Obstetrics and Gynecology Residents' Perspectives on Obtaining Out-of-state Abortion Skills Training Post-Dobbs: A Qualitative Study

Abstract

PURPOSE: Despite the direct impact of obstetrics and gynecology (OB/GYN) residency training on patient care, little research has examined how the Dobbs decision affects residents in abortion-restricting states who must travel out of state for abortion training. This study qualitatively explores the perceptions of OB/GYN residents living in abortion-restricting states and the impacts of obtaining out-of-state abortion skills training (OSAST) post-Dobbs. METHODS: Data are from a sample comprising 19 OB/GYN residents living in states that banned abortion or set 6-week gestational limits. Residents had either completed (n = 7), planned to complete (n = 11), or were unsure about completing (n = 1) OSAST. Participants completed semistructured interviews, and grounded theory analysis identified themes relating to their lived experiences with and impacts of OSAST. RESULTS: Seven key themes were identified in the data: financial challenges, personal life disruptions, emotional safety, administrative and legal obstacles, training adequacy concerns, future employment plans, and ethical and professional decision-making. Participants described substantial financial, logistical, social, and emotional challenges in obtaining abortion training. Limited access to abortion training impacted residents' perceived clinical competence and confidence in their ability to provide abortion care in the future. CONCLUSION: OB/GYN residents' worries about their clinical competence given training constraints raise concerns about the ability of the future OB/GYN workforce to provide high-quality abortion care, particularly for patients already facing critical health disparities. The challenges they described suggest that residents seeking OSAST could benefit from additional support to streamline administrative processes and ease the process of temporary relocation.