Fact Sheet: Medical Indications for Separating a Mother and Her Unborn Child

Editor’s Note: Originally published in May 2022, this paper underwent revisions and was republished in July 2026.

Since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, there have been widespread claims that women in pro-life states will be unable to get the care they need during pregnancy emergencies. Pro-life laws have been criticized and challenged based on assumptions that induced abortion is an essential part of healthcare and necessary for treating dangerous maternal health conditions.^[1] According to this claim, to keep women safe, easily accessible elective abortion is needed.^[2]

These arguments are nothing new. Although it is frequently stated that 5,000-10,000 women were killed yearly from “back alley” abortions before legalized abortion, early abortionist and co-founder of NARAL Dr. Bernard Nathanson admitted that these numbers “were totally false.” In his words, “[I]t was a useful figure, widely accepted, so why go out of our way to correct it with honest statistics?”^[3] In fact, the number of deaths from illegal abortions was far lower and had already fallen dramatically in the years before Roe v. Wade, partially due to the availability of antibiotics and improvements in surgical techniques and anesthesia.^[4]

In our modern era, life-threatening situations are rare; however, when women are affected by them, induced abortion that aims to kill the unborn child is not the answer. Instead, there are humane medical interventions that aim for both the mother and her unborn child to live when possible and do not inflict direct violence on the unborn child. In addition, laws that protect life already distinguish in their definitions between the acts of elective induced abortion, which is restricted, and life-saving medical care of women, which is not.^[5] Furthermore, maternal fetal medicine specialists provide excellent care with the goal of helping high-risk mothers and their babies make it safely through pregnancy and delivery.

The Medical Facts

Life-threatening situations requiring separation of a mother and her unborn child are uncommon.^[6] Furthermore, as mentioned above, an elective induced abortion should not be confused with a medical indication for separating a mother from her unborn child. The two actions differ greatly in their intent.

The intent of an induced abortion is to end the life of an unborn child. The U.S. Centers for Disease Control and Prevention (CDC) defines an induced abortion as “an intervention … intended to terminate a suspected or known intrauterine pregnancy and that does not result in a live birth.”^[7] The CDC further clarifies that this “excludes management of intrauterine fetal death, early pregnancy failure/loss, ectopic pregnancy, or retained products of conception.”^[8] In an induced abortion, the Royal College of Obstetricians and Gynaecologists notes, “the intention is that the fetus should not survive and that the process of abortion should achieve this.”^[9]

In contrast, when a mother and unborn baby must be separated in an obstetric emergency before the baby can survive outside the womb, the death of the baby is a “tragic, unavoidable consequence,” but never the direct intent of the intervention.^[10] The American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) advises that these interventions are “clearly distinct from decisions to end the life of the fetal human being for reasons other than to save the life of the mother or to avert proportional irreversible damage to a major body system when doing so cannot be accomplished in any other way.”^[11] A survey of over 200 U.S. obstetrician-gynecologists, of whom the vast majority were pro-choice, revealed that these doctors differentiate between induced abortions and interventions intended to protect the mother’s health, with only a fifth indicating that induction of labor in the case of intrauterine infection should be classified as an abortion.^[12]

Interventions in pregnancy for obstetric emergencies are more correctly termed “premature medically indicated maternal fetal separation.” In these cases, the purpose of delivery is not to kill the fetus, as in elective abortion, but to save the life of the mother and the life of the fetus, or if that is not possible, to save the life of the mother. This can be done in such a way, either via induction or C-section, that the baby is given an opportunity, even if slim, to live, while addressing the mother’s health risks. Even when urgent delivery is needed, there is usually time to perform labor induction. Moreover, with modern surgical techniques, a C-section delivery, if indicated, is usually very safe, even in an extremely sick woman.^[13] (One out of three pregnancies in our country are delivered this way.^[14])

By comparison, a dilation and evacuation (D&E) dismemberment abortion (the technique used to perform 95% of late abortions^[15]) may necessitate extended time for cervical preparation, depending on gestational age, to facilitate dilation, and will necessarily dismember the potentially pain-capable unborn child.^[16] A truly sick woman, such as one suffering a hypertensive crisis or septic infection, should be delivered in a hospital with available emergency equipment, and this procedure should never be performed in an abortion facility, which may have less available resuscitative equipment and less stringent facility standards. If the baby is too young or sick to survive, perinatal hospice will ensure he or she is comfortable while the family says goodbye.^[17] A D&E dismemberment abortion, of course, circumvents this appropriate part of the grieving process.

