Family Planning for Patients With Inflammatory Bowel Disease in the Post-Dobbs Era.

Federal protections for abortion care in the United States ended in June 2022. For people with inflammatory bowel disease (IBD) who are capable of pregnancy, the implications of an unwanted or mistimed conception, particularly in the setting of active disease flares or teratogenic treatment, are precarious and geographically variable. Prioritizing evidence-based and person-centered counseling for preconception health and contraceptive care needs is important during health care visits and not limited to reproductive health providers. Development of multidisciplinary clinics or complex contraception clinics in high-volume IBD centers can support time-sensitive counseling and services for patients. This article reviews reproductive considerations for people with IBD, particularly in the setting of legislative restrictions in the post-Dobbs landscape.

The US Supreme Court Dobbs decision's impact on the future plans of 2023 residency graduates at the University of Utah.

OBJECTIVES: This study aimed to understand how the Dobbs decision impacted graduating resident physicians in Utah and to understand residents' perspectives on abortion access. STUDY DESIGN: We invited all 2023 graduating residents at the University of Utah, from all specialties, to participate in this survey. We analyzed univariate relationships between respondent demographics and change of career plans post-Dobbs. We also performed a thematic analysis of free text responses. RESULTS: We received responses from 85 residents (55% of all graduating residents from the University of Utah) representing 19 specialties. Six (7%) residents changed their practice location due to the Dobbs decision. Most residents supported and wanted to advocate for legal abortion. In a thematic analysis, many graduating residents do not want to live in an abortion-restrictive state. CONCLUSIONS: The Dobbs decision impacts physicians across all specialties, not just obstetrician/gynecologists. IMPLICATIONS: Future research into the impact of the Dobbs decision should include physicians of all specialties.

Effects of the Dobbs v Jackson Women's Health Organization Decision on Obstetrics and Gynecology Graduating Residents' Practice Plans.

OBJECTIVE: To explore the association of the Dobbs v Jackson Women's Health Organization ( Dobbs ) decision on future practice locations of graduating obstetrics and gynecology residents. METHODS: This is a mixed-methods survey study of obstetrics and gynecology residents graduating from sites with Ryan Program abortion training programs (109 sites) between March 8, 2023, and April 25, 2023. We conducted both univariate and multivariable logistic regression analyses to identify factors that were associated with post- Dobbs change in career plans, particularly location. We also performed a thematic analysis using responses to the survey's optional, open-ended prompt, "Please describe how the Dobbs v Jackson Women's Health Organization decision impacted your professional plans." RESULTS: Of an estimated 724 residents graduating from residencies with Ryan Program abortion training programs, 349 participated in the survey (48.2% response rate); 17.6% of residents indicated that the Dobbs decision changed the location of intended future practice or fellowship plans. Residents who before the Dobbs decision intended to practice in abortion-restrictive states were eight times more likely to change their practice plans than those who planned to practice in protected states before the Dobbs decision (odds ratio 8.52, 95% CI 3.81-21.0). In a thematic analysis of open-ended responses, 90 residents wrote responses related to "not living in a state with abortion restrictions." Of residents pursuing fellowship, 36 indicated that they did not rank or ranked lower programs in restrictive states. CONCLUSION: These findings demonstrate reduced desire of residents in obstetrics and gynecology to practice or pursue fellowship in restrictive states after residency. This reduction in obstetrics and gynecology workforce could significantly exacerbate maternity care deserts.