How U.S. healthcare institutions’ actions, or inactions, shaped physician experiences after Dobbs: A qualitative study

To document how Wisconsin healthcare institutions’ (in)action under a near-total abortion ban post- Dobbs influenced physician experience and patient care. We recruited 21 obstetrician-gynecologists from academic, community, and religiously affiliated healthcare systems across Wisconsin, a midwestern U.S. state, between June 2022 and December 2023 to participate in 45–60-minute semi-structured Zoom interviews about the impact of Dobbs on Wisconsin reproductive healthcare delivery. We analyzed transcripts using an inductive-deductive approach and employed a framework method to identify key themes. After Dobbs , participants reported that most healthcare institutions abdicated responsibility, leaving providers to navigate legal uncertainties and create clinical workflows to ensure safe patient care. Tepid or absent institutional responses were widely perceived as exacerbating clinician distress and mistrust in healthcare systems. These findings provide firsthand evidence that healthcare institutions are not passive conduits of state law, but active agents whose decisions shape how reproductive healthcare is delivered, or denied, in a post- Dobbs landscape. Institutional inaction, inconsistent guidance, and failure to support physicians have added another layer of harm to an already strained reproductive healthcare system.