Some research indicates that D&E is associated with a lower complication rate and shorter hospital stay than induction of labor; however, there was no statistically significant difference in serious complications between the two methods.^[18] While not all OB/GYNs may have the clinical skills to perform a later D&E,^[19] all OB/GYNs can perform inductions or C-sections, thus allowing the woman’s own physician to care for her in her distress and allowing for appropriate medical care for women when delivery is necessary.

Conditions that may require premature, medically indicated maternal-fetal separation

Ectopic pregnancy

When an embryo implants outside of the uterus, most commonly in the fallopian tube, it has the potential to become a life-threatening crisis for the mother. Ectopic pregnancy occurs in 1-2% of U.S. pregnancies,^[20] but accounts for a disproportionate share of pregnancy-related deaths.^[21] As the pregnancy grows it will stretch the tube and may eventually cause it to rupture. This can cause catastrophic internal bleeding and has resulted in many maternal deaths.^[22] Once diagnosed, physicians will offer treatment due to the substantial risks to the mother. Treatment options include methotrexate injection, surgical removal of the pregnancy tissue (salpingostomy), surgical removal of the tube (salpingectomy), or, occasionally, close monitoring without treatment if there are signs the ectopic pregnancy may be miscarrying.^[23] Current technology does not allow reimplantation of the embryo into the uterus to allow the baby to continue to develop,^[24] so it is not possible for the baby, who is implanted in the fallopian tube, to survive. The baby will inevitably miscarry and possibly threaten the mother’s life if the pregnancy is allowed to continue.

Treatment of ectopic pregnancy is not controversial among most physicians, and even AAPLOG affirms, “At this time in history, there are no surgical or medical options which allow an ectopic embryo to survive” and that “[p]reventing death in the maternal patient requires that the embryo either spontaneously or artificially die, or be removed.”^[25] In fact, many states, including Texas, specifically exclude treatments for ectopic pregnancy from the state definition of induced abortion.^[26]

Previable premature rupture of membranes (PPROM)

On rare occasions, the amniotic membrane ruptures very early in pregnancy before the fetus can survive separated from his or her mother (previability). Sometimes this is associated with active labor, but at other times labor is absent and the clinician is confronted with the difficult decision of how to manage the patient. The prognosis for the fetus is very poor, particularly when this occurs before a viable gestational age. The risk of stillbirth is high^[27] and fewer than half of liveborn babies will survive to leave the hospital.^[28] Labor often ensues before the baby has reached the gestational age in which he or she can survive, and even if the baby reaches the point of viability, the lack of amniotic fluid may cause the lungs to fail to mature, leaving he or she unable to breathe when delivered.

Additionally, the risk of infection (chorioamnionitis) for the mother is very high. Even if she does not show obvious evidence of infection, it is likely that an infection is present and may have been the event that caused the membranes to rupture. Microscopic examination has found evidence of infection in 94% of placentas delivered between 21-24 weeks for different obstetric indications, including PPROM.^[29] The risk to the mother of developing a more serious infection if the pregnancy continues is high,^[30] and may progress to sepsis (overwhelming blood infection) or even maternal death.

When chorioamnionitis occurs in this situation, the continued presence of the fetus and pregnancy tissue in the uterus prevents intravenous antibiotics from adequately treating the infection, so it is necessary to empty the uterus to resolve the life-threatening medical event. However, this does not require an induced abortion with the intention of killing the fetus. As AAPLOG explains, “Separating the mother from the placenta is an act of source control in the treatment of intraamniotic infection or sepsis. It is the separation of the mother from the placenta that saves her life … killing her fetus (intentional feticide) is not the life-saving treatment.”^[31]

Recent research suggests that administration of antibiotics may help very young babies survive to birth following PPROM, giving hope to women who wish to expectantly manage their condition and delay ending their pregnancies.^[32] However, not every woman will be a candidate for this option.

