Journal Article: Supporting Clinical Best Practices after Dobbs

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Journal Article: Supporting Clinical Best Practices after Dobbs

ReproHH Staff

An infographic featuring a quote from the New England Journal of Medicine article, "Supporting Clinical Best Practices after Dobbs"

In a recent New England Journal of Medicine article, legal and clinical experts examine a troubling reality emerging across the U.S.: in the years since Dobbs v. Jackson Women’s Health Organization, some of the greatest harms to pregnant patients are occurring not outside the healthcare system, but within it.

The article, Supporting Clinical Best Practices after Dobbs, authored by Michelle Oberman, J.D., M.P.H., Lisa Soleymani Lehmann, M.D., Ph.D., and Yvonne Lindgren, J.D., J.S.D., describes how state abortion bans have disrupted long-standing standards of care. Clinicians are often forced to navigate vague, untested laws while trying to make urgent medical decisions. The result, the authors argue, is a “yellow-light” moment in medicine — cases where the right clinical path is unclear not because of medical uncertainty, but because of legal fear.

We are honored to have the Reproductive Health Hotline (ReproHH) named in this review as one of the primary resources for clinicians seeking information on clinical best practices and the standard of care. 

Below is an excerpt from the article: 

Laws that criminalize or otherwise prohibit the provision of abortion — what we refer to here broadly as “bans” — have placed a traffic light in the path of clinical best practices. Under contemporary bans, there are some clear red lights — one cannot perform an “elective” abortion — and some clear green lights, such as terminating a molar pregnancy. But much of the care provided before Dobbs now seems legally risky, and clinicians have responded to the ambiguity as drivers do when approaching a yellow light: some drive through, even as the light turns red; others stop abruptly, fearing the light will turn red before they can pass.

Abortion bans disrupt the medical standard of care, complicating treatment decisions for pregnant patients. Doctors need meaningful legal, clinical, and ethical guidance to navigate yellowlight cases. But such guidance has not been forthcoming. Meanwhile, in the absence of prosecutions or medical malpractice litigation, the threat of criminal liability is degrading the quality of care for pregnant patients in ban states and precipitating a crisis of professional ethics. To prevent the risky retreat from clinical best practices, there is an urgent need to clarify what those practices entail.
Supporting Clinical Best Practices after Dobbs
The New England Journal of Medicine

 Read the full NEJM article: https://www.nejm.org/doi/full/10.1056/NEJMms2510113

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