Abortion bans make ‘evidence-based medicine’ impossible in some cases, new report says

Some 41 states restrict abortions, a ‘core component’ of maternal fetal practice, high-risk pregnancy non-profit says

Maternal fetal specialists should see abortion care as a “core component” of their practice in states where laws restrict abortion, according to a new special statement from the Society for Maternal-Fetal Medicine (SMFM).

Some 41 states ban abortion at some point in pregnancy, and these legal restrictions make it difficult or impossible for clinicians to practice “standard-of-care, evidence-based medicine”, the report, released on Tuesday, says.

The Dobbs decision made it even more challenging for patients to access abortion care in the US, as more restrictions went into effect in some states. Deaths from ectopic pregnancies nearly doubled between 2020 and 2025, a ProPublica analysis found, and later-abortion providers in haven states report that patients are showing up “ later and sicker ”.

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

In July 2021, Kate Dineen was about 33 weeks pregnant and giddy with excitement. Her husband was finally able to join her for his first ultrasound of their second child, after Covid restrictions were loosened. But then the room went quiet; the silence stretched on as the ultrasound tech lingered over images of the baby’s brain. Soon, after an MRI and consultation with a pediatric neurologist, they learned that their son had suffered a catastrophic stroke in utero, and his chances of surviving even the pregnancy were poor.

Dineen remembers asking, “What are my options?” One of the specialists said, “You may still be able to explore termination – if you’re able to travel.” Dineen was stunned. She lived in Massachusetts , where abortions were banned after 24 weeks except in specific cases – and her case didn’t qualify for an exception, she learned. The maternal fetal team at her hospital offered to link her to a later abortion clinic in Washington DC, Dineen said.

She and her husband rushed to find childcare for their 18-month-old son and made the long drive to Maryland, where they stayed multiple nights, to receive care.

“We’re just so grateful to get the compassionate care that we needed and deserved, and should have been able to get closer to home,” Dineen said. If she’d been able to get the abortion in Massachusetts , it would’ve been much easier to grieve and find closure, she said. “Instead, our lives were turned completely upside down,” she said. “I feel like I barely survived it.”

Maternal fetal specialists are at the forefront of many reproductive health decisions – including genetic diagnosis, ultrasound diagnoses and screening for anomalies, and complicated maternal medical conditions.