01.003
Mercier RJ, Buchbinder M, Bryant A, Britton L. The experiences and adaptations of abortion providers practicing under a new TRAP law: a qualitative study. Contraception 2015;91:507–12. doi: 10.1016/j.contraception.2015.03.003
doi: 10.1016/j.contraception.2015.03.003
Heuerman AC, Bessett D, Matheny Antommaria AH, Tolusso LK, Smith N, Norris AH, et al. Experiences of reproductive genetic counselors with abortion regulations in Ohio. J Genet Couns 2021 [Epub ahead of print]. doi: 10.1002/jgc4.1531
doi: 10.1002/jgc4.1531
Corbin J, Strauss A. Grounded theory research: procedures, canons, and evaluative criteria. Qual Sociol 1990;13:3–21. doi: 10.1097/AOG.0000000000004176
doi: 10.1097/AOG.0000000000004176
Increasing access to abortion. ACOG Committee Opinion No. 815. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020;136:e107–15. doi: 10.1097/AOG.0000000000004176
doi: 10.1097/AOG.0000000000004176
Cohen D, Joffe C. Obstacle course. The everyday struggle to get an abortion in America. University of California Press; 2020.
Principles for identifying and assessing conflicts of interest. In: Institute of Medicine (US) Committee on Conflict of Interest in Medical Research, Education, and Practice, Lo B, Field MJ, editors. Conflict of interest in medical research, education, and practice. National Academies Press (US); 2009.Refstyled
Grossman D, Grindlay K, Altshuler A, Schulkin J. Induced abortion provision among a national sample of obstetrician-gynecologists. Obstet Gynecol 2019;133:477–83. doi: 10.1097/AOG.0000000000003110
doi: 10.1097/AOG.0000000000003110
Freedman L, Landy U, Darney P, Steinauer J. Obstacles to the integration of abortion in obstetrics and gynecology practice. Perspect Sex Reprod Health 2010;42:146–51. doi: 10.1363/4214610
doi: 10.1363/4214610
Joffe C. Dispatches from the abortion wars: the costs of fanaticism to doctors, patients, and the rest of us. Beacon Press; 2010.
American College of Obstetrics and Gynecologists. Joint statement on abortion access during the COVID-19 outbreak. Accessed May 26, 2020. https://www.acog.org/news/news-releases/2020/03/joint-statement-on-abortion-access-during-the-covid-19-outbreak
American College of Obstetrics and Gynecologists. ACOG statement on abortion bans. Accessed May 26, 2020. https://www.acog.org/news/news-releases/2019/05/acog-statement-on-abortion-bans
American College of Obstetrics and Gynecologists. Abortion policy. Accessed May 26, 2020. https://www.acog.org/clinical-information/policy-and-position-statements/statements-of-policy/2017/abortion-policy
Informed consent and shared decision making in obstetrics and gynecology. ACOG Committee Opinion No. 819. American College of Obstetricians and Gynecologists. Obstet Gynecol 2021;137;e34–41. doi: 10.1097/AOG.0000000000004247
doi: 10.1097/AOG.0000000000004247
Harris L. Recognizing conscience in abortion provision. N Engl J Med 2012;367:981–3. doi: 10.1056/NEJMp1206253
doi: 10.1056/NEJMp1206253
Ethical decision making in obstetrics and gynecology. ACOG Committee Opinion No. 390. American College of Obstetrics and Gynecology. Obstet Gynecol 2007;110:1479–87. doi: 10.1097/01.AOG.0000291573.09193.36
Harris L, Martin L, Debbink M, Hassinger J. Physicians, abortion provision and the legitimacy paradox. Contraception 2013;87:11–6. doi: 10.1016/j.contraception.2012.08.031
doi: 10.1016/j.contraception.2012.08.031

Auteurs

Meredith P Field (MP)

Division of Social Sciences, Alfred University, Alfred, New York; and the College of Public Health, the Division of Epidemiology, College of Public Health, and the Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, and the Department of Sociology, the Department of Obstetrics and Gynecology, and the Department of Pediatrics, College of Medicine, and the Department of Women's, Gender & Sexuality Studies, College of Arts and Sciences, University of Cincinnati, and the Ethics Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

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