Department of Family and Community Medicine, University of Kentucky, Lexington, Kentucky
Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky.
Ann Fam Med. 2024 Nov-Dec;22(6):492-501. doi: 10.1370/afm.3183.
The (Dobbs) Supreme Court decision revoked the constitutional right to abortion. Now, restrictive state abortion laws may contribute to the shortage and strain already felt in primary care practice, especially related to the provision of reproductive health care. The purpose of this study is to evaluate perceived impacts of state abortion legislation on family medicine clinicians' practice and medical education regarding reproductive health care.
Ten questions were added to the 2022 Council of Academic Family Medicine Educational Research Alliance general membership survey to evaluate impact on relevant themes in reproductive health care and training after the Dobbs decision. Responses were categorized by severity of restriction of state abortion policies.
Of 1,196 respondents, 49.7% reported employment in states with very restrictive or restrictive abortion policies. The 991 respondents with clinical responsibilities reported significant ( <.05) changes in their counseling practices, clinical decision making, worry of legal risks, and trust in patients' self-reported reproductive medical history, compared with peers in protective states. Perceived patient trust toward clinicians remained unchanged. Almost one-half of clinical respondents reported an absence of reproductive health care guidance or recommendations. Restrictive abortion policies significantly ( <.05) reduced the desirability and confidence in resident training programs.
Reported changes to clinical activities and training, coming early after the Dobbs decision, affect our current and future workforce and therefore, our patients. Future studies are needed to document continued impact of state restrictions and inform policy to support family medicine clinicians in reproductive health practice and education.
（多布斯）最高法院的裁决推翻了堕胎的宪法权利。现在，限制堕胎的州法律可能会加剧初级保健实践中已经感受到的短缺和压力，特别是在提供生殖保健方面。本研究的目的是评估州堕胎立法对家庭医学临床医生实践和生殖保健医学教育的感知影响。
在 2022 年学术家庭医学教育研究联盟理事会全体成员调查中增加了 10 个问题，以评估多布斯裁决后与生殖保健和培训相关主题的影响。根据州堕胎政策限制的严重程度对回答进行分类。
在 1196 名受访者中，49.7%报告在堕胎政策非常严格或严格的州就业。有临床责任的 991 名受访者报告说，与在保护州的同行相比，他们在咨询实践、临床决策、担心法律风险以及对患者自我报告的生殖医学史的信任方面发生了重大变化（<.05）。患者对临床医生的信任感知没有变化。近一半的临床受访者报告说，缺乏生殖保健指导或建议。限制堕胎政策显著（<.05）降低了对住院医师培训计划的渴望和信心。
在多布斯裁决后不久，报告的临床活动和培训变化影响了我们当前和未来的劳动力，因此也影响了我们的患者。需要进一步研究来记录州限制的持续影响，并为支持家庭医学临床医生在生殖保健实践和教育方面提供政策信息。
