The highly politicized nature of abortion care in this country can make it difficult for institutions and obstetric providers to thoughtfully remark upon and plan for policy decisions that impact patient care. Individuals at high risk for pregnancy mortality and morbidity have unique needs for reproductive health services, including abortion care. Variations in state and institutional policies make it impossible to provide overarching, proscriptive guidance for specific clinical scenarios. However, below are suggested frameworks for discussion at the practice, institutional, and/or regional levels that can assist members in preparing to respond to clinical scenarios in restrictive environments. As more is learned about the impact of these medically inappropriate abortion restrictions on clinical care, this document will be periodically reviewed and updated.