There are countless devastating effects that can and will result from the fall of Roe v. Wade, but one emergent and chilling consequence of the Supreme Court’s decision is how abortion bans may influence the crucial treatment of miscarriages.
By definition, a miscarriage—known as a spontaneous abortion—is a nonviable pregnancy that occurs before the 20th week of gestation; after that, it’s considered a stillbirth. The treatment options are very similar to those of abortion—there is no way to stop or prevent a miscarriage that has already been diagnosed. That means providers in states with total or near-total bans, such as Texas, now face a legally murky landscape of care.
As Luu Ireland, MD, an ob-gyn in Massachusetts and fellow with Physicians for Reproductive Health, tells SELF, a miscarriage is a pregnancy that cannot be safely carried to term. “There is no chance of it going on to be a normal pregnancy,” Dr. Ireland says. While the research varies, it’s estimated that between 10% to 20% of pregnancies end in miscarriage, per the Mayo Clinic, but experts believe that figure could be much higher.
Sometimes a miscarriage means that the embryo is not having cardiac activity at the expected time, or that the gestational sac (a fluid-filled structure that protects the embryo) is growing but the fetus isn’t, or that someone is actively bleeding in the process of passing a pregnancy. It’s difficult for a doctor to know what has caused a particular miscarriage, but as Planned Parenthood notes, it’s almost never something the pregnant person did. And Dr. Ireland is clear: “What clinches a diagnosis is what the outcome would be, which is, this is not a viable pregnancy, and it will never be a normal pregnancy.”
Meera Shah, MD, chief medical officer at Planned Parenthood Hudson Peconic, tells SELF that there are a couple of treatment options for a miscarriage: One involves administering the exact same two drugs that are used in a medication abortion (mifepristone and misoprostol), and another involves performing a dilation and curettage, or a D&C, which is a surgical procedure that is done to remove tissue from inside the uterus. “Regardless of the status of the pregnancy, whether it’s a viable pregnancy or a miscarriage, the treatment options are exactly the same,” Dr. Ireland says.
How might abortion bans affect crucial miscarriage treatment?
Similar to the way that abortion bans can potentially affect the life-saving treatment needed for an ectopic pregnancy, treating a miscarriage may become unnecessarily complicated and could lead to dangerous delays in care in states where legal abortion is illegal or criminalized, according to Dr. Ireland.
“Because it’s the same medication used in abortions, we are seeing a lot of pushback from pharmacists,” Dr. Ireland says. “Patients aren’t getting the medication they need because the pharmacist is worried about legal repercussions. Instead of providing appropriate medical care, pharmacists are having to think about what they need to do to keep themselves safe. As a result, they are denying care to patients undergoing the very difficult process of having a miscarriage.”