Hesitant Medicine: Reproductive Healthcare In a Post-Dobbs Era

Background/Purpose: The overturning of Roe v. Wade (1973) by Dobbs v. Jackson Women’s Health Organization (Dobbs) (2022) marked a pivotal shift in U.S. reproductive healthcare policy, removing federal protection for abortion access and effectively placing the authority of abortion regulation with individual states. This decision has resulted in a fragmented policy landscape with regulations varying from one extreme to the next across each state. As of late 2025, twelve states enforce a total abortion ban (i.e., abortion is prohibited at all gestational stages with limited exceptions) thereby leading to the delayed if not denied ability for abortion seekers to receive care as well as miscarriage mismanagement by physicians. The effects of the overturning of Roe v. Wade are exacerbated at the intersection of race, citizenship status, and class. Hesitant medicine refers to medical situations in which healthcare providers delay or avoid consultations, procedures, or other medical decisions or actions due to uncertainty about the legal repercussions. This under-researched phenomenon has become more relevant and pervasive in the field of reproductive healthcare since the overturning of Roe v. Wade.

Methods: This exploratory, mixed-method study seeks to answer the following question: Since the overturning of Roe v. Wade, how has hesitant medicine impacted patient–provider relationships and patient experiences in reproductive healthcare settings? Utilizing convenience and snowball sampling methods (N=208), we distributed an anonymous online survey to various public spaces in Texas and posted the survey on social media sites including that of the Texas Equal Access Fund. The survey collected responses from those receiving reproductive care across 28 different states. The survey included twelve close-ended prompts related to access to contraception, medication and care during miscarriage, trust and comfort level in provider, delays during pregnancy related complications, feeling confident a provider would prioritize their lives and feeling their safety was at risk due to a provider’s hesitation.

Results: Utilizing linear regression, findings showed a statistically significant relationship between those receiving care in abortion ban states and various forms of hesitant medicine.Those receiving care in abortion ban states (p<.001) as well as Asian and bi/multiracial respondents (p<.05) felt less confident their provider would prioritize their life even if that meant terminating a pregnancy that was no longer viable. Moreover, respondents in abortion ban states were more likely to feel their safety or health was put at risk due to a provider’s hesitation or fear of consequences than those not receiving care in abortion ban states (p<.01). We conducted thematic analysis on responses to one open-ended survey question; qualitative findings both corroborated quantitative findings and provided additional insights to various forms of hesitant medicine as experienced by patients.

Conclusions/Implications: This study significantly contributes to the emergent literature pertaining to the impact of hesitant medicine in reproductive healthcare. It offers recommendations for social workers and healthcare practitioners in reproductive healthcare settings where hesitant medicine may impact patients; it also offers policy considerations relevant to this post-Dobbs era. Finally, this study points to important directions for future research in the area of hesitant medicine.