Investigating Moral Distress in the Reproductive Healthcare Workforce post Dobbs

Abstract: Humanistic caring requires providers to value and respect every patient. Loss of federal protections for abortion following Dobbs v. Jackson Women’s Health raises concerns about the prospect of heightened moral distress among reproductive healthcare providers, many of whom face new legal and civil penalties for providing what they perceive to be necessary care. This interdisciplinary panel brings together empirical findings from two separate studies examining moral distress among providers following Dobbs. The panel will be introduced and moderated by a nurse bioethicist with expertise in moral distress in healthcare settings. The first panelist, a medical anthropologist, will share results from interviews with 54 obstetrician-gynecologists from 13 states with abortion bans. Participants attributed distress to the cumulative toll of being unable to provide everyday evidence-based healthcare, in addition to the acute burden of more rare and devastating cases. Second, a philosopher will report quantitative findings from a national survey of 310 abortion providers assessing self-reported moral distress levels, comparing responses in restrictive and non-restrictive states. Although a majority (78%) reported experiencing more moral distress since Dobbs, levels were twice as high for providers in “restrictive” compared to “protective” states and higher in “surge” states. Third, an obstetrician-gynecologist in complex family planning will present key themes from a qualitative analysis of 164 responses to an open-ended question on the national survey, including distress caused by loss of professional identity when unable to use specialized training, bearing witness to patients’ and providers’ trauma, and being forced to provide substandard care.