Institutional leadership after Dobbs: a mixed methods analysis of US medical schools' public statements regarding abortion

BMJ Glob Health. 2024 Jan 4;9(1):e013641. doi: 10.1136/bmjgh-2023-013641.

Abstract

Introduction: Medical schools, as significant and influential organisations within their communities, have the potential and the capacity to impact abortion policy. Organisations often engage in advocacy by issuing public statements that clarify their stance on specific policies. This study analyses the quantity and quality of publicly discoverable statements that US medical schools issued regarding Dobbs v Jackson Women's Health Organization.

Methods: We conducted a mixed methods study using an explanatory sequential design. Using qualitative analysis, an inductive thematic approach was used to identify themes from public statements made within 6 months of 2 May 2022, Dobbs leak. Descriptive statistics and logistic regression analysis were used to assess the association between themes and institutional characteristics.

Results: Most institutions (n=124/188, 65.96%) did not issue public statements regarding Dobbs. Among all 188 US medical schools, allopathic institutions (OR=12.19, 95% CI (2.83 to 52.57), p=0.001), schools in protective states (OR=3.35, 95% CI (1.78 to 6.29), p<0.0001) and those with family planning divisions (OR=4.60, 95% CI (2.33 to 9.08), p<0.0001) were at increased odds of issuing statements. Of the 64 medical schools with statements, 64.06% (n=41/64) espoused pro-choice views, 34.37% (n=22) were neutral/non-committal and 1.56% (n=1) expressed antiabortion views. Those in protective states were at 3.35 times increased odds of issuing pro-choice statements (95% CI (1.16 to 9.72), p=0.03) compared with restrictive counterparts.

Conclusion: Medical schools largely did not take a public stance on Dobbs. By refraining from actively engaging in this critical discourse, medical schools are foregoing a leadership opportunity to affect meaningful sociopolitical change, particularly in states with restrictive abortion laws.

Keywords: Health policy; Health systems; Maternal health; Obstetrics; Public Health.

MeSH terms

  • Abortion, Induced*
  • Family Planning Services
  • Female
  • Humans
  • Leadership
  • Policy
  • Pregnancy
  • Schools, Medical*