By Melinda Young
Seven out of 10 OB/GYNs interviewed by researchers reported symptoms of anxiety and depression, directly related to the impact of the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, according to a new study.1 Twenty percent of participants said they felt hopelessness, helplessness, and disappointment because of legal changes that affected their work.1
“We had one participant who had a very poor outcome and had difficulty sleeping for several weeks, thinking about how they were not able to provide the care their patient needed,” says Erika Sabbath, ScD, an associate professor in the School of Social Work at Boston College in Chestnut Hill, MA. Sabbath also is co-director for the Harvard Center for Work Health and Wellbeing in Boston.
Another OB/GYN reported, “I have a family. I worry [about] a bad legal outcome. I worry [about] losing my license. I worry about losing my livelihood. I worry about my stress and burden being something that I carry at home and affecting my partner. It bleeds into everything.”1
Some participants reported seeking psychotherapy or antidepressant medications to manage their symptoms post-Dobbs.1 They described their emotional pain as a moral injury, grief, and anger at the laws and politicians who enacted the laws: “I never expected to be limited by what I could discuss with patients based on politicians. And I just think it is so arrogant of them to insert themselves into my exam room because of them not really understanding what women go through and the kinds of horrible, terrible things that can happen. It just makes me so angry. No other field goes through this. No other field has criminal charges as a threat [for] taking care of patients.”1
Investigators interviewed 54 OB/GYNs in 13 of the 14 states with near-total abortion bans as of March 2023. Their average age was 42 years, the age range was 33 to 66 years, and 81% self-identified as female.1 Several participants cried during their interviews. One told researchers that the “level of stress and anxiety that we live at, it’s not sustainable, and I don’t think I’m the only one.”1
One question asked participants what kept them up at night. “What we got from that question was many people described how the loss impacted their sleep, and they laid awake thinking about particular cases and how the laws might impact them personally or professionally,” Sabbath says. “Some described physical health impacts and impacts on their ability to take health-enhancing behaviors.”
Some physicians reported exercising less, overeating, and gaining weight. “Most people focused on the mental health effects,” she says. “What we noted across many participants was burnout. They said this was either a problem simmering before Dobbs and the policies exacerbated it, or they got through the pandemic relatively unscathed, but this was the thing that made them burn out.”
A couple of OB/GYNs talked about their concerns about having children. “They talked about potentially wanting to further expand their family and not knowing if it was a safe environment to do so,” Sabbath says. “They talked about the potential health impact on their kids if their kid had an unwanted pregnancy.” About one in 10 OB/GYNs had already left the abortion-ban state, and about 60% were somewhat to seriously considering leaving, she adds.
The cross-sectional study does not have answers about the long-term effect of abortion bans on OB/GYNs. “We don’t know whether there will be habituation and getting used to this environment, so the health effects decrease or whether they will intensify from the cumulative toll of working in this environment,” Sabbath explains. “We have another ongoing study to do interviews with more physicians in 2025, so we’ll have a second snapshot two years later that will let us see what that long-term impact is, and it will be with different people.”
The new study’s timing should include any initial effects from the Trump administration’s changes of abortion rules and access, such as if the administration begins to enforce the Comstock Act, further limiting abortion services nationwide. “The timing happens to be good for addressing that question,” Sabbath says. “It’s a national study and survey with qualitative interviews of OB/GYNs in states across the policy environment in mid-2025.”
Investigators will be witnesses to the impact of new policies on OB/GYNs as the changes occur. If legal abortion access is ended nationwide or curtailed by the banning of abortion medication, researchers will see how OB/GYNs react and how their mental health is affected by the changes. “It’s quite concerning to think about those effects being spread around without the escape hatch of going to a more protective state,” Sabbath says.
For some physicians, continuing to provide healthcare to women despite the abortion landscape is a calling and mission. “We have a lot of physicians who felt very strongly they needed to run into the fire,” she says. “They felt a real obligation to use their skills to help women in environments where there was no one else who could help them.”
The study notes that OB/GYNs’ health could suffer further if the mental health effects, sleep disruption, and deterioration of healthy behaviors led to increased risk of chronic health conditions, such as cardiovascular disease. All of these factors point to abortion bans as being a work-related health hazard for OB/GYNs.1
One participant spoke of a patient who needed a hysterectomy after her IUD failed and she had a life-threatening pregnancy complication. “I … had difficulty sleeping for the next several weeks because I was so upset for her that she had done everything right and when her contraception failed her, we also then failed her, and she had a horrible outcome,” she said.1
Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.
Reference
- Sabbath EL, McKetchnie SM, Arora KS, Buchbinder M. Are state abortion bans an occupational health hazard for obstetrician-gynaecologists? Findings from a multistate qualitative study. Occup Environ Med. 2024;81:493-497.
