OBJECTIVE: 

To analyze obstetrician–gynecologists' (ob-gyns’) experiences with, and perspectives on, how Ohio's abortion-restrictive regulatory landscape affects their health care practices.

METHODS: 

Between 2019 and 2020, we conducted qualitative interviews and focus groups with ob-gyns (N=35) who had practiced in Ohio for at least 6 months between 2010 and 2020. Discussions were recorded, transcribed, coded, and analyzed thematically using ATLAS.ti software.

RESULTS: 

Participants perceived Ohio abortion regulations affecting their practice in three key ways: abortion regulations framed abortion and physicians who provide abortion as separate and distinct from other medical practices and physicians; many institutional interpretations of abortion regulations undermined physician expertise and professional autonomy; and the constellation of abortion regulations, institutional interpretations, physicians' trepidation, and their perceived inability to exercise clinical judgment worked together to limit abortion access and increase risks to patients' lives and health. The combined factors left participants feeling distraught that they were unable to practice medicine in an ethical and compassionate manner.

CONCLUSION: 

Ohio abortion regulations limit ob-gyns' ability to provide comprehensive reproductive health care, creating ethical dilemmas for these physicians as they attempt to care for their patients. As Ohio's abortion laws increase in number and restrictiveness, they further undermine obstetric and gynecologic ethical practice guidelines. However, medical institutions play a key role in determining abortion provision in Ohio; through their interpretation of the law, institutions can demonstrate support or further limit ob-gyns’ ability to exercise clinical judgment and provide ethical, compassionate care to their patients. Considerable work remains to bring Ohio's abortion regulations, institutional interpretations, and physician practices into alignment with professional clinical practice and ethics guidelines.

中文翻译：

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俄亥俄州堕胎条例和妇产科医生的道德困境

客观的： 

分析妇产科医生 (ob-gyns) 的经验和观点，了解俄亥俄州限制堕胎的监管环境如何影响他们的医疗保健实践。

方法： 

在 2019 年至 2020 年期间，我们对 2010 年至 2020 年间在俄亥俄州执业至少 6 个月的妇产科医师（N=35）进行了定性访谈和焦点小组讨论。使用 ATLAS 对讨论进行记录、转录、编码和分析。 ti 软件。

结果： 

参与者认为俄亥俄州的堕胎法规在三个关键方面影响了他们的实践：堕胎法规将堕胎和提供堕胎的医生与其他医疗实践和医生分开并区别开来；许多对堕胎法规的机构解释削弱了医生的专业知识和专业自主权；堕胎法规、机构解释、医生的恐惧以及他们认为无法进行临床判断的一系列因素共同作用，限制了堕胎的可及性，增加了患者生命和健康的风险。综合因素让参与者感到心烦意乱，因为他们无法以合乎道德和富有同情心的方式行医。

结论： 

俄亥俄州的堕胎法规限制了妇产科医生提供全面生殖保健服务的能力，这给这些试图照顾患者的医生带来了道德困境。随着俄亥俄州的堕胎法数量和限制性的增加，它们进一步破坏了妇产科道德实践指南。但是，医疗机构在确定俄亥俄州的堕胎规定方面发挥着关键作用；通过对法律的解释，机构可以证明支持或进一步限制妇产科医生进行临床判断和为患者提供合乎道德的、富有同情心的护理的能力。为了使俄亥俄州的堕胎法规、机构解释和医师实践与专业临床实践和道德准则保持一致，仍有大量工作要做。