Maternal fetal medicine practice under abortion bans
Awarded 2023
High-risk pregnancy care, post-Dobbs
Lori Freedman, PhD
University of California, San Francisco

We propose a qualitative study, based upon in-depth interviews with maternal-fetal-medicine physicians (MFMs) in three restrictive policy contexts, to understand the impact of state and institutional abortion bans on MFM practices for previable pregnancy complications and how might these deviate from their professional standards of care. Specifically, we ask how MFMs interpret EMTALA in practice, if or how they employ workarounds long used to preserve patient safety under institutional abortion bans in Catholic facilities, how chilling effects on legal care manifest, how clinicians adjust their referring behaviors, and how they calculate personal and professional risk for themselves and their patients? MFMs will be recruited from 1) ban-locked states with significant geographic barriers to referral, 2) Indiana which has had a uniquely drawn-out period of legal uncertainty, and 3) from Catholic hospitals affiliated with the University of California. The three environments are chosen to compare and contrast the impacts of the various restrictive policies on best MFM practices. The team is well-balanced in terms of expertise and positionality; The PI, Lori Freedman, is a senior scholar, a sociologist, and a bioethicist. Maryani Palupy Rasidjan is a post-doctoral scholar at ANSIRH and a medical anthropologist with over a decade of ethnographic field research experience and expertise in critical race studies and Black Feminist Health Science Studies. Indiana consultant Kathryn LaRoche from Purdue University and clinician consultant Daniel Grossman, director of the ANSIRH program at UCSF, together lend additional geographical and medical expertise.