Medical uncertainty in the shadow of Dobbs
Treating obstetric complications in a new reproductive frontier
Bibliographic Data
| ID | 4596403 |
|---|---|
| Authors | M Buchbinder (0000-0002-2319-662X, University of North Carolina at Chapel Hill), Kavita S Arora (0000-0002-9912-9466, University of North Carolina at Chapel Hill), Samantha M Mcketchnie (0000-0001-8004-4430, Boston College), Erika L Sabbath (0000-0002-7866-7812, Boston College) |
| Year | 2025 |
| Volume | 369 |
| Pages | 117856 |
| Publication date | 2025-03-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2025.117856 |
| PMID | 39970515 |
| OpenAlex | W4407568008 |
| Language | EN |
| References cited | 45 |
Recent changes to United States medical practice following the U.S. Supreme Court's decision in Dobbs v Jackson Woman's Health Organization have led to new forms of medical uncertainty arising from the interpretation and implementation of state law. Post-Dobbs legal restrictions are particularly challenging because they entail multiple forms of uncertainty that intensify when combined, with risks to pregnant patients and to the clinicians who care for them. In this article, we identify and describe three distinct types of uncertainty that obstetrician-gynecologists (OB-GYNs) in states with abortion bans encounter when caring for patients with an obstetric complication known as preterm prelabor (or premature) rupture of membranes (PPROM, i.e., 'water breaking'). PPROM represents a paradigmatic case in which prognostic, legal, and existential uncertainty coalesce, leading to stress and discomfort for both patients and the clinicians caring for them. Focusing on OB-GYNs, we describe each of these forms of medical uncertainty in turn, and then elaborate a case study to show how they operate in tandem over time. In doing so, we add to a growing body of literature highlighting the relationship between structural conditions shaping medicine and uncertainty in practice. Whereas evidence-based medicine is organized around the logic of reducing uncertainty, we find that doing so is far more difficult when the uncertainty arises from politics as opposed to clinical factors
Economics · Frontier · Political science · Psychoanalysis · Shadow (psychology · Assisted Reproductive Technology and Twin Pregnancy · Law · Medicine · Psychology · Reproductive Health and Technologies
Pharmaceutical Reason
Uncertainty Management and Curve Flattening Behaviors in the Wake of Covid-19’s First Wave
Abortion restrictions and medical residency applications
Sources of moral distress among obstetrician-gynecologists after Dobbs
Regulatory Objectivity in Action
Saving Babies
Negotiating Intersecting Precarities
Physicians as shock absorbers
Complex syndromes, ambivalent diagnosis, and existential uncertainty
Uncertainty in times of medical emergency
Projected diagnosis, anticipatory medicine, and uncertainty
Our hands are tied
Technically an abortion
The expansion of abnormality and the biomedical norm
Agents of scientific uncertainty
Evidence-Based Medicine, Clinical Uncertainty, and Learning to Doctor
Uncertainty and Control in Professional Training
State of Confusion
Uncertain and under Quarantine
Contesting and Differentially Constructing Uncertainty
Uncertain Expertise and the Limitations of Clinical Guidelines in Transgender Healthcare
Interventive Care
Expanded newborn screening
Impure Science
Working knowledge, uncertainty and ontological politics
Understanding and managing uncertainty in health care
Learning to manage uncertainty
Expanding boundaries in psychiatry
Uncertainty work as ontological negotiation
Constructing classification boundaries in the memory clinic
Seeking certainty through narrative closure
Medical Technologies and the Dream of the Perfect Newborn
| Citation velocity | historical |
|---|---|
| Highly cited | No |