Abortion care and counseling are core to the practice of maternal-fetal medicine, says new guidance

by Society for Maternal-Fetal Medicine

edited by Sadie Harley, reviewed by Andrew Zinin

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Maternal-fetal medicine subspecialists (MFMs) should use their expertise to improve maternal safety by maximizing patient access to the full range of reproductive health care 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 health care, including abortion care, particularly in states where abortion is restricted.

The new statement, endorsed by the Society of Family Planning, addresses patient counseling, patient transfers and referrals, institutional collaboration, and OB-GYN residency and MFM fellowship training.

After the Supreme Court's 2022 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 firsthand that restrictions on abortion care hinder our ability to provide compassionate, evidence-based health care 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 best care without unnecessary delay."

SMFM recommends that all patients with an increased risk of medical complications during pregnancy be provided with accurate, evidence-based information about 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 the legal interpretation of abortion restrictions can minimize uncertainty about legally permissible health care in medical emergencies or legal "gray 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," Lappen said. 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 for many people in the U.S. to access 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.

More information

SMFM Special Statement: Considerations for management of high-risk pregnancies when abortion care is restricted, Pregnancy (2026). DOI: 10.1002/pmf2.70376

Clinical categories

Obstetrics & gynecologyReproductive healthPregnancyWomen's health Provided by Society for Maternal-Fetal Medicine Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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