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

July 30, 2026
in Policy
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State abortion laws and moral distress in a national sample of obstetrician-gynecologists

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

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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

To access the embargoed study: Visit our JAMA Network Media Center website at this link

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Editor’s Note: Please see the article for additional information, including full author list, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.



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JAMA Network Open

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  • /Health and medicine/Medical specialties/Obstetrics/Abortion

  • /Social sciences/Political science/Legal system/State law

  • /Social sciences/Philosophy/Ethics/Medical ethics

  • /Social sciences/Sociology/Society/Social values

  • /Social sciences/Psychological science/Clinical psychology/Mental health/Stress management

  • /Applied sciences and engineering/Information science/Data samples/Representative samples

  • /Health and medicine/Medical specialties/Obstetrics

  • /Health and medicine/Medical specialties/Gynecology

  • /Scientific community/Science careers/Scientific workforce/Physician scientists

  • /Health and medicine/Human health/Human biology/Human reproduction/Pregnancy

  • /Health and medicine/Health care

  • /Health and medicine/Health care/Health care delivery

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