As abortion access dwindles, medically necessary miscarriage treatment becomes the next anti-choice target.
On Halloween in 2009, I learned doctors and nurses in the ER often put on masks or small costumes to try to brighten the mood in case any children came through for surgery. That night, my mood couldn’t have been any darker. Earlier that morning, we deposited our almost-2-year-old daughter at her grandparents so I could spend the evening at the hospital having a D&C. My second pregnancy was about to come to an end.
Every reproductive-rights activist can probably point to the moment when they became a fighter for the cause. That evening was mine, and this is my origin story. At my first prenatal appointment my doctor couldn’t find a heartbeat despite my being almost 12 weeks pregnant. His bedside, handheld ultrasound revealed a small, blurry figure missing the distinction of growing limbs that a baby should show by that point in gestation. The next day a transvaginal probe showed me there would be no happy end for that pregnancy. The ultrasound technician quietly informed me that there had been no growth for at least three weeks, then awkwardly offered to print me a photo to document the pregnancy. My Halloween D&C came two days after being forced to call new ob-gyns to see if anyone could perform the procedure, two days of sitting with something inside of me that I desperately wanted out, needed to have out, in order to feel back in control of my body and my family and begin planning for the future again. Two days of terror that I would suddenly begin to bleed and have to watch it end on its own, that I might see tiny fragments of the baby that wasn’t meant to be. And two days of worrying that it might actually never end, that I’d always have this failed pregnancy inside me, blocking me from the second child we thought we would be holding in our arms.
No one ever suggested that we go to an abortion clinic. No one ever mentioned how much easier it would have been, that I wouldn’t have needed to call doctor after doctor explaining that I had miscarried, but that there was no sign that the fetus was ever coming out. That I wouldn’t have had to struggle through those calls, that I didn’t have to spend Halloween in an ER just because I couldn’t stand to wait even one more day to finally have it over and done. That I didn’t have to spend thousands out of pocket for the surgery, even with insurance coverage. That I didn’t have to listen to doctors jovially making jokes in the waiting room as I sat, prepped for surgery, or be knocked completely unconscious with anesthetic.
No one ever suggested I had another choice.
Since then, I’ve heard countless stories of people who have discovered their own missed miscarriages (when the embryo or fetus stops developing, but the body continues to retain the pregnancy as if it were still viable) and who went to abortion clinics to have a final surgical abortion to completely terminate the pregnancy. For many, especially those without insurance, the process is cheaper and faster. From my own experience, I can’t say for certain that it is emotionally easier. Some are accosted by sidewalk counselors urging them to “keep their babies,” not realizing that these patients desperately wanted to keep their babies. They are shouted at by self-proclaimed street preachers declaring them “baby killers” when the only one who killed a baby was God or Mother Nature, or just a mistake in the DNA chain. And even if they make it into the clinic with no opposition, I can say that I wouldn’t have been in a headspace where I could be in a room with people ready to terminate unwanted pregnancies when I myself so badly wanted my own pregnancy to continue.
Still, it is a situation that happens far more often than many are aware of, and an option that people should realize is available for those who can handle it. It is also why I became so irrationally angry when I saw Lauren Enriquez of Human Life Coalition—an anti-abortion advocacy group—claim that “miscarriage management is just a euphemism for abortion.”
Enriquez is using the term apparently to argue that Planned Parenthood is dubbing some of their abortion services as “miscarriage services” in order to lessen their percentage of abortion in comparison to other services offered. She later points to a New Republic article from 2013 that calls miscarriage management a way to deal with abortion in areas where the procedure is illegal—people attempt to end pregnancies on their own, then will show up at health facilities bleeding and in pain, which allows doctors to then provide a legal D&C in order to terminate the pregnancy completely once the miscarriage has already begun. “This abortionist in Texas admits to using miscarriage as a euphemism for illegal abortion,” Enriquez states in a tweet.
While Enriquez’s arguments on their own are problematic and harmful—especially those who have experienced their own missed miscarriages, which happen in roughly one in 100 pregnancies and require medical intervention to finish—they are also a glimpse behind the veil of anti-abortion intent when it comes to laws against the procedure, as well as who would be punished if abortion does again become illegal. Her assertions that Planned Parenthood is “hiding” abortions as “miscarriage management” and that other abortion providers have or will do similar if they can’t offer legal abortion care shows just how easily the anti-abortion movement will pivot into investigating miscarriages if Roe is overturned and states can once more ban abortion.
Pro-abortion-rights advocates have long argued that if abortion is illegal, all miscarriages will be grounds for investigation, and Enriquez’s line of thought proves how correct we really are. Activists who oppose abortion are already claiming “miscarriage management” is a cover-up, that doctors or clinics are using the term to hide the abortions they are providing, and this is while abortion still remains legal. With miscarriage already being under such intense scrutiny right now, there is no doubt that it will be increasingly so as abortion dwindles in accessibility, opening those who experience pregnancy loss to suspicion and even criminal inquiries even as they are dealing with the emotional and physical fallout of their doomed pregnancies.
My heart continues to bleed for all of those who have experienced the loss of a wanted pregnancy—either the immediate, surprising end of a miscarriage, the lingering loss of missed miscarriage, or the painful blow of a stillbirth or a child born too early to survive. Just as no person should ever be forced to give birth against their will, no one should ever have their miscarriage diminished, questioned, or otherwise politicized under the guise of “pro-life” activism. How we birth, how we end our pregnancies, and where those activities occur are choices that should always be ours, and ours alone.
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