Key facts
- Maternal-fetal specialists should see abortion care as a core component of their practice in states with abortion restrictions, according to the SMFM.
- Legal restrictions in 41 US states make it difficult or impossible for clinicians to practice standard-of-care, evidence-based medicine.
- Deaths from ectopic pregnancies nearly doubled between 2020 and 2025, a ProPublica analysis found.
- Kate Dineen had to travel from Massachusetts to Maryland for an abortion due to state restrictions.
- Massachusetts has removed its 24-week abortion ban, allowing access to reproductive care at any point in pregnancy.
Maternal-fetal specialists should integrate abortion care into their practice, even in states with restrictive laws, according to a new statement from the Society for Maternal-Fetal Medicine (SMFM). The report highlights that legal restrictions in approximately 41 US states impede clinicians' ability to provide standard, evidence-based medical care, impacting patient outcomes.
Justin Lappen, chair of SMFM’s reproductive health committee and a co-author, stated that the practice of maternal-fetal medicine is inseparable from family planning and abortion care. He emphasized the importance of health systems creating safe care systems and understanding the legal landscape to provide comprehensive care.
The statement comes as challenges to accessing abortion care have increased following the Dobbs decision. A ProPublica analysis indicated that deaths from ectopic pregnancies nearly doubled between 2020 and 2025. Providers in states where abortion is legal report that patients are arriving later and in worse health.
Kate Dineen shared her experience of traveling from Massachusetts to Maryland for an abortion after learning her son had suffered a catastrophic stroke in utero and her case did not qualify for an exception under Massachusetts law at the time. She is now an advocate for reproductive equity, emphasizing that bans with exceptions often function as complete bans, as demonstrated by her need to travel hundreds of miles.
Following advocacy from Dineen and others, Massachusetts legislators expanded abortion exceptions in 2022 and have since removed the 24-week ban, allowing patients access to standard reproductive care at any point in pregnancy. Dineen noted that maternal-fetal specialists played a crucial role in guiding the discussion and advocating for these legal changes.