The Society for Maternal-Fetal Medicine released a new clinical statement this month to assist physicians treating high-risk pregnancies in states with abortion restrictions. The guidance aims to clarify legal boundaries and medical protocols for providers facing complex cases where pregnancy complications arise.
Navigating Legal Uncertainty
Since the Supreme Court’s Dobbs decision in June 2022, hospital systems have struggled with inconsistent policies regarding reproductive care. Dr. Justin Lappen, an Ohio-based maternal-fetal medicine specialist who chaired the committee drafting the statement, noted that healthcare institutions created patchwork rules that often confused clinicians on the ground.
The new guidelines urge medical facilities to establish cross-state referral networks and reach internal agreements on permissible treatments under local laws. Providers are advised to collaborate with legal teams to interpret the federal Emergency Medical Treatment and Labor Act (EMTALA) and determine when it mandates specific interventions.
Disparities in Patient Outcomes
The statement cites research highlighting significant differences in health outcomes based on state legislation. In Texas, which enacted Senate Bill 8 in 2021 to restrict abortion at an early gestational stage, delays in treating patients with premature rupture of membranes resulted in worse clinical results.
Data reviewed by the society showed a 57% complication rate—including serious infections, intensive care admissions, and blood transfusions—in Texas cases where the fetus did not survive. In contrast, comparable studies from states without such restrictions recorded a 33% complication rate.
Divergent Professional Standards
The medical community remains split on how to define standard care in this environment. The Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists maintain that access to abortion and counseling constitutes the standard of care, allowing for conscientious objections by individual physicians.
Conversely, some doctors align with the American Association of Pro-Life Obstetricians and Gynecologists, which provides its own clinical guidance. That organization partners with the Alliance Defending Freedom and the Alliance for Hippocratic Medicine, a group that previously sued to revoke federal approval of one medication used in pregnancy termination.
A representative from the pro-life association was unavailable for comment on the new guidelines. Meanwhile, Dr. David Hackney, another Ohio specialist, published a book in August detailing strategies for managing high-risk pregnancies within the current legal framework.