Leading experts in high-risk pregnancies issue report on reproductive health services

Safe reproductive health services, including contraception and abortion, can be lifesaving for some women. However, accessing these services can be a challenge for many women in the United States, particularly low-income women of color. Restrictive state legislation, disparities in access to trained providers, and a lack of evidence-based, standardized guidelines for counseling serve as barriers for women receiving the health services they need.

Among continued efforts to prevent maternal morbidity and mortality, the Society for Maternal-Fetal Medicine (SMFM), hosted a two-day workshop entitled "Reproductive Services for Women at High Risk for Maternal Mortality." The workshop was held in conjunction with SMFM's 39th Annual Pregnancy Meeting in Las Vegas, Nevada in February 2019 and was co-sponsored by the American College of Obstetricians and Gynecologists, Fellowship in Family Planning, and Society of Family Planning.

Workshop participants discussed assessment, counseling, and training for providers who care for women with high-risk pregnancies. A summary of the workshop and its recommendations titled, "Executive Summary: Reproductive Services for Women at High Risk for Maternal Mortality Workshop," has been published in the American Journal of Obstetrics and Gynecology (AJOG).

"Access to the full spectrum of reproductive health services, including pregnancy termination, is critical to women's overall health and saves women's lives," said Sean Blackwell, MD, SMFM's immediate past-president and originator of the workshop. "We hope that this presidential workshop and its summary shine a light on the unique considerations of women who have an increased risk of death during or after pregnancy."

The executive summary emphasizes the need for a wide range of safe, equitable reproductive health services for women at high risk for maternal death and makes recommendations on how to remove barriers and improve patient care. Family planning interventions, particularly access to safe, timely abortion, have been shown to prevent maternal deaths worldwide. Patient-centered, shared decision-making should be highly valued when counseling women, and more research must be conducted with high-risk women to develop evidence-based solutions for the current maternal mortality crisis.

More in-depth publications on this topic with clinical guidance and future research questions will be published by SMFM at a later date. "We hope our summary of the workshop will inspire future research and prompt further collaboration between maternal-fetal medicine subspecialists, family planning subspecialists, and obstetrician-gynecologists," said Blackwell.