Effects of the Dobbs decision on abortion and related service provision among sexual and reproductive health clinics in the United States: results from a qualitative study.

Since the release of the Dobbs v. Jackson Women's Health Organization Supreme Court decision in June 2022, researchers have been working to better understand the impact that the growing number of abortion restrictions is having on the provision of and access to abortion services in the United States (US). Less is known about the impact of abortion restrictions on the provision of sexual and reproductive health (SRH) services more broadly, including at clinics that do not directly offer abortion. Between November 2023 and February 2024, we conducted interviews with SRH managers, clinic managers, and other administrators at publicly funded SRH clinics around the US to generate evidence on the effects of state-level abortion restrictions on the provision of abortion and related services, such as pregnancy options counselling and abortion referrals, at facilities providing contraceptive services. Through content analysis, we found that, while clinics in states with abortion restrictions have stopped providing abortions or are struggling to provide abortions amidst the variety of restrictive policies, clinics in states without these restrictions are also facing difficulties, specifically having to adjust their care provision due to the increase in patients seeking abortion. Simultaneously, the complicated web of abortion regulations has led providers in all states to experience challenges related to combating misinformation and protecting reproductive autonomy. These findings demonstrate the ways in which the ripple effects of Dobbs extend well beyond abortion and affect the wider network of publicly funded SRH care.