"I Went Into This Field to Empower Other People, and I Feel Like I Failed": Residents Experience Moral Distress Post- Dobbs

J Grad Med Educ. 2024 Jun;16(3):271-279. doi: 10.4300/JGME-D-23-00582.1. Epub 2024 Jun 13.

Abstract

Background The 2022 Supreme Court ruling in Dobbs v Jackson Women's Health Organization nullified the constitutional right to abortion, which led to effective bans in at least 14 US states and placed obstetrics and gynecology (OB/GYN) residents in dilemmas where they may have to withhold care, potentially causing moral distress-a health care workforce phenomenon less understood among resident physicians. Objective To identify and explore moral distress experienced by OB/GYN residents due to care restrictions post-Dobbs. Methods In 2023, we invited OB/GYN residents, identified by their program directors, training in states with restricted abortion access, to participate in one-on-one, semi-structured interviews via Zoom about their experiences caring for patients post-Dobbs. We used thematic analysis to analyze interview data. Results Twenty-one residents described their experiences of moral distress due to restrictions. We report on 3 themes in their accounts related to moral distress (and 4 subthemes): (1) challenges to their physician identity (inability to do the job, internalized distress, and reconsidering career choices); (2) participating in care that exacerbates inequities (and erodes patient trust); and (3) determination to advocate for and provide abortion care in the future. Conclusions OB/GYN residents grappled with moral distress and identified challenges from abortion restrictions.

MeSH terms

  • Abortion, Induced / ethics
  • Abortion, Induced / psychology
  • Abortion, Legal / ethics
  • Abortion, Legal / psychology
  • Adult
  • Female
  • Gynecology* / education
  • Humans
  • Internship and Residency*
  • Interviews as Topic
  • Male
  • Morals
  • Obstetrics* / education
  • Physicians / psychology
  • Pregnancy
  • Psychological Distress
  • United States