Abortion Provision by Family Physicians Before and After Dobbs: Trends Across Career Stages and State Restrictions.

Abstract

Family physicians (FPs) are well-positioned to integrate abortion into primary care. However, little is known about how FPs' abortion practices have been affected by the Dobbs v Jackson Women's Health Organization (Dobbs) Supreme Court decision. This study examines the percentage of FPs providing abortion, comparing across career stages, state restrictions, and before and after the Dobbs decision. Data was collected from the American Board of Family Medicine National Graduate Survey (2016 to 2024) and the Practice Demographic Survey (2019 to 2024), representing early- and mid-to-late-career FPs, respectively. Respondents (n=60,077) were grouped by time of survey completion, before or after Dobbs. Bivariate analysis assessed associations between abortion provision and state restrictions, personal/practice characteristics, and reproductive health service provision. Regression analysis assessed changes in abortion provision after Dobbs. Of 31,553 respondents in the three years pre-Dobbs, 1.3% provided abortion, and of 28,544 respondents in the three years post-Dobbs, 1.4% provided abortion. Post-Dobbs in abortion legal states, early-career FPs increasingly provided abortion (2.8% to 6.3%) compared to mid-to-late-career FPs (1.3% to 1.8%), which was confirmed in adjusted analyses (adjusted OR= 2.12, 1.67-2.70). While the overall percentage of FPs providing abortion remained stably low pre- and post- Dobbs, a modest but notable increase was observed among early-career FPs in abortion legal states. This trend among early-career FPs in specific states suggests a developing opportunity to enhance access, necessitating increased training and resources for this group.