Addressing Knowledge Gaps in Perinatal Palliative Care Amidst Changing Abortion Laws

A recent review published in Health Affairs Scholar highlights significant limitations in the existing research on perinatal palliative care (PPC) in the United States, raising concerns about its capacity to effectively serve a vulnerable and expanding patient population in the context of tightening abortion restrictions. Led by Abigail B. Wilpers, Ph.D., WHNP-BC, an assistant professor at Penn Nursing's Department of Family and Community Health, the study critically examines the breadth and depth of current evidence supporting PPC.

PPC is an interdisciplinary approach that offers comprehensive support—from prenatal diagnosis through labor, birth, neonatal care, and end-of-life services—addressing pregnancies complicated by life-limiting fetal conditions (LLFCs). This model integrates medical management with psychosocial and bereavement support to assist families in making values-driven decisions. The review emphasizes that an increase in families being directed towards PPC due to recent policies underscores the urgent need for robust, U.S.-based research.

The study titled "Dobbs-driven expansion of perinatal palliative care: a scoping review of the evidence and its limits" highlights several key findings:

• PPC remains a largely understudied area in the U.S., with limited evidence on critical outcomes such as maternal health and neonatal comfort.
• There is a lack of comprehensive data regarding the utilization rates of PPC across diverse populations, with existing research often lacking demographic variety.
• Patient satisfaction with PPC is generally high, mainly reflecting compassionate and supportive care; however, few studies explore the specific experiences of families compelled to seek PPC due to restrictive abortion laws.
• Current evidence is insufficient to assess whether PPC can support the increasing number of patients now being directed to it by legislation rather than personal preference.

The authors highlight that these gaps hinder the ability to evaluate the safety, effectiveness, acceptability, and equity of PPC, which are essential for ensuring it genuinely meets the needs of all families. This comprehensive review acts as a call to action for more rigorous, nationally focused research to inform policies and optimize care for vulnerable families facing complex pregnancies.

In conclusion, as legislative changes continue to influence reproductive health choices, understanding and strengthening the evidence base for PPC becomes increasingly critical. Only through targeted research can healthcare providers and policymakers ensure that PPC effectively and equitably supports families navigating difficult fetal diagnoses amid evolving legal landscapes.

source: https://medicalxpress.com/news/2025-06-illuminating-gaps-perinatal-palliative-evidence.html