Miscarriage and Abortion: Both Are Pregnancy Losses, but Only One Is Criminalized

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Culture & Conversation Abortion

Miscarriage and Abortion: Both Are Pregnancy Losses, but Only One Is Criminalized

Allison Coffman

Pregnancy loss is ongoing. We must stop focusing on the reason for the loss and start focusing on people’s well-being.

For many, the roller coaster that is the year 2020 started when the whole nation went on lockdown in March. Mine began in February, when I experienced my first miscarriage.

I will never forget the ultrasound technician searching for a heartbeat, my partner and I anxiously waiting to see the doctor, and then my OB-GYN breaking the news that my pregnancy wasn’t viable.

The following months were incredibly difficult. We cried, talked, and shared the news slowly to our circle of close friends and family. Everyone assured us that this is common, and the next one would be healthy.

I had another miscarriage in June. After a second loss, I felt broken, like my body had betrayed me, robbing me of the family that could have been. I felt utterly alone. Few people knew we were trying to get pregnant, and even fewer understood what it was like to have not just one but two miscarriages in the middle of a global pandemic.

Sex. Abortion. Parenthood. Power.

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The feeling of isolation and frustration increased as I turned to the internet for answers. Although there are some good resources on miscarriage, stories about pregnancy loss were largely missing. And the only stories in the news were written after someone’s successful pregnancy. It was as if society was telling me that pregnancy loss is something to be ashamed of and not shared unless you eventually have a successful pregnancy—a “happy ending.” This wasn’t my story.

Throughout my career, I have worked with communities, social justice organizations, health-care providers, and decision-makers to bring issues around abortion access and reproductive justice to the forefront. Because of my personal experience and work, I now see that the difference between abortion and miscarriage—two common forms of pregnancy loss—is actually miniscule.

Shared isolation, guilt, and shame surrounds pregnancy loss—both miscarriage and abortion. Even though as many as 1 in 4 pregnancies end in miscarriage and nearly 1 in 5 ends in abortion, people rarely talk about them. The silence and shame surrounding pregnancy loss comes from the belief that a woman’s value lies in her ability to reproduce. And if she cannot or will not have children, she is less valuable. But I know we are much more than that, and I actively have to fight to defend my and others’ right to exist regardless of our pregnancy outcomes.

There are plenty of unwanted pregnancies that end in miscarriage by chance, just as there are many wanted pregnancies that end in abortion by choice.

The same procedures used for miscarriage management are also used for abortions. My miscarriage was clinically called a “missed abortion,” meaning the pregnancy ended, but my body had not yet released it. To help my body safely miscarry, my OB-GYN performed a surgical procedure called dilation and curettage (D&C). D&C is the same procedure used to perform many abortions—the only difference is that one is criminalized, and the other is not.

Yet both miscarriage and abortion are subjected to medically unnecessary laws and regulations that prevent people from accessing the care they need. My OB-GYN couldn’t prescribe me mifepristone—one of the safest and most effective drugs for abortion and miscarriage management—because of a ridiculous law. Luckily, there were alternative treatments, but this is not always the case. Look at what happened to Michigan Sen. Gary Peters’ first wife, for example. She nearly died when their local hospital denied her an abortion, even though her pregnancy was no longer viable.

And the legal situation is getting worse. States like Georgia have passed “personhood” laws. These laws would bestow full legal rights on fetuses, further opening up pregnant people to prosecution for any actions that could be perceived as having led to pregnancy loss (including poor diet or missing prenatal appointments). And with the confirmation of Amy Coney Barrett to the Supreme Court, there is a strong chance Roe v. Wade could be overturned, leading to even greater criminalization of pregnancy loss across the United States.

There is certainly one significant difference between abortion and miscarriage. One is by choice, and one is by chance. But when we look at individual circumstances, is this difference really that stark? There are plenty of unwanted pregnancies that end in miscarriage by chance, just as there are many wanted pregnancies that end in abortion by choice. How much is it about “personal choice” versus going with the best option when faced with a fetal abnormality, potentially life-threatening pregnancy complications, poverty, or many other situations that you could be experiencing largely by chance?

The truth is that pregnancy loss is pregnancy loss. We must stop focusing on the reason for the loss and start focusing on people’s well-being. No matter how much we shame people and how much we regulate it, pregnancy loss will continue, and people will continue to need support.

It is time to break the silence.

We must share our stories, in all their diversity, and demand that lawmakers draft and enact legislation that protects our reproductive well-being. Together we can normalize pregnancy loss and start providing people with the care they need to heal and move forward with their lives.