SMFM Declares Abortion Care Integral to Maternal-Fetal Medicine Amid State Restrictions

The Society for Maternal-Fetal Medicine (SMFM) released a special statement urging that abortion care be treated as a “core component” of maternal-fetal practice in states with restrictive laws. The statement notes that 41 states ban abortion at some point in pregnancy, creating obstacles to “standard-of-care, evidence-based medicine.” It also cites a ProPublica analysis showing that deaths from ectopic pregnancies nearly doubled between 2020 and 2025. SMFM argues that clinicians must be prepared to address pregnancy complications that intersect with family planning and abortion services.

The Guardian

Kate Dineen’s 2021 experience illustrates the practical impact of these bans. While 33 weeks pregnant in Massachusetts, she learned her fetus had suffered a catastrophic stroke. Because Massachusetts permits abortions only up to 24 weeks except for narrow exceptions, Dineen was ineligible. Her care team arranged transport to a later-abortion clinic in Maryland, requiring a multi-day trip and childcare for her 18-month-old son.

The Guardian

Following testimonies from Dineen and others, Massachusetts lawmakers expanded the abortion exception in 2022 to include “grave fetal diagnoses.” Dineen called the amendment an improvement but noted continued gaps. The state is now removing the 24-week ban, allowing patients to obtain reproductive care at any point in pregnancy. Dineen credited maternal-fetal specialists for guiding the policy shift, calling it a “real game-changer.”

The Guardian

SMFM chair Justin Lappen emphasized that health systems must develop “safe systems of care” and understand the “state reproductive health legal landscape.” Lappen urged providers to expand abortion access up to the legal limit and to exploit exceptions fully, while acknowledging that “the law is intended to be sort of black and white” yet pregnancy complications exist in “shades of gray.”

The Guardian

• “In some ways, the practice of maternal-fetal medicine is inseparable from family planning and abortion care,” — Justin Lappen, chair of SMFM’s reproductive health committee and a co-author of the statement

The Guardian

• “It’s really important for health systems, for hospitals, to be able to create safe systems of care and to understand what the state reproductive health legal landscape looks like,” — Justin Lappen, chair of SMFM’s reproductive health committee and a co-author of the statement

The Guardian

• “The law is intended to be sort of black and white,” — Justin Lappen, chair of SMFM’s reproductive health committee and a co-author of the statement

The Guardian