Abortion care and counseling is core to the practice of maternal-fetal medicine, says new SMFM guidance
Washington, DC – Maternal-fetal medicine subspecialists (MFMs) should use their expertise to improve maternal safety by maximizing patient access to the full range of reproductive healthcare under current state abortion restrictions, according to the Society for Maternal-Fetal Medicine (SMFM). Providing abortion care and counseling is central to MFM clinical practice and cannot be separated from high-risk pregnancy care, according to SMFM.
SMFM Special Statement: Considerations for management of high-risk pregnancies when abortion care is restricted, published in PREGNANCY, addresses actions that MFMs and institutions can take to build consensus and create systems and processes that ensure patients receive optimal, evidence-based reproductive healthcare, including abortion care, particularly in states where abortion is restricted. The new statement, endorsed by the Society of Family Planning, addresses patient counseling, patient transfer and referrals, institutional collaboration, and Ob-Gyn residency and MFM fellowship training.
After the 2022 Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, many states increased abortion restrictions. These restrictions are forcing more patients to travel out of state for abortion care and have created confusion and uncertainty among physicians and institutions in high-risk pregnancy situations.
“As high-risk pregnancy physicians, we know first-hand that restrictions on abortion care hinder our ability to provide compassionate, evidence-based healthcare for our patients,” said Justin R. Lappen, MD, chair of the SMFM Reproductive Health Committee. “This new guidance helps MFMs use their expertise, experience, and leadership to build reliable and collaborative systems so that pregnant patients receive the very best care without unnecessary delay.”
SMFM recommends that all patients with an increased risk of medical complications during pregnancy should be provided with accurate, evidence-based information about the health risks and all treatment options and their availability, including abortion care. In addition, providing accurate, unbiased, evidence-based counseling about treatment and prognosis is critical for pregnant patients with a fetal anomaly diagnosis, and all patients should have the option of abortion care.
Organizing interdisciplinary discussions among institutional, community, regional, and state-level stakeholders to achieve consensus on legal interpretation of abortion restrictions can minimize uncertainty about legally permissible healthcare in medical emergencies or legal ‘grey zones’ in abortion-restrictive states, according to SMFM.
“Collaborative partnerships with institutions and clinics in surrounding states that provide abortion care should be developed so that patients can be quickly and safely transferred for care,” said Lappen. MFMs should also be aware of existing resources, such as hotlines, abortion funds, and practical support networks that provide funding and travel support for patients.
Abortion care is difficult to access for many in the US because of judicial, legislative, and institutional barriers. Although existing data show the harm created by these abortion restrictions, more research is needed on their impact, including patient outcomes with severe obstetrical complications, data on maternal morbidity and mortality and fetal and infant mortality, training goals and competencies for MFM fellows, and patient volume and transport to states without restrictions.
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About SMFM
The Society for Maternal-Fetal Medicine (SMFM), founded in 1977, is the medical professional society for obstetricians who have additional training in high-risk, complicated pregnancies. SMFM represents more than 6,500 members who care for high-risk pregnant people and provides education, promotes research, and engages in advocacy to reduce disparities and optimize the health of high-risk pregnant people and their families. SMFM and its members are dedicated to optimizing maternal and fetal outcomes and assuring medically appropriate treatment options are available to all patients.
Journal
Pregnancy
Article Title
SMFM Special Statement: Considerations for management of high-risk pregnancies when abortion care is restricted
Article Publication Date
15-Sep-2026
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