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

The Society for Maternal-Fetal Medicine (SMFM) has issued new guidance emphasizing that abortion care and counseling are integral to the practice of maternal-fetal medicine (MFMs). According to the SMFM, MFMs must leverage their expertise to enhance maternal safety by ensuring patients have access to the complete range of reproductive health care, even under current state abortion restrictions.

The guidance, published in Pregnancy, outlines actions that MFMs and institutions can take to establish systems and processes that guarantee patients receive optimal, evidence-based reproductive health care, including abortion care, particularly in states where abortion is severely restricted. This statement, endorsed by the Society of Family Planning, covers various aspects such as patient counseling, referrals, institutional collaboration, and training for OB-GYN residency and MFM fellowship programs.

The guidance comes in light of the 2022 Supreme Court decision in the Dobbs v. Jackson Women's Health Organization case, which has led to increased abortion restrictions in numerous states. Such restrictions have forced patients to travel out of state for abortion care, causing confusion and uncertainty among physicians and institutions dealing with high-risk pregnancies.

The SMFM stresses that all high-risk pregnancy patients should receive accurate, evidence-based information about potential health risks and treatment options, including abortion care. They also recommend providing unbiased, evidence-based counseling about treatment and prognosis for patients with fetal anomaly diagnoses and maintaining the option of abortion care.

To address uncertainty arising from legal interpretations of abortion restrictions, SMFM advises organizing interdisciplinary discussions among institutional, community, regional, and state-level stakeholders. Developing collaborative partnerships with institutions and clinics in states that offer abortion care can facilitate quick and safe patient transfers.

MFMs should also be aware of existing resources, such as hotlines, abortion funds, and networks providing financial and travel support for patients. While existing data highlight the negative impacts of abortion restrictions, further research is needed on their effects, including maternal morbidity and mortality, fetal and infant mortality, training goals and competencies for MFM fellows, and patient volume and transportation to states without restrictions.