State abortion laws and moral distress in a national sample of obstetrician-gynecologists

About the Study: To what extent do obstetrician-gynecologists (OB-GYNs) experience clinical constraints associated with their state’s abortion laws, and are those constraints associated with moral distress? In a cross-sectional study surveying 864 OB-GYNs, those in abortion-restrictive states endorsed higher levels of 3 specific clinical constraints (counseling, care provision, and care for patients with potentially life-threatening pregnancy complications) compared with OB-GYNs in protective states. Greater levels of each clinical constraint were associated with higher moral distress scores in restrictive and protective states. These findings suggest that OB-GYN moral distress, associated with inability to provide certain forms of care to pregnant patients, transcends abortion policy context; institution-level policies and practices to support OB-GYNs are indicated nationally, not only in states with the most restrictive abortion laws.

Corresponding Author: Erika L. Sabbath, ScD, Boston College School of Social Work, 140 Commonwealth Ave, Chestnut Hill, MA 02467 (erika.sabbath@bc.edu).

10.1001/jamanetworkopen.2026.26232

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