About the Study: To what extent do obstetrician-gynecologists (OB-GYNs) experience clinical constraints associated with their state’s abortion laws, and are those constraints associated with moral distress? In a cross-sectional study surveying 864 OB-GYNs, those in abortion-restrictive states endorsed higher levels of 3 specific clinical constraints (counseling, care provision, and care for patients with potentially life-threatening pregnancy complications) compared with OB-GYNs in protective states. Greater levels of each clinical constraint were associated with higher moral distress scores in restrictive and protective states. These findings suggest that OB-GYN moral distress, associated with inability to provide certain forms of care to pregnant patients, transcends abortion policy context; institution-level policies and practices to support OB-GYNs are indicated nationally, not only in states with the most restrictive abortion laws.