Case Western Reserve University, Cleveland, OH, USA.
University of Cincinnati, Cincinnati, OH, USA.
J Health Soc Behav. 2023 Dec;64(4):470-485. doi: 10.1177/00221465231172177. Epub 2023 Jun 2.
This study examines an underexplored source of medical uncertainty: the political context of care. Since 2011, Ohio has passed over 16 abortion-restrictive laws. We know little about how this legislation affects reproductive health care outside of abortion clinics. Drawing on focus groups and interviews with genetic counselors and obstetrician-gynecologists, we examine how abortion legislation impacts their work. We find that interpretation and implementation of legislation is not straightforward and varies by institution and region of the state. An ever-changing legislative landscape combined with uneven implementation of restrictions into policy produces uncertainty in reproductive health care. We also found uncertainty about the legal consequences of abortion in restrictive contexts, with obstetrician-gynecologists reporting greater concerns given their proximity to care provision. We argue that uncertainty can result in stricter interpretations of regulations than necessitated by the law, thereby amplifying the impacts of an already restrictive context for abortion care.
医疗保健的政治背景。自 2011 年以来，俄亥俄州已经通过了超过 16 项限制堕胎的法律。我们对于这项立法如何影响堕胎诊所之外的生殖保健知之甚少。我们利用焦点小组和对遗传咨询师以及妇产科医生的访谈，研究了堕胎立法如何影响他们的工作。我们发现，立法的解释和执行并不简单，而且因机构和州的不同而有所不同。不断变化的立法环境以及限制政策在各州的实施不平衡，导致生殖保健存在不确定性。我们还发现，在限制堕胎的环境中，对于堕胎的法律后果存在不确定性，由于妇产科医生更接近提供护理，因此他们的担忧更大。我们认为，不确定性可能导致对法规的解释比法律所要求的更严格，从而放大了已经对堕胎护理具有限制作用的环境的影响。