Other indications

Separating a mother from her fetus at a time when the baby is uncertain to survive may sometimes be indicated for severe hypertension, placental abruption, rapidly worsening cardiac disease, and a few other rare conditions.

Miscarriage management

Abortion advocates in the media sometimes claim that physicians in states with restrictive abortion laws will be legally unable to treat women suffering spontaneous abortions (miscarriages) because the treatments are similar to provision of early induced abortions. However, no pro-life state considers treatment for a pregnancy in which the unborn baby has already died to be the same as an induced abortion.^[33] Texas’ definition of abortion, for example, explicitly excludes miscarriage management, as do the definitions of many other states.^[34]

Once diagnosed, an early pregnancy loss can be treated in several ways: expectant management (watchful waiting) may be employed if the miscarriage appears to be occurring naturally, a dilation and suction aspiration procedure (sometimes called D&C) removes the tissue in a minor surgery, or medications to cause uterine contractions may be given to hasten the process.^[35]  Misoprostol is often used because it is readily available, but those with access to mifepristone (the restricted component of the drug-induced abortion regimen) sometimes add this drug to misoprostol for miscarriage management. It should be noted that mifepristone is dispensed under a Food and Drug Administration Risk Evaluation and Mitigation Strategy (REMS), so only certified prescribers will be able to administer the drug.^[36]

In some cases, a woman may present with “threatened” or “inevitable” miscarriage, when the unborn baby is still alive but the pregnant woman is experiencing pain or bleeding that suggests that a miscarriage is taking place. The typical treatment for threatened miscarriage is expectant management,^[37] because unnecessary intervention risks harming a pregnancy that may still continue to birth.^[38] However, when there are clinical indications that a miscarriage is already underway and loss will inevitably occur, doctors may need to intervene in order to prevent dangerous maternal bleeding or infection.^[39] In this case, the intent is to separate the previable baby from the mother in order to protect the mother’s life, not to intentionally cause the baby’s death.

Conclusion

It is clearly the standard of care for any physician to intervene in a pregnancy that presents a risk to the mother’s life. Laws restricting induced abortion will not prohibit such an intervention. Regardless of whether abortion is available, or whether a state or country has restricted abortion, if a mother is facing medical risks from a pregnancy, her health can, and by medical standards must, be addressed. The medical procedures to treat these situations can be provided by OB/GYNs who overwhelmingly do not perform abortions. When emergencies arise, pregnant women and their babies can both be cared for in a manner that respects both patients and gives them both the greatest opportunity for survival.

Ingrid Skop, M.D., F.A.C.O.G., is Vice President and Director of Medical Affairs for the Charlotte Lozier Institute.

[1] “Abortion is essential health care, even with wanted pregnancies.” Center for Reproductive Rights. August 1, 2023. Accessed July 1, 2026. https://reproductiverights.org/news/abortion-health-care-wanted-pregnancies/.

[2] Winny A., “Abortion restrictions and the threat to women’s health.” Johns Hopkins Bloomberg School of Public Health. May 19, 2023. Accessed July 6, 2026. https://publichealth.jhu.edu/2023/a-year-without-roe.

[3] Houghton, M. “Rapid Response to: Bernard Nathanson,” BMJ (2011). Available at: https://www.bmj.com/rapid-response/2011/11/03/how-abortion-movement-started-deceit-and-lies-dr-nathanson.

[4] Coble YD, Estes EH, Head A, et al. “Induced termination of pregnancy before and after Roe v Wade: Trends in the mortality and morbidity of women.” JAMA. 1992;268(22):3231-3239; Strauss LT, Gamble SB, Parker WY, et al. Abortion surveillance—United States, 2004. MMWR Surveill Summ. 2007;56(9):1-33. https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5609a1.htm.

[5] Harned ME, Skop I. “Pro-life laws protect mom and baby: pregnant women’s lives are protected in all states.” Charlotte Lozier Institute. December 9, 2025. Accessed July 1, 2026. https://lozierinstitute.org/pro-life-laws-protect-mom-and-baby-pregnant-womens-lives-are-protected-in-all-states/.

[6] Even in cases where induced abortion is reported for life-threatening cases, these situations are rare. For example, in Florida, 106 abortions (0.22%) were reported for a life-endangering physical condition in 2025. See Agency for Health Care Administration, “Reported Induced terminations of Pregnancy (ITOP) by Reason, by Trimester, 2025 – Year to Date,” https://ahca.myflorida.com/content/download/26214/file/TrimesterByReason2025.pdf.

