What role should maternal-fetal medicine physicians play in the era of abortion restriction?

In 2019, a total of 25 abortion bans were signed into law by states in the Southeast and Midwest. As of May 2019, 33 states have passed laws restricting or limiting abortion services, including "trigger laws" that make abortion illegal in the event that Roe v. Wade is overturned. In addition, 9 states have passed extreme abortion laws, such as making abortion illegal early in gestation (as early as 6-8 weeks' gestation), which are all currently enjoined and not in effect. The Society for Maternal-Fetal Medicine, American College of Obstetricians and Gynecologists, and Society of Family Planning agree that access to abortion is essential to women's health and oppose legislation that directly affects the patient-physician relationship. It is time for maternal-fetal medicine physicians to play a more active role in the fight for abortion access. A 2012 study of maternal-fetal medicine physicians found only 31% of respondents performed dilation and evacuation for termination of pregnancies, predominantly based on whether the provider was trained in dilation and evacuation procedures during fellowship. We performed a 2018 survey of all maternal-fetal medicine fellows and program directors and found that more than two-thirds (62 of 90 [68.9%]) of fellows desire dilation and evacuation training; however, only 9 of 39 (23.1%) program directors believe dilation and evacuation training should be required. The maternal-fetal medicine community is well positioned to improve access to abortion services in the United States by prioritizing dilation and evacuation training for fellows and actively participating in reproductive health advocacy.