A new study has found that abortion restrictions in the United States are making it harder for women to access proper care for miscarriages. The research, published in the Journal of the American Medical Association on 18 May, reveals that in states with abortion bans, miscarriage management is shifting away from medication and towards a 'wait-and-see' approach, falling below standard care.
The study analysed data from 123,598 people with private insurance, including 54,181 living in states with trigger bans on abortion after six weeks following the Dobbs v Jackson Women's Health Organization decision in June 2022. It found a 2.8 percentage point increase in expectant management—where patients are sent home to wait—and a 2.2 percentage point decrease in medication management in those states.
Lead author Maria Rodriguez, professor of obstetrics and gynaecology at Oregon Health & Science University, said: 'We wanted to understand how, when you restrict access to abortion, that might affect people who are having a pregnancy loss or an early miscarriage. What we found was that people had fewer choices to the type of care they got, and they were receiving lower-quality care as well.'
The study notes that spontaneous abortion—the medical term for miscarriage—requires the same treatment options as induced abortion. Rodriguez added: 'We use the same medications, it's the same procedure.' The research is likely an under-estimate as it only covers privately insured individuals, who are generally wealthier and have more resources than those on Medicaid.
Jenna Nobles, lead author of a separate September 2024 study in Health Affairs, said: 'We need to have medical capacity in place to support people, because mismanaged miscarriage care can be extremely dangerous.' She noted that 25% to 30% of recognised pregnancies end in miscarriage, affecting not just patients but also partners, families and friends.
