Media promotes questionable study in attempt to vilify pro-life laws

A small study utilizing video interviews with a group of physicians from nine pro-life states (with an average of under eight years practicing medicine among them) claims that laws protecting preborn children from direct and intentional killing are a hindrance to medical care for patients.

Forbes' article on the study mirrors the narrative of multiple pro-abortion articles, claiming that pro-life laws "are forcing doctors across multiple specialties to delay or withhold standard pregnancy care, putting women’s lives at risk due to fear of legal consequence."

Key Takeaways:

• Researchers conducted video interviews with just 40 physicians across nine pro-life states (with an average of less than eight years practicing medicine among them), yet the study is being touted as if it should be interpreted broadly.

• The doctors were self-selected participants in the study, which makes them less likely to be a reliable, varied pool of participants and more likely to hold the strongest opinions.

• Some of the physicians' frustrations centered around feeling as if there were delays in care due to pressure to reach a definitive diagnosis before treating a patient, requiring a woman to have more than one scan or test to determine a condition and course of treatment, and general complaints about having to consult with other doctors or get second opinions out of an alleged fear of prosecution.

The Details:

For the study, researchers conducted "semistructured interviews... via videoconference" in an attempt to show that "abortion bans" are having negative effects on women who aren't seeking elective abortions — and the media has eagerly spread this narrative.

Forbes gushes that the researchers are "affiliated with top hospitals and universities," and points to a biased study about the alleged "economic cost of abortion restrictions," seemingly never looking ahead to the impending economic crisis created by a plummeting birth rate.

The "qualitative study" was published on June 22 by the JAMA Network and was "conducted between May 13, 2024, and May 23, 2025." Researchers interviewed only "40 US physicians practicing in 9 states [Alabama, Idaho, Indiana, Kentucky, Mississippi, Oklahoma, Tennessee, Texas and West Virginia] with total abortion bans." The study notes that "[p]articipants included physicians from emergency medicine, family medicine, and obstetrics and gynecology specialties...." Out of these, 18 were OB/GYNs, eight were in family medicine, and 14 were in emergency medicine. They averaged less than eight years in practice.

The study's introduction in JAMA begins with clear bias, claiming that "Loss of abortion access carries significant risk, as morbidity and mortality of pregnancy and childbirth exceed those of abortion," linking to the single study that actually showed such a result from Drs. Raymond and Grimes in 2014 — with results that have never been replicated.

Buried near the end of the study is a section describing its "limitations" — including significant issues like self-selected participation or purposive sampling, along with the use of snowball sampling, defined as "a non-probability sampling method where existing participants help recruit future participants." The "Limitations" section reads (emphases added):

... As with all qualitative work, the findings rely on subjective participant accounts that may be infused with personal beliefs or recall bias. Participants self-selected into the study [known as purposive sampling]. which may lead to overrepresentation of those with the strongest opinions or particularly challenging experiences. Finally, we did not capture the perspectives of physicians who ultimately left states with abortion bans, whose experiences may differ meaningfully from those who remain.

While a list of the study's largely open-ended interview questions is available, what isn't offered to readers is full documentation of the answers researchers received from participants who volunteered for the study. And yet, the study design used an "interpretivist paradigm," which "focuses on understanding the subjective meanings and experiences of participants." The study noted:

The semistructured interview guide was used to explore clinical decision-making, patient care, counseling practices, and the influences of abortion bans on physicians’ professional responsibilities. Interviews lasted 30 to 45 minutes and were audiorecorded with participants’ consent. Recordings were transcribed verbatim, reviewed for accuracy, and deidentified. Data collection and analysis occurred concurrently and continued until thematic saturation was reached.

The study's data sharing statement reads:

The data generated and analyzed in this study are not publicly available due to the sensitive nature of the topic and the potential risk of participant identification. In the current legal and political context surrounding abortion care, even deidentified qualitative data may pose risks to participant confidentiality and safety; therefore, data will not be shared.

Zoom In:

Despite this statement, the authors included within the study a small chart of partial commentary obtained from participants. Some of the complaints from doctors (in states that treat preborn children as actual human beings) included:

• Feeling pressure to get a "definitive diagnosis" before treating pregnant patients

• Policies that may require a woman to have more than one scan or test to determine proper course of action

• Needing to consult a hospital's legal team/cardiology before completing a C-section

• Confusion about how/whether to treat ectopic pregnancies

• Concern that the pathologist might contradict the doctor's pre-procedure diagnosis

• Concern that not immediately offering an abortion is like "playing God"

• Feeling the need to get a second opinion from radiology regarding a suspected miscarriage

• Inability to let a miscarrying patient diagnose herself with miscarriage

... and more.

Researchers also noted (emphasis added), yet didn't include :

A few EM physicians reported no change in ectopic pregnancy management, often because they routinely consulted OB-GYN physicians. One EM physician expressed that state-level exceptions were sufficient to guide timely care:

The [state] Medical Board released a statement … confirming that procedures to treat [ectopic pregnancy] are not abortions … we could do whatever was medically necessary ... didn’t have to wait until the woman was basically dying to intervene. That’s always been clear to me, but I guess it hasn’t been clear to others.

And perhaps that's really the issue here. Hospitals need to make clear policy based on state law, and inform their physicians of this policy. Most hospitals have had years to make this happen. So why isn't it happening everywhere?

Researchers also noted:

A few OB-GYN physicians reported that they could still offer abortion for previable PPROM at their institutions. However, most physicians stated that PPROM alone was no longer considered sufficiently life-threatening to allow intervention, and termination was allowed only in cases of sepsis, significant bleeding, or fetal demise.

The PPROM Foundation has a detailed list of treatment protocols for the condition, stating in part (emphases added):

There are three treatment options in pregnancies affected by PPROM: elective termination of pregnancy, expedient induction of pregnancy, and Expectant Management. Much depends on the gestational age at rupture and presenting complications (infection, fetal or maternal distress).

Treatment must be individualized, especially with consideration of gestational age at rupture and with an assessment of the predicted maternal, fetal, and neonatal risks for complications.

Traditionally, termination of pregnancy pre-viability was the preferable option because of the presumed risk of maternal sepsis and very poor fetal outcome. In the past two decades, there has been a dramatic improvement in neonatal outcomes after preterm birth because of the use of antenatal corticosteroids...

The patient choosing Expectant Management must monitor symptoms closely for infection, watch for contractions or signs of labor, avoid unnecessary internal exams, attend regular appointments with the maternal-fetal medicine specialist, comply with activity level as directed by the physician, and notify the provider in the event of any changes to condition...

The Bottom Line:

Overall, this study is small, anecdotal, and relies on self-enrolled individuals (with relatively brief careers in medicine) who, therefore, likely have the strongest opinions on the subject. There is no solid data here, and certainly not enough information to be gleaned from an average of just five physicians per surveyed pro-life state.

Ultimately, this qualitative study fails to provide proof of much at all.