This qualitative study examined how state-level total abortion bans are associated with abortion-adjacent clinical care — including management of early pregnancy loss (EPL), ectopic pregnancy, molar pregnancy, preterm prelabor rupture of membranes (PPROM), and maternal comorbidities — among 40 physicians across emergency medicine, family medicine, and OB-GYN practicing in 9 ban states (interviews conducted May 2024–May 2025).
Six major themes emerged: (1) delays in care and deviations from standard practice across multiple pregnancy complications; (2) physician ambiguity and fear; (3) loss of patient autonomy and shared decision-making; (4) erosion of patient-physician trust; (5) physicians forced into new gatekeeping roles; and (6) increased health system burdens. Physicians described needing extra confirmatory testing and institutional approval even for emergent, life-saving interventions.
Small purposive/snowball sample (n=40) from 9 states limits generalizability; self-selection bias likely over-represents physicians with concerns about bans; qualitative design captures perceptions rather than objective clinical outcomes.
Clinicians in abortion-ban states should be aware that legal restrictions are delaying care well beyond elective abortion — including for ectopic pregnancy, PPROM, and EPL — and that patients may face gatekeeping barriers even in emergencies. Advocacy for clear institutional guidance and legal protections for physicians may help reduce treatment delays.
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