WASHINGTON, DC (May 15, 2020) — In a new commentary in Women's Health Issues, Gabriela Weigel and colleagues from the Henry J. Kaiser Family Foundation explain how efforts to restrict abortion can create a legal and medical environment that criminalizes pregnancy loss and limits clinicians' ability to provide high-quality care to those who experience miscarriages or stillbirths.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Commentary authors Gabriela Weigel, Laurie Sobel, and Alina Salganicoff note that 38 states have “fetal homicide laws,” and several have pressed criminal charges against women who experienced violence or physical trauma or use substances while pregnant. Six states directly criminalize self-managed abortion (in which a pregnant person attempts to end their pregnancy outside of a health care setting using non-prescribed medications or other means), and at least 20 have opened criminal investigations or made arrests for suspected self-managed abortions. Such actions can discourage those who use substances or experience pregnancy loss from seeking recommended care, the authors warn.
For those who do seek care for pregnancy loss, options can be restricted because of laws that limit access to abortion. Weigel and colleagues note that mifepristone—which can be used in miscarriage management and is also part of the drug regimen used for medication abortions—is challenging to obtain due to Food and Drug Administration rules. In addition, many states prohibit procedures such as dilation and extraction and/or dilation and evacuation procedures used to manage some pregnancy loss cases that occur later in pregnancy. Even in places where these interventions are available, the authors explain that patients may struggle to find a provider who can offer them. Recent legislation aimed at abortion providers could decrease the number of clinicians trained in the medication and procedures that are used for both abortions and miscarriage management.
“For many, pregnancy loss comes with significant grief and stigma; fear of legal action could have the unintended consequence of deterring these individuals from obtaining needed prompt, high-quality, and compassionate care,” Weigel and her colleagues conclude.
“As policymakers consider whether to adopt, retain, or alter enforcement of policies that limit access to abortion, they should be aware of the potential impacts of their decisions on people experiencing pregnancy loss,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “Politicians should not be restricting access to abortion, but if that is their goal, I hope they will read this commentary and craft their policies in ways that limit the harm they cause to people who experience pregnancy loss.”
“Criminalizing Pregnancy Loss and Jeopardizing Care: The Unintended Consequences of Abortion Restrictions and Fetal Harm Legislation” has been published in the May/June issue of Women’s Health Issues.