ABORTION ADVOCATES PUSH MISCARRIAGE-CARE MISINFORMATION

National Review

 

Abortion Advocates Push Miscarriage-Care Misinformation

By Ericka Andersen

January 24, 2025 6:30 AM

 

Contrary to claims of abortion rights advocates, pro-life doctors say state bans aren’t keeping women from medical care.

 

Nearly every expectant mother who has seen the telltale line on a pregnancy test or who has searched the sonogram while the tech wands her belly knows the flash of worry: What if this little life doesn’t make it?

 

Each year in the United States, around 1 million pregnancies end in miscarriage, and another 20,000 babies die before they are born or shortly after, owing to birth defects. Pregnancy loss is common yet incredibly personal for women longing for a child. It’s easy to understand why Americans, pro-lifers as well as those calling for “reproductive rights,” are outraged at the idea of women not getting timely, thorough care when they miscarry or undergo a stillbirth.

 

In the post–Roe era, anger and fear over pregnancy care have woven their way into the national conversation. That conversation grew even louder leading up to the 2024 election, with abortion on the ballot in multiple states and serving as a focal point of the campaign of Democratic presidential nominee Kamala Harris. But Americans on either side of the abortion issue disagree over whether such fears are founded.

 

Abortion-rights activists and politicians, with mantras like “bans off our bodies,” claim that state laws designed to restrict abortion affect other medical treatments, including miscarriage and life-threatening pregnancy complications. Both misoprostol, the medication sometimes used in miscarriage, and dilation and curettage (D&C), the surgical treatment for miscarriage, can also be used in abortion.

 

Pro-life physicians say the hype doesn’t match what’s happening in hospitals. Even in the states with the strictest abortion bans, they say they can treat women who suffer miscarriage, ectopic pregnancies, and other severe conditions without legal threat.

 

States “may outlaw a D&C for the express purpose of performing an induced abortion, which intends the death of that fetal human being,” said Dr. Christine Francis, president of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG). “But a D&C to treat a miscarriage is still perfectly legal in every state in the country.”

 

Francis, the daughter of ministry leaders, dreamed of becoming a medical missionary and has never performed an abortion. She works at a Catholic hospital, which doesn’t offer the procedure, in Indiana, where abortion is banned.

 

Overturning Roe has not affected Francis’s practice. At Parkview Health in Fort Wayne, she still cares for women suffering miscarriage and ectopic pregnancies. She delivers babies, including those who came several weeks early and those who were stillborn. She’s treated pregnant women with gestational diabetes, preterm labor, preeclampsia, and other complications.

 

Francis is adamant that even in states with abortion restrictions, good physicians know they can “immediately intervene” to save a pregnant woman’s life. “I can assess the patient in front of me and determine whether or not her pregnancy needs to end through a maternal–fetal separation because of a life-threatening complication,” she said. “I don’t have patients dying.”

 

But, as head of AAPLOG, she does have more rumors, misinformation, and fears to address. Some Christian women who oppose abortion are discussing the claims and posting on social media, concerned about women not having “access to life-saving care or medication.” They hear stories about delayed or denied care and worry about it happening to them, their daughters, their friends.

 

A few tragic cases in the news have stoked fears further. Abortion-rights proponents blame the restrictions; pro-life legal experts and doctors say they’re examples of medical malpractice.

 

ProPublica reported on what it says were preventable deaths of two women in Georgia who suffered complications after medication abortions. One wasn’t given D&C on arriving in the emergency room; the other, family said, never went to the hospital because she assumed that abortion law prevented her from getting treatment.

 

In Texas, more than 20 women have sued the state for denying care in cases of life-threatening pregnancy complications. They include a woman who went into sepsis after her doctors would not perform an emergency abortion when water broke at just 18 weeks. The Texas Supreme Court ruled against the plaintiffs because Texas law already permits abortions for life-saving reasons. Physicians cannot be disciplined for performing an abortion when exercising “reasonable medical judgment.”

 

Many of the women in the Texas case had babies with trisomy 18 and other fatal diagnoses, but doctors had determined that the mothers’ lives and health weren’t at risk. In Texas, aborting babies for fetal anomalies, even if they have no chance to live outside the womb, is illegal. Some of the women traveled out of state for abortions. Others carried their pregnancies to term, met their babies, and saw them die soon after birth.

 

Most Christians who oppose abortion recognize the difference between a medical treatment to save a woman’s life that will almost certainly result in her baby dying and a procedure intended to end a pregnancy. They also know that miscarriage isn’t abortion.

 

In medical records, miscarriage is categorized as a “spontaneous abortion,” whereas a pregnancy ended by medication or procedures intended for that purpose would be designated an “induced abortion.” Both could involve the same treatment, but that doesn’t mean that restrictions on induced abortion would apply to miscarriage.

 

“Two things can be the same thing procedurally but be very different ethically,” said Emily Geiger, director of education and outreach at the Equal Rights Institute, comparing it to the difference between cremation and burning someone alive. “If the human being burned is still alive, that is horribly wrong,” she added. “That is murder. It is recognized in the law as really bad. If it’s cremation, that’s fine. We recognize that this is okay. This is a thing that is deceased.”

 

Donna Murphy, founder of Heaven’s Gain Ministries, which works with those who are grieving miscarriages, said that she sees 1,700 families a year suffering from miscarriage and that none have been denied care at Texas hospitals. “Pretending” that miscarriage care “hasn’t been available is disgusting to me,” she said. Yet prominent sources report that the laws threaten doctors’ ability to treat women who miscarry. For example, the Baker Institute for Public Policy at Rice University in Houston wrote, “In some miscarriage cases, physicians must decide whether to leave a pregnant patient in critical condition or risk legal repercussions and the loss of their medical license for performing an abortion.”

