B104-19 Physicians Report Numerous Impacts to Pulmonary and Critical Care Practice From State Abortion Prohibitions

Abstract Rationale Pulmonary and critical care medicine (PCCM) physicians care for critically ill pregnant patients and manage pregnancy-sensitive conditions. State-level abortion prohibitions implemented since 2022 have impacted care for these patients, but we lack quantitative data on their reported impact on PCCM practice. Methods We performed an anonymous, cross-sectional, web-based survey of PCCM physicians practicing in states with abortion prohibitions between February and May 2025. We cross-matched the National Provider Identifier Registry with the American Thoracic Society (ATS) member directory to determine eligibility and obtain contact information. Participants were screened to confirm they cared for critically ill pregnant patients and/or those with pregnancy-sensitive conditions (e.g., pulmonary hypertension) in states with abortion prohibitions. They answered questions about state abortion prohibitions and whether these prohibitions have impacted their practice through multiple-choice and Likert responses. Data analysis was performed using R (v.4.5.1). Results Of 1152 eligible participants, 202 participated (response rate 17.5%). Half of physicians felt prohibitions had/would impact care for critically ill patients (52.0%, n = 91/175), patients with pregnancy-sensitive conditions (57.4%, n = 85/148), and the doctor-patient relationship (50.0%, n = 101/202). Many physicians caring for critically ill patients (40.6%, n = 71) and patients with pregnancy-sensitive conditions (34.5%, n = 51) reported changes to their practice due to abortion prohibitions. Among physicians caring for critically ill pregnant patients (n = 175) with a medical indication for abortion, 38.3% (n = 67) would consult Ethics or legal counsel and 21.1% (n = 37) would consult hospital administration. One in six (n = 30) reported they would transfer a critically ill patient needing abortion due to state prohibitions. Among physicians caring for patients with pregnancy-sensitive conditions (n = 148), 50.6% (n = 75) were unsure if they could legally counsel their patients on obtaining an abortion. Most surveyed physicians (61.3%, n = 124) reported they were unsure or did not know how to obtain a medically indicated abortion for their patients. Among physicians reporting some familiarity with state abortion prohibitions (n = 180), half were unsure or thought the law prohibited abortion in cases of medical risk (51.1%, n = 92) and one-third in cases of imminent threat to life (36.6%, n = 66). Conclusions Many PCCM physicians in states with abortion prohibitions reported that abortion prohibitions have resulted in changes to their practice and caused significant professional uncertainty regarding abortion management, counseling, and legality for critically ill pregnant patients and those with pregnancy-sensitive conditions. These results raise concerns about impacts to patient safety and quality of care and a need for greater clarity and guidance regarding state-level abortion prohibitions for PCCM physicians. This abstract is funded by: American Thoracic Society Unrestricted Research Grant