OB-GYN job satisfaction in a changing landscape of legal restrictions on their practice

OBJECTIVES: This study aimed to investigate the experiences of obstetrician-gynecologists (OB-GYNs) in U.S. states with restrictive and non-restrictive abortion laws to understand their perspectives on the changing political landscape and how these changes affect job satisfaction in the post-Dobbs era. STUDY DESIGN: We conducted semi-structured interviews with 24 OB-GYNs from states with restrictive and non-restrictive abortion laws from April-December 2024. Fourteen OB-GYNs practiced in restrictive states; nine practiced in non-restrictive states; and one practiced in both. Interviews lasted 25 min on average and were audio-recorded via Zoom. We transcribed and de-identified recordings and used Nvivo v. 14 for inductive thematic analysis. RESULTS: OB-GYNs from restrictive and non-restrictive states described the impact of abortion laws on their practice. Restrictive-state OB-GYNs described their inability to offer the full scope of care, fulfill patient expectations, and how circumstances in which they were hindered from following evidence-based care guidelines could lead to unsafe clinical situations. Across states, OB-GYNs conveyed frustration towards the impact of politics on reproductive health, fear of legal repercussions, and anxiety towards future restrictions. Political tensions amplified burnout for some. OB-GYNs felt that reproductive healthcare is underappreciated and underfunded. CONCLUSIONS: Consistently feeling limited in their ability to provide optimal care creates emotional burdens among OB-GYNs in restrictive states. Fear of legal fallout heightens risk for unsafe clinical scenarios in all states and could be addressed through institutional support and legal clarifications. OB-GYNs' growing perception that reproductive healthcare is underappreciated suggests broader dissatisfaction that requires action to ensure a sustainable workforce. IMPLICATIONS: OB-GYNs experience challenges fulfilling patient needs and managing changing reproductive health policies. They also experience dissatisfaction with the politicization of reproductive healthcare. Developing spaces for peer support and advocating for legal clarifications could facilitate better clinical decision-making and quality of care.