{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T03:47:20Z","timestamp":1772768840805,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"vor","delay-in-days":43,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Clinical management of emergency pregnancy care, such as ectopic pregnancy or heavy bleeding with pregnancy of unknown location, includes upholding legal and ethical standards. For health care providers unwilling to provide evidence\u2010based life\u2010saving abortion care due to personal beliefs, clear guidance dictates disclosure of these limitations to the patient and colleagues, followed by immediate referral for appropriate care. However, this decision\u2010making pathway may not be engaged due to a variety of factors: providers\u2019 beliefs preclude adherence to referral responsibilities, political discourse confuses patients as to their options and rights, and a constantly changing state and national legal landscape leads providers to question their ability to practice to their full scope of clinical care. Although this disruption of evidence\u2010based standard of care existed pre\u2010Dobbs, the moral disorder is now heightened. This Clinical Rounds highlights a patient vignette describing the risks of abortion restrictions for patients and providers alike, particularly when an individual provider's concerns for violating institutional guidelines sets a precedent for nursing response and forecloses on collaborative input or ethics consultation. The history of physician\u2010only abortion exceptionalism and exclusion of nurses and midwives despite a significant history of nurses and midwives in abortion care grounds an argument for focusing on the impact of unethical and substandard care on the interprofessional care team leading to moral distress and negative patient outcomes. Patient\u2010centered models of care, such as frameworks common in nursing and midwifery, offer opportunities to consider how all providers practicing to their full scope in interprofessional and collaborative ways, such as in emergency rooms and labor departments, might mitigate obstructions to abortion care that risk pregnant people's lives.<\/jats:p>","DOI":"10.1111\/jmwh.13598","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T16:02:32Z","timestamp":1702569752000},"page":"774-779","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ethics, Abortion Access, and Emergency Care Post\u2010Dobbs: The Gray Areas"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1030-6022","authenticated-orcid":false,"given":"Stephanie","family":"Tillman","sequence":"first","affiliation":[{"name":"Albert Gnaegi Center for Health Care Ethics, Saint Louis University  Saint Louis Missouri"},{"name":"Feminist Midwife, LLC Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9064-6494","authenticated-orcid":false,"given":"Meghan","family":"Eagen\u2010Torkko","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Studies University of Washington Bothell Bothell Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Levi","sequence":"additional","affiliation":[{"name":"Consultant  Albuquerque New Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Ethical and Religious Directives for Catholic Health Care Services","author":"United States Conference of Catholic Bishops","year":"2018"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.03.034"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCQ.0000000000000596"},{"key":"e_1_2_9_5_1","unstructured":"Dobbs v Jackson Women's Health Org 142 SCt 2228 (2022)."},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hast.1441"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13170"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2020.S1.190417"},{"key":"e_1_2_9_9_1","volume-title":"When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867\u20101973","author":"Reagan LJ","year":"1998"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1923.02650120019006"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1910010"},{"key":"e_1_2_9_12_1","volume-title":"Abortion Counseling and Social Change from Illegal Act to Medical Practice: The Story of the Clergy Consultation Service on Abortion","author":"Carmen A","year":"1973"},{"key":"e_1_2_9_13_1","volume-title":"Killing the Black Body: Race, Reproduction, and the Meaning of Liberty","author":"Roberts DE","year":"2017"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.2307\/j.ctt1pwt69x"},{"key":"e_1_2_9_15_1","volume-title":"The Story of Jane: The Legendary Underground Feminist Abortion Service","author":"Kaplan L","year":"1997"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1206253"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.19468"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2207423"},{"key":"e_1_2_9_19_1","first-page":"781","article-title":"Fetal protection laws: moral panic and the new constitutional battlefront","volume":"102","author":"Goodwin M","year":"2014","journal-title":"Calif L Rev"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","unstructured":"SinghS RemezL SedghG KwokL OndaT.Abortion Worldwide 2017: Uneven Progress and Unequal Access.Guttmacher Institute;2018. 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