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Poster Session 3

(893) Obstetric emergencies, when to provide abortions, and state restrictions: a survey of US emergency physicians

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Rauvynne N. Sangara, MA, MD (she/her/hers)

    MFM Fellow
    Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California
    Los Angeles, CA, United States

    • Coauthor(s)

  • PG

    Priscilla Garza

    University of Southern California
    Los Angeles, California, United States

  • EL

    Emma Lantos, MD

    University of Southern California
    Los Angeles, California, United States

  • ST

    Sophie Terp, MD

    University of Southern California
    Los Angeles, California, United States

  • SA

    Sarah Axeen, PhD

    University of Southern California
    Los Angeles, California, United States

  • BN

    Brian Nguyen, MD, MSc

    Program Director of Complex Family Planning
    University of Southern California
    Los Angeles, California, United States

Objective:

To explore emergency medicine (EM) provider attitudes about obstetric emergencies, the appropriateness of their management via abortion, and the influence of abortion restrictions on clinical decision making.

Study Design:

We distributed an anonymous, cross-sectional, electronic survey to EM providers nationwide using social media platforms and specialty listservs. Using Likert-type scales, the survey listed several obstetric presentations; p</span>articipants then reported (1) which might qualify as obstetric emergencies, (2) the appropriateness of abortion as management for these conditions, (3) the availability of abortion at their site, and (4) their beliefs on obligation to provide abortion if against state law. We examined variations based on the abortion permissiveness or restrictiveness of the participant’s state of practice via bivariate analysis.

Results:

Most respondents (N=203) identified as non-Hispanic white (69%), female (57%), attending physicians (74%), in abortion-permissive states (61%). A majority thought that ruptured ectopic pregnancy (96%), hemorrhage (82%), septic abortion (59%), pulmonary embolism (51%), and hypertensive disease (51%) were obstetric emergencies requiring immediate, life-saving intervention. Abortion was viewed as often/always appropriate for ectopic pregnancy (97%), septic abortion (89%), incomplete abortion (83%), hemorrhage (65%), hypertensive disease (52%), pregnancy loss (50%), infection (45%), preterm premature rupture of membranes (38%), and pulmonary embolism (11%). Many (21%) believed legal restrictions would prevent EM providers from considering abortion for obstetric emergencies; 9% reported that abortion restrictions personally affected their clinical decision-making. Most (84%) agreed that EM clinicians must provide and/or facilitate abortion for obstetric emergencies, even if prohibited by state law. Responses did not vary by abortion permissive versus restrictive states (p=0.48).

Conclusion:

EM providers consider many diagnoses to be obstetric emergencies with abortion being an appropriate treatment in many cases, even if prohibited by state law.