A MARTÍNEZ, HOST:
Abortion restrictions take a toll on women who can't access the procedure or who find themselves in life-threatening situations. A new study in the Journal of the American Medical Association underscores another impact on obstetricians working in states where abortion is now mostly illegal. Here's Katia Riddle.
KATIA RIDDLE, BYLINE: Epidemiologist Erika Sabbath has spent her career talking to doctors about what stresses them out, specifically guilt or sadness when they can't provide the kind of care to their patients they know is possible. Sabbath is one of the lead researchers on this study. They interviewed over 50 obstetricians in states with restrictions.
ERIKA SABBATH: I mean, I think that a lot of people feel like they have a target on their back.
RIDDLE: Sabbath says many obstetricians she talked to were scared to speak publicly. In some states, doctors can face years in jail for violating or just misinterpreting abortion law.
SABBATH: And so what we offered was a way for people to be able to share those really painful and profound experiences under the kind of cloak of anonymity.
RIDDLE: She recounts a story she heard from a doctor. A patient was in critical condition. To save this patient's life, the doctor needed permission from the hospital's lawyers to perform an abortion.
SABBATH: But the legal team was not available 24/7.
RIDDLE: The patient started to hemorrhage. The doctor still didn't have permission to perform the abortion.
SABBATH: And she said, I didn't yet have legal coverage for that, but there's only so many times you can transfuse someone and they're begging for their life before you say this is unconscionable.
RIDDLE: Doctor Kavita Arora is an obstetrician in North Carolina who also worked on the study. She can speak firsthand to moral distress. The abortion ban there is 12 weeks. It's not as strict as some, but still, working there, she feels the law's impact constantly.
KAVITA ARORA: It's still really hard to have to sit there with a patient and cry with them and say, I know you have two kids at home and this is not a desired pregnancy, but unfortunately there is nothing I can do in this state.
RIDDLE: In many states, the law says abortions can be performed only when the mother's life is at risk. That is not always an easy call.
ARORA: There's always this question of how sick do you need to be before we are able to offer you all of the options that, clinically, we should be able to offer you?
RIDDLE: That's why she wanted to study this topic.
ARORA: This is not one or two OB-GYNs here and there.
RIDDLE: She says the majority of OB-GYNs they interviewed reported feeling fear.
ARORA: They're feeling burnt out, or they're feeling consequences to their clinical practice.
RIDDLE: But at least one doctor says consequences may be exactly what's needed. Howard Herrell is an obstetrician in the rural Appalachia Highlands of Tennessee, a state with criminal penalties for violating abortion law.
HOWARD HERRELL: I do think that eventually someone may be arrested for this.
RIDDLE: Herrell is sympathetic to the doctors who fear running afoul of these laws, but he thinks the only way around obstetricians' collective fear may be through it.
HERRELL: We may actually need cases to percolate through the legal system to deal with the impact of this law and to get voters' attention about how unfair it is.
RIDDLE: Obstetricians, he says, can support each other through these kinds of high-profile cases.
HERRELL: I think it's not a question of worrying about being arrested or not worrying about being arrested.
RIDDLE: It's a question, says Dr. Howard Herrell, of when is the right time for a little civil disobedience?
For NPR News, I'm Katia Riddle.
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