Dobbs Worsened Pregnancy-Related Mortality, OBGYNs Say

Most obstetricians-gynecologists in the United States say that the Supreme Court's Dobbs decision has worsened their ability to manage pregnancy-related emergencies, a survey reveals.

Since the U.S. Supreme Court made a ruling in Dobbs v. Jackson Women's Health Organization case last June that stripped the constitutional right to abortion, 14 states have banned or severely limited access to abortion.

The Kaiser Family Foundation, a non-profit organization focusing on health policy, surveyed 569 office-based OBGYNs practicing in the U.S. who spend at least 60% of their working hours in direct patient care and provide sexual and reproductive health care to at least 10% of patients.

In the states where abortion is banned, 40% of office-based OBGYNs report they have personally felt constraints on their ability to provide care for miscarriages and other pregnancy-related medical emergencies since the Dobbs decision. This is the case for 20% of OBGYNs nationally.

Most OBGYNs (68%) say their ability to manage pregnancy-related emergencies has worsened since the ruling decision. Six in ten (64%) believe that the decision has worsened pregnancy-related mortality, racial and ethnic inequities in maternal health (70%), and the ability to attract new OBGYNs to the field (55%).

Maternal mortality has been on the rise in the U.S.. In 2021, the rate was 32.9 deaths per 100,000 live births, compared to 23.8 deaths in 2020, according to federal data. Research shows that infant mortality rates are higher in states where abortion is more restricted.

Nationally, two-thirds of OBGYNs (68%) say they understand the circumstances under which abortion is legal in the state they practice very well, compared to 45% of OBGYNs in states where abortion is restricted by gestational limits.

Although abortion bans foresee exceptions for "medical emergencies" to protect the life and health of the mother, the lack of clarity on these laws often puts OBGYNs and women experiencing pregnancy complications in a legal gray zone. For some, delays in abortion care result in life-threatening situations.

Nearly six in ten (59%) of OBGYNs practicing in states with gestational limits and 61% of OBGYNs working in states with abortion bans report being very or somewhat concerned about their own legal risk when making decisions about patient care and the necessity of abortion

Over a third of OBGYNs nationally (36%) say their ability to practice within the standard of care has become worse. The share in states where abortion is banned rises to 55%.

Since the Dobbs decision, half of the OBGYNs practicing in states where abortion is banned say they have had patients in their practice who were unable to obtain the abortion they sought. This is the case for one in four (24%) office-based OBGYNs nationally.

At least 66 abortion clinics across 15 states have closed in the wake of the Dobbs ruling. Another 30 former abortion clinics have remained open in states that enacted bans and now offer services such as pregnancy confirmation and dating, referrals, and follow-up care.