GUEST OPINION: Why abortion shouldn't be a default response to cancer during pregnancy

Disclaimer: Opinions expressed in this guest post are solely those of the author.

On March 17, 2026, the Society of Maternal Fetal Medicine (SMFM Consult Series #76) released its guidance for physicians regarding cancer in pregnancy. In that guidance, the SMFM poses this patient centered question: “What are the options for my pregnancy after a cancer diagnosis?”

The response is, “Your options depend on the type and stage of cancer, how far along your pregnancy is, and your personal preferences. You may be offered treatment during pregnancy, or you may be able to delay treatment until after the baby is born.” 

This is very important, as recent stories have seemed to advocate abortion in these patients.

Key Takeaways:

• Women diagnosed with cancer during pregnancy have multiple options, despite stories that appear to advocate abortion in such circumstances.

• Treatment is based on the type of cancer, the stage at diagnosis, its behavior, and gestational age of the baby.

• A 2020 multidisciplinary consensus on cancer management during pregnancy stated, "it was erroneously thought that inducing an abortion could improve the prognosis of the patient but this assumption is no longer supported by current evidence."

The Details:

As a board certified OBGYN physician who is a strong advocate of life-affirming pregnancy care, I am often asked by abortion advocates if I would endorse termination of a pregnancy in response to the diagnosis of a maternal malignancy diagnosed in that pregnancy. My answer is always the same: “While cancer during pregnancy presents complex challenges, abortion is not the default response.”

How common is it?

Recent published data put the frequency of a cancer diagnosis during pregnancy at approximately 63 per 100,000 deliveries. The most common cancer types include breast (8.4 per 100,000 deliveries), leukemia (8.4 per 100,000 deliveries), Hodgkin’s lymphoma (7.4 per 100,000 deliveries), non-Hodgkin’s lymphoma (5.4 per 100,000 deliveries), and thyroid cancer (4.0 per 100,000 deliveries).

However, a new cancer diagnosis during pregnancy does not mean that the pregnancy must be terminated. That is a perfect example of the proverbial saying, “throwing the baby out with the bathwater.”

Treatment options

Treatment for any malignancy is based on the type of cancer, the stage at diagnosis, its behavior (slow growing or aggressive), and during pregnancy the gestational age at diagnosis is a large variable. 

For some slow-growing, early-stage cancers, such as certain cervical cancers, treatment might be delayed until later in the pregnancy or after delivery.

For other more aggressive cancers, it may be possible to defer certain chemotherapeutic agents until after the first trimester.

Chemotherapy is generally avoided during the first trimester (up to 14 weeks from the last menstrual cycle) due to the high risk of harm to the developing baby, including birth defects or miscarriage, as this is a critical period for organogenesis (the time interval during which the bodies organs are forming).

However, studies have shown that chemotherapy administered during the second and third trimesters (after 14 weeks) is generally considered safer for the fetus and does not significantly increase the risk of birth defects or stillbirths.

With advances in neonatal care, it may be possible to delay certain chemotherapy options until the child has the greatest chance of survival outside of the womb, typically at or after 30-32 weeks of pregnancy. 

Surgical removal of a mass can generally be safely performed at any stage in a pregnancy. The issue of radiation therapy during pregnancy is the most complicated.

Radiation therapy is generally deferred until after delivery. 

Case in point

Let’s take breast cancer as an example.

Breast cancer is a hormone responsive cancer, meaning it may use estrogen and progesterone, reduced in high quantities during a pregnancy, for growth.

However, as medical evidence evolves quickly, physicians have come to understand that breast cancer diagnosis during pregnancy does not always imply the need for an immediate end to the pregnancy.

Additionally, while older studies, including meta-analyses, reflected worse prognoses for pregnancy related breast cancer compared to non-pregnancy related cases, these studies either included studies from the 1960s and 70s when diagnosis and treatment were radically different, had inconsistent definitions of pregnancy-associated breast cancer, and/or were poorly age and staged matched.

Therefore, as stated in the new UK guidance, “The applicability to modern day practice of the findings from these reports is limited.” The more updated clinical stance is that, “By using diagnostic and treatment options for women with {pregnancy related breast cancer} which are as close as possible to women with non-pregnancy related breast cancer, similar outcomes can be achieved” without pregnancy termination (RCOG Green Top recommendations No 12).

While the new March 2026 guidelines for physicians are more “life-affirming,” it actually is not "new" news. As stated in a 2020 multidisciplinary consensus on cancer management during pregnancy (emphasis added):

In the past, it was erroneously thought that inducing an abortion could improve the prognosis of the patient but this assumption is no longer supported by current evidence. In general, surgical treatment is similar to that for a non-pregnant woman and, depending on the stage, lumpectomy or mastectomy may be performed. Surgery may be carried out in any trimester with little risk to the fetus. 

The Bottom Line:

While a cancer diagnosis during pregnancy can present difficult choices, it doesn't automatically mean that the pregnancy must immediately end, and certainly not with the intentional ending of a child's life.

Many women are able to receive effective treatment while pregnant, with careful monitoring and adjustments to protect the baby. This position is endorsed by the American Cancer Society.

It is crucial to have open and comprehensive discussions with a multidisciplinary healthcare team, including oncologists, obstetricians, and maternal-fetal medicine specialists, to explore all available options and create an individualized treatment plan that prioritizes the health of both mother and child.