A new statement from the Society for Maternal-Fetal Medicine (SMFM) urges maternal-fetal specialists to view abortion care as a central part of their practice, especially in states with strict abortion laws. The report, released recently, highlights how legal restrictions on abortion in 41 U.S. states have complicated the ability of healthcare providers to offer standard, evidence-based care. These challenges were further intensified after the Supreme Court's Dobbs decision, which overturned Roe v. Wade, leading to increased restrictions in several states. The statement also notes a troubling rise in deaths from ectopic pregnancies, with numbers nearly doubling between 2020 and 2025, according to a ProPublica analysis. In some states, providers report that patients are arriving for later abortions "later and sicker," indicating more severe complications due to delayed access. Justin Lappen, chair of SMFM’s reproductive health committee and a co-author of the statement, emphasized that maternal-fetal medicine is closely tied to family planning and abortion care. He explained that maternal-fetal specialists are often involved in critical reproductive health decisions, such as diagnosing genetic conditions, identifying complications, and managing complex pregnancies. The statement encourages these specialists to expand their roles and advocate for comprehensive care, ensuring that health systems are prepared to support patients in advance of emergencies. Kate Dineen, a Massachusetts resident, shared her personal experience with these challenges. In July 2021, she was 33 weeks pregnant when an ultrasound revealed that her unborn son had suffered a catastrophic stroke. While she was in Massachusetts, where abortions after 24 weeks are generally banned, she learned that her case did not qualify for an exception. Despite the difficulty, Dineen and her husband traveled to Washington, D.C., to receive the care they needed. She described the experience as life-altering, saying that had she been able to get the abortion closer to home, it would have made the grieving process easier. Her story highlights the real-world impact of restrictive abortion laws and the importance of access to care. Dineen, who is now an advocate with Reproductive Equity Now, praised the SMFM for recognizing the role of abortion care in maternal-fetal medicine. She urged providers to use legal exceptions to the fullest extent possible in states with abortion bans. However, she also warned that exceptions alone are not enough to ensure access to care. In Massachusetts, despite the existence of exceptions, she had to travel hundreds of miles for her procedure. After advocacy efforts, the state expanded its abortion exception to include "grave fetal diagnoses" in 2022, and later removed the 24-week ban. Dineen said these changes have allowed maternal-fetal specialists to play a more active role in shaping reproductive healthcare policies, ensuring that patients can make personal medical decisions with their providers at any stage of pregnancy.