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.
Obstet Gynecol. 2022 Aug 1;140(2):253-261. doi: 10.1097/AOG.0000000000004870. Epub 2022 May 30.
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.
分析妇产科医生（ob-gyns）在俄亥俄州堕胎限制法规对其医疗实践的影响方面的经验和看法。
在 2019 年至 2020 年期间，我们对至少在 2010 年至 2020 年期间在俄亥俄州行医 6 个月以上的妇产科医生（n=35）进行了定性访谈和焦点小组讨论。讨论内容被记录、转录、编码，并使用 ATLAS.ti 软件进行主题分析。
参与者认为俄亥俄州的堕胎法规通过三种方式影响他们的实践：堕胎法规将堕胎和提供堕胎的医生与其他医疗实践和医生区分开来；许多机构对堕胎法规的解释破坏了医生的专业知识和专业自主权；堕胎法规、机构解释、医生的恐惧以及他们认为无法行使临床判断的能力，这些因素共同限制了堕胎的可及性，并增加了患者生命和健康的风险。这些综合因素使参与者感到苦恼，因为他们无法以合乎道德和富有同情心的方式行医。
俄亥俄州的堕胎法规限制了妇产科医生提供全面生殖健康护理的能力，给这些医生带来了伦理困境，因为他们试图照顾自己的患者。随着俄亥俄州堕胎法的数量和限制的增加，它们进一步破坏了妇产科的伦理实践准则。然而，医疗机构在确定俄亥俄州堕胎服务的提供方面发挥着关键作用；通过对法律的解释，机构可以表明支持或进一步限制妇产科医生行使临床判断并为患者提供道德、富有同情心的护理的能力。俄亥俄州的堕胎法规、机构解释和医生实践与专业临床实践和伦理准则保持一致，仍有大量工作要做。
