The OHSU retrospective cohort study (JAMA, n=123598 commercially insured patients, 2018-2024) documents a modest but consistent post-Dobbs shift: 2.8% rise in expectant management and 13.8% increase in misoprostol-only regimens in ban states. As an observational analysis of insurance claims, it establishes association rather than causation and cannot rule out secular trends in patient preference or coding changes. What the coverage underplays is the mechanism of legal fear: clinicians in restrictive states appear to default to watchful waiting to avoid any perception of intent to terminate, even when mifepristone-misoprostol remains the evidence-based standard endorsed by ACOG. This pattern echoes earlier Texas data (Obstetrics & Gynecology 2023) showing delayed miscarriage treatment after S.B.8. The commercial-insurance limitation is acknowledged by the authors yet still understates harm; Medicaid populations face compounded barriers. Ongoing mifepristone litigation further chills supply chains nationwide, converting a reproductive-rights ruling into a maternal-health quality problem.