[7] CDC’s Abortion Surveillance System FAQs: How does CDC define abortion? U.S. Centers for Disease Control and Prevention. November 27, 2024. Accessed June 26, 2026. https://www.cdc.gov/reproductive-health/data-statistics/abortion-surveillance-system.html.

[8] Ibid.

[9] Termination of Pregnancy for Fetal Abnormality in England, Scotland and Wales: Report of a Working Party. Royal College of Obstetricians and Gynecologists. 2010:29, https://www.rcog.org.uk/media/21lfvl0e/terminationpregnancyreport18may2010.pdf.

[10] American Association of Pro-Life Obstetricians & Gynecologists. AAPLOG Practice Guideline no. 13: “Ethical Considerations in Ending a Pre-Viable Pregnancy for Maternal-Fetal Vital Conflict.”

[11] Ibid.

[12] Flink-Bochacki R, McLeod C, Lipe H, Rapkin RB, Rubin SL, Heuser CC. “Classification of periviable pregnancy-ending interventions for maternal life endangerment as induced abortion.” Contraception. 2023;123:110011. doi:10.1016/j.contraception.2023.110011.

[13] Bergh EP, Vieira LA, Bigelow CA, Overbey JR, Fox NS. “Emergent primary cesarean delivery and maternal operative morbidity.” J Matern Fetal Neonatal Med. 2019;32(11):1880-1883. doi:10.1080/14767058.2017.1421930.

[14] Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final Data for 2024. Natl Vital Stat Rep. 2026;75(2). https://www.cdc.gov/nchs/data/nvsr/nvsr75/nvsr75-02.pdf. See Table 9.

[15] ACOG, “Second-Trimester Abortion.” Practice Bulletin No. 135, Obstetrics & Gynecology: June 2013; 121(6): 1394-1406. doi: 10.1097/01.AOG.0000431056.79334.cc, https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2013/06/second-trimester-abortion.

[16] “Surgical abortion (second trimester).” UCSF Health. Accessed June 29, 2026. https://www.ucsfhealth.org/care/treatments/surgical-abortion-second-trimester; Dupontclinic.com, “Abortion After 26 Weeks.” Available at: https://dupontclinic.com/services/abortion-after-26-weeks/.

[17] American Association of Pro-Life Obstetricians & Gynecologists. AAPLOG Practice Bulletin no. 1: “Perinatal Hospice.” 2017. Available at: www.aaplog.org.

[18] Hoffman EA, Kaufman J, Koelper NC, Sonalkar S, Roe AH. “Outcomes After Induction of Labor Compared With Dilation and Evacuation for the Management of Rupture of Membranes in the Second Trimester.” Obstet Gynecol. 2024;143(4):550-553. doi:10.1097/AOG.0000000000005515.

[19] Kole MB, Villavicencio J, Werner EF. “Reproductive services for the patient at increased risk for morbidity and mortality during the second trimester.” Semin Perinatol. 2020;44(5):151270. doi:10.1016/j.semperi.2020.151270; Steinauer JE, Turk JK, Pomerantz T, Simonson K, Learman LA, Landy U. “Abortion training in US obstetrics and gynecology residency programs.” Am J Obstet Gynecol. 2018;219(1):86.e1-86.e6. doi:10.1016/j.ajog.2018.04.011.

[20] “Ectopic Pregnancies,” Voyage of Life (Charlotte Lozier Institute). Available at: https://lozierinstitute.org/dive-deeper/ectopic-pregnancies/.

[21] Laura L Marion , George Rodney Meeks. “Ectopic pregnancy: History, incidence, epidemiology, and risk factors.” Clin Obstet Gynecol. 2012 Jun;55(2):376-86. doi: 10.1097/GRF.0b013e3182516d7b.

[22] Creanga AA, Syverson C, Seed K, Callaghan WM. “Pregnancy-related mortality in the United States, 2011-2013.” Obstet Gynecol 2017;130(2):366–73. DOI: 10.1097/AOG.0000000000002114. Free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5744583/.

