Patients May Not Receive Miscarriage Care in a Post-Roe America

“That’s the kind of thing we’re going to be seeing more and more,” warns Maya Manian, a professor at American University’s Washington College of Law who focuses on health care access and reproductive justice and rights.Typically, when someone has a miscarriage—the spontaneous loss of a pregnancy before the 20th week—they are offered three options by their caregiver: medication to cause the tissue to pass out of the womb; surgery (a procedure referred to as dilation and curettage, or D&C) to remove the tissue from the uterus; or the choice to sit tight and watch for signs of danger. “My fear is that there’ll be some states that want to interpret that in a very, very narrow way,” says Lisa Harris, an ob-gyn and professor at the University of Michigan.The vagueness of the laws mean that medical professionals will have to decide whether to terminate a pregnancy—knowing that penalties for calling a case too soon or it not perfectly fitting the risk criteria could range from hefty fines to suspension of their medical license to life in prison. What if carrying the pregnancy didn’t meant the patient would die, but they would have severe disabilities as a result?The future availability of the drugs needed to treat a miscarriage could also be in peril if Roe falls. The medication option—two drugs, misoprostol and mifepristone—is the best and most effective treatment for a miscarriage where the pregnancy hasn’t passed yet, says Harris. Research has also shown that pregnant women of color are more likely than their white counterparts to give birth at a Catholic hospital.Catholic health care facilities are governed by the Ethical and Religious Directives, a set of rules that dictate that aborting a pregnancy only becomes permissible if fetal heart tones are not present or the pregnant person becomes ill—essentially, the watch-and-wait method.