Abstract Rationale Since 2022, many states have enacted abortion prohibitions with severe penalties for physicians who violate these laws. Pulmonary and critical care medicine (PCCM) physicians treat critically ill patients who are pregnant and/or patients with pregnancy-sensitive conditions (e.g., pulmonary hypertension) in the intensive care unit and pulmonary clinic. Little is known about the broader perceived institutional impacts of abortion restrictions within PCCM. Methods Between February and May 2025, we conducted a cross-sectional survey of PCCM physicians practicing in states with abortion prohibitions for ≤12 weeks’ gestation who currently care for critically ill pregnant patients and/or those with pregnancy-sensitive conditions. We cross-referenced the National Provider Identifier Registry with the American Thoracic Society directory to determine eligibility and contact information. Participants reported perceptions about their institution’s response to abortion restrictions, institutional support, recruitment and retention, and moral distress using Likert scales (Figure 1). Results Among 1,152 eligible participants, 202 (17.5%) completed the survey. Approximately 75% were between 25 and 55 years old (n = 152), 30% identified as female (n = 60), 49% had been practicing ≤10 years (n = 98), and 75% practiced in an academically-affiliated system (n = 151). Half of participants reported that their health system had not made public or internal statements (n = 103, 51%; n = 95, 47%, respectively) regarding abortion restrictions and their impact on care. The majority of participants were unsure or did not think their institution had created a policy/procedure for providing medically necessary abortion care in response to state restrictions (n = 147, 73%). Nearly 1 in 5 physicians were unsure or did not think their colleagues would support them if they participated in medically necessary care that included an abortion (n = 36, 18%), and over half were unsure or did not think their health system administration would support them (n = 117, 58%). Over one-third perceived that abortion restrictions had or would affect faculty and trainee recruitment and retention, and 38% reported it had or would affect decisions about their future employment. Most participants agreed that abortion restrictions had led to increased moral distress (n = 117, 57%). Conclusions In this cross-sectional survey study, PCCM physicians reported limited awareness of institutional responses to abortion restrictions and uncertainty about institutional support available when assisting patients in need of medically indicated abortion care. Impacts to recruitment and retention of faculty and trainees raise concerns about future access to PCCM services in areas where abortion care is restricted. Our results suggest opportunities for institutional action to reduce physician moral distress and uncertainty. This abstract is funded by: American Thoracic Society Unrestricted Research Grant
Wilson et al. (Fri,) studied this question.