“My heart was in my stomach”: Texas-based obstetricians' and gynecologists’ experiences post anti-abortion legislation

The purpose of this study is to investigate the downstream effects of anti-abortion legislation on the practice of obstetrics and gynecology in urban Texas. We conducted semi-structured interviews until saturation with eleven obstetricians/gynecologists (OBGYNs) to explore the effects of Texas’s abortion laws. Analysis consisted of inductive and deductive approaches. We identified three main themes regarding the downstream effects of Texas abortion laws: the conflicting role of colleagues as a support system and a source of frustration and distrust for OBGYNs, the lowered standard of care for those with a desired pregnancy, and concerns that anti-abortion legislation will decrease the quality and quantity of OBGYNs in Texas. Interwoven across these themes is a sense of medical confusion and burnout caused by the vaguely worded statutes. Abortion laws affect providers and patients far beyond the accessibility and availability of elective abortion. Texas anti-abortion legislation is vaguely written, resulting in institutional confusion and delays, provider burnout, and compromised care for women experiencing pregnancy, including pregnancy loss or other complications. This is at least partially due to disagreement and distrust between colleagues, particularly in regard to care provided in situations where the law is unclear. Finally, participants fear that anti-abortion laws will negatively affect the training and availability of OBGYNs statewide, threatening future reproductive care and rights. We interviewed 11 Texas obstetrician/ gynecologists (OBGYNs) to explore how anti-abortion laws affect their medical practice and overall wellbeing. Participants described three main issues: Overall, anti-abortion laws create confusion, delays, and stress for medical providers, which might cause burnout. Texas’s anti-abortion laws create an environment of medical uncertainty, professional strain, and worse patient care. They restrict abortion and hurt the practice of obstetrics and gynecology more broadly, with possible long-term effects for both providers and patients in the state. Based on this paper, we suggest that healthcare organizations and medical training programs provide better support for OBGYNs to navigate the legal and medical landscape in Texas and other states with anti-abortion legislation.