Experiences of Obstetrician–Gynecologists in a Post-Dobbs Wisconsin: Establishing a Critical Evidence Base in an Abortion-Restricted State [ID 1270]

INTRODUCTION: After the Dobbs decision, Wisconsin physicians faced the threat of an 1849 state law widely interpreted to criminalize the provision of abortion except in lifesaving emergencies. We sought to document how the post- Dobbs legal landscape and institutional responses to the 1849 law shaped the ability of obstetrician–gynecologists to provide health care to patients facing pregnancy-related risks and complications. METHODS: Between June 2022 and December 2023, we recruited 21 obstetrician–gynecologists from both rural and urban areas with varying hospital affiliations, scopes of practice, and individual demographics to participate in semistructured, remote interviews. Interviews explored experiences providing pregnancy care under the threat of a statewide abortion ban and in light of preexisting abortion restrictions and institutional policies. Investigators coded and analyzed qualitative data using a combined inductive–deductive approach. RESULTS: Wisconsin obstetrician–gynecologists experienced uncertainty and confusion after Dobbs and dismay over inadequate institutional guidance and support. The threat of criminalization and differing institutional interpretations of the 1849 law jeopardized evidence-based clinical practice, amplified preexisting barriers for pregnant patients, and resulted in inconsistent pregnancy care provision across the state. CONCLUSIONS/IMPLICATIONS: The threat of criminalization in post- Dobbs Wisconsin resulted in precarity for obstetrician–gynecologists and delayed and substandard care for pregnant patients. The absence of clear guidance and support from institutions and health care systems was a particularly harmful but potentially addressable barrier. Physician experiences in post- Dobbs Wisconsin contribute to a critical evidence base on the harms of abortion restrictions and remain relevant to states facing similar bans that criminalize or restrict health care.