[23] Mullany K, Minneci M, Monjazeb R, C Coiado O. “Overview of ectopic pregnancy diagnosis, management, and innovation.” Womens Health (Lond). 2023;19:17455057231160349. doi:10.1177/17455057231160349.

[24] Sammut, Stephen, and Christina Camilleri. “Ectopic Pregnancy Transfer Procedure Study.” Sammut Lab, 5 Sept. 2019. Available at: https://sammutlab.com/ectopic-transfer-study/.

[25] American Association of Pro-Life Obstetricians & Gynecologists. AAPLOG Practice Bulletin no. 9: “Ectopic Pregnancy.” 2020. Available at: https://aaplog.org/wp-content/uploads/2020/03/Practice-Bulletin-9-Ectopic-Pregnancy.pdf.

[26] Harned ME, Skop I. “Pro-life laws protect mom and baby: pregnant women’s lives are protected in all states.” Charlotte Lozier Institute. December 9, 2025. Accessed July 1, 2026. https://lozierinstitute.org/pro-life-laws-protect-mom-and-baby-pregnant-womens-lives-are-protected-in-all-states/.

[27] Sim WH, Araujo Júnior E, Da Silva Costa F, Sheehan PM. “Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability.” J Perinat Med. 2017 Jan 1;45(1):29-44.

[28] Kibel M, Asztalos E, Barrett J, et al. “Outcomes of Pregnancies Complicated by Preterm Premature Rupture of Membranes Between 20 and 24 Weeks of Gestation.” Obstet Gynecol. 2016 Aug;128(2):313-20.

[29] Kim JC, Romero R, Chaemsaithong P,Chaiyasit N, Yoon BH, Kim YM. “Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance.” Am J Obstet Gynecol. 2015 Oct; 213(4): S29–S52.

[30] Margato MF, Martins GL, Passini Júnior R, Nomura ML. “Previable preterm rupture of membranes: gestational and neonatal outcomes.” Arch Gynecol Obstet. 2012 Jun;285(6):1529-34.

[31] American Association of Pro-Life Obstetricians & Gynecologists. AAPLOG Practice Guideline no. 13: “Ethical Considerations in Ending a Pre-Viable Pregnancy for Maternal-Fetal Vital Conflict.”

[32] Hammerquist AL, Saucedo AM, Bowler SL, Pammi M, Eppes C, Van den Veyver I, Jochum MD, Barrozo ER. “Antibiotic administration after previable preterm prelabor rupture of membranes is associated with prolonged latency.” Pregnancy. 2026;2(4):e70342. doi:10.1002/pmf2.70342.

[33] Harned ME, Skop I. “Pro-life laws protect mom and baby: pregnant women’s lives are protected in all states.” Charlotte Lozier Institute. December 9, 2025. Accessed July 1, 2026. https://lozierinstitute.org/pro-life-laws-protect-mom-and-baby-pregnant-womens-lives-are-protected-in-all-states/.

[34] Harned ME, Skop I. Pro-life laws protect mom and baby: pregnant women’s lives are protected in all states.

[35] American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology. ACOG Practice Bulletin No. 200: Early Pregnancy Loss. Obstet Gynecol. 2018;132(5):e197-e207. doi:10.1097/AOG.0000000000002899.

[36] Information about Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. U.S. Food and Drug Administration. January 17, 2025. Accessed July 1, 2026. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/information-about-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation.

[37] Mouri M, Hall H, Rupp TJ. “Threatened Miscarriage.” In: StatPearls. Treasure Island (FL): StatPearls Publishing, February 12, 2024; Hendriks E, MacNaughton H, MacKenzie MC. “First trimester bleeding: evaluation and management.” American Family Physician. 2019;99(3):166-174. https://www.aafp.org/afp/2019/0201/p166.

[38] Cox T, Skop I, Harned ME. “Fact sheet: are pro-life state laws preventing pregnant women from receiving emergency care?” Charlotte Lozier Institute. September 13, 2024. Accessed July 7, 2026. https://lozierinstitute.org/fact-sheet-are-pro-life-state-laws-preventing-pregnant-women-from-receiving-emergency-care/.

[39] Cox T, Skop I, Harned ME. “Fact sheet: are pro-life state laws preventing pregnant women from receiving emergency care?”