To investigate obstetrician–gynecologists’ practises in the United States regarding postpartum sterilisation where the Medicaid permission form was not legitimate was the study’s goal. Using the American College of Obstetricians and Gynecologists’ web database, researchers performed a qualitative research in which we recruited ob-gyns practising in ten geographically varied U.S. states for semi-structured telephone interviews. They used the constant comparative technique and grounded theory concepts to evaluate interview transcripts. Thirty obstetricians were questioned. Although the majority of physicians stated that they did not perform sterilisations without a valid Medicaid sterilisation form, others stated that they did so on occasion due to an ethical obligation to their patients’ health, being in a position of greater authority or seniority, interpreting the emergency justification section of the form more broadly, or backdating the form. The physicians who stated that they would never proceed without a signed form worked at major institutions and were afraid about losing funds and participating in possibly illegal or fraudulent activity.

The various actions of physicians in delivering postpartum sterilisation without a formal Medicaid permission form show that the regulation needs to be revised. To provide fair care, unclear wording and the consequences of the Medicaid sterilisation policy must be addressed.