 

Pro-lifers counter that it’s impossible to perform an abortion on a woman who has miscarried, since her unborn baby is no longer alive and she is no longer pregnant. Even professional medical organizations say that “vague” language in state law about abortion exceptions is problematic. But the American College of Obstetricians and Gynecologists (ACOG) and other guiding bodies have done little to help doctors understand the scope of liberty they have in making these tough decisions.

 

Janene Oleaga, a reproductive-rights attorney, told National Review that abortion regulations in some states are “causing confusion regarding the legal status of embryos and how the value of an embryo is weighed against the value of a woman’s life.” She calls state exemptions for medical necessity “wholly ineffective” because they “require women to become close to death before they receive medical treatment.”

 

Yet “nowhere in this law,” even in Texas, “is a requirement that the threat be immediate,” wrote Dr. Ingrid Skop, vice president and director of medical affairs at the pro-life Charlotte Lozier Institute. “At the time of diagnosis of a potentially life-threatening pregnancy complication, physicians should be able to offer intervention.”

 

Women who have almost died because of delays in care risk infection and complications. Sepsis is the second leading cause of maternal death, and doctors are legally permitted to intervene before sepsis sets in.

 

Texas recently clarified its language further, adding a clause to ensure that doctors understand and have leeway to make professional medical decisions regarding emergencies. Other states as well are adding language.

 

Arkansas states that it’s legal to provide medical care for ectopic pregnancies, pregnancies with no cardiac activity, and abortion if necessary to “preserve the life” of a patient “whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself.” In South Dakota, the law says abortion is legal if “appropriate and reasonable medical judgment that performance of an abortion is necessary to preserve the life of the pregnant female.” In Oklahoma, the state constitution guarantees the right to an abortion when necessary to save the mother’s life.

 

Pro-life advocates fear that no language or clarity will be enough for pro-abortion advocates who push for no restrictions on the procedure.

 

Before Roe v. Wade was overturned, the vast majority of restrictive states already had strong abortion regulations. Some even banned as early as six weeks. Doctors in these states have always had to grapple with abortion restrictions and make decisions about life-saving abortions and miscarriage care.

 

“Doctors and administrators who are misapplying the law need to be slammed with medical malpractice lawsuits, because they are conducting medical malpractice against these poor mothers and women who live through traumatic experiences,” said Chelsey Youman, national director of public policy for the Human Coalition. “They’re failing to treat in accordance, not only with the law but with their Hippocratic oath and duty to care for their patients.”

 

Dr. Callum Miller, an ethicist and philosopher, told National Review he believes that abortion advocates are deliberately deceptive about women not being able to receive miscarriage or life-saving care. “They know if they can convince people that abortion bans would prevent people getting basic care for miscarriage, they can get otherwise pro-life people to oppose abortion bans,” he said. Miller said that a doctor who refuses to remove the remains of a baby that no longer has a heartbeat is either “legally ignorant to an astonishing and culpable degree” or “deliberately deceiving the patients and, therefore, willfully endangering them.”

 

“Either way, they are acting with the utmost incompetence, whether it’s from the doctors, administrators, or legal teams,” said Miller.

 

Dr. John David Gordon, medical director of Rejoice Fertility in Knoxville, Tenn., called out concerns about doctors facing prosecution as a straw man argument. “The attorney general in Tennessee has made it quite clear that he is never going to prosecute a doctor who took care of a patient with an ectopic pregnancy,” he said. “And there’s never been a single case of that happening.”

 

Gordon does not perform abortions, but has “never thought twice” of referring women to maternal-fetal specialists who can determine whether that’s necessary as a life-saving process. He said that is what you do when that is the necessary treatment.

 

Yet doctors and medical students receive unclear directions on their professional responsibilities. Gordon heard from medical students who were told by hospital boards they could be prosecuted for treating ectopic pregnancies in cases where the fetus has a heartbeat but sadly the pregnancy has implanted in the fallopian tube and not in the uterus.

 

“If these laws are really causing physicians to delay treating women with ectopic pregnancies leading to the ectopic pregnancies to rupture resulting in severe morbidity and even mortality, then it would seem to me that the doctor would be guilty of malpractice, and that hospital would be guilty of causing the doctor to commit malpractice,” said Gordon. Center for Reproductive Rights attorney Marc Hearron told the Associated Press that hospitals and physicians “also need to be concerned about running afoul of federal law” to protect the health and life of mothers.

 

To date, hospitals are facing investigations and penalties for violating the law by not adequately caring for women. None have been called into question for performing an illegal abortion.

 

Sarah H., who asked that her last name be withheld, gets frustrated when she hears fellow Texans repeat the claims that women can’t get miscarriage care because of abortion laws. In the past year, she has had two miscarriages and was treated without hesitancy. “I miscarried naturally but ended up being hospitalized twice due to heavy blood loss and complications due to retained tissue,” she said. “With my second miscarriage, I was taken into surgery immediately when I went back to the hospital.”

 

Pro-life ob-gyns, who have always given miscarriage care and abortions in emergencies, aren’t alarmed by new restrictions, despite facing the same penalties. It’s because abortion advocates “know that what’s going to get most people in America to side with them potentially is if they instill fear that women are not going to be able to receive essential health care,” said Francis. “And it’s a lie — all you have to do again is look at those of us who have practiced this way our entire careers.”