The Effect of Dobbs on Management of Early Pregnancy Problems Among Wisconsin Obstetrician–Gynecologists: A Scenario-Based Pilot Survey Study [ID 1176]

INTRODUCTION: The Dobbs decision put into effect a near-total abortion ban in Wisconsin. We aim to determine how Wisconsin obstetrician–gynecologists have changed management of problems in early pregnancy after Dobbs . METHODS: We conducted a Qualtrics survey between September 2023 and January 2024 using a convenience sample of Wisconsin obstetrician–gynecologists who manage pregnancies of unknown location (PULs). The survey presented hypothetical but common clinical scenarios involving problems in early pregnancy, presented different management options, and asked whether participants would have selected a different management option prior to Dobbs . We report descriptive statistics and used Fisher’s exact test for the association between groups. RESULTS: Our final analytic sample was N=38. The majority of participants were White (87%), female (79%), and did not identify as an abortion provider prior to Dobbs (58%). Nearly half (47%) reported changing their management of PUL after Dobbs . Regarding hypothetical management of an undesired PUL with abnormally rising β-hCG, 47% recommended additional testing rather than immediate intervention, 72% of whom reported they would have offered a different recommendation prior to Dobbs . Regarding hypothetical management of a patient requesting intervention for likely early pregnancy loss and vaginal bleeding, 86% declined offering immediate intervention, 63% of whom said they would have offered a different recommendation prior to Dobbs . CONCLUSIONS/IMPLICATIONS: Wisconsin obstetrician–gynecologists appear to more conservatively manage early pregnancy problems after Dobbs . These pilot study findings contribute to an evidence base illustrating how abortion bans lead to changes in clinical management of complications in early pregnancy.