Anti-abortion laws can have unintended medical consequences that go beyond women who want to terminate a pregnancy — especially when treating a miscarriage, experts say. If cardiac activity already exists — which typically occurs for about six weeks and is currently used as a threshold for an abortion in a handful of states — it creates a difficult situation for doctors caring for patients who are not treating well. We already know that suspicion will be more likely in some pregnant people – the poor and people of color. For decades, adverse pregnancy outcomes have been criminalized, and at least 75 percent of prosecutions for behavior during pregnancy have targeted women of color. According to Roe, this criminalization will increase exponentially. People least likely to be suspected of abortion are those who exhibit the socially expected grief response and have actively sought medical help before or during pregnancy. Because of the structural inequality of the health care system, people who have already received medical care are much more likely to be insured, educated and white. Medications used during a medical abortion can also be used to treat miscarriage. These drugs – called mifepristone and misoprostol – can help a woman survive a miscarriage. I`m often asked if herbs prescribed to prevent miscarriage could do the same thing — or worse, let a pregnancy expire if the fetus develops abnormally and would have to miscarry under normal circumstances. Oxytocin (Pitocin): Causes uterine contractions. Used to induce labor, treat postpartum hemorrhage and pregnancy loss, and sometimes help contract the uterus after abortions.
From 5 to 10 weeks GA, the term “embryo” describes the developing pregnancy, while “fetus” is used from 11 weeks GA. Other terms are defined in the glossary. A recent study, although small, looked at 15 women whose pregnancies were poorly localized.25 Endometrial biopsy and hysteroscopy were used to determine whether an ectopic pregnancy or a missed abortion was observed. In eight patients, an empty cavity was identified during diagnostic hysteroscopy and the endometrial biopsy was negative. In two patients, hysteroscopy did not contribute and the endometrial biopsy was negative. One pregnancy was found in one patient and an IUD with blood in the cavity was found in the other. In three patients who underwent early abortion, hysteroscopy and endometrial biopsy revealed chorionic villi. Finally, hysteroscopy identified chorionic villi in two patients who had an early abortion, and an endometrial biopsy was not helpful. “There`s this false assumption that abortion can be regulated, restricted and criminalized without affecting women`s health care in general,” said Yvonne Lindgren, an associate professor of law at the University of Missouri-Kansas City who specializes in reproductive rights. Complications of early pregnancy loss include hypovolemic shock due to excessive bleeding and septic abortions due to infection of refused contraceptive products.
Fortunately, these complications are rare and complication rates are similar for nascent medical and surgical management. [2] As a result, the prognosis for spontaneous abortion is remarkably good. However, bleeding and miscarriage infections can contribute to maternal mortality, especially in low-income countries where the social determinants of health reduce access to quality obstetric care. [6] Some medications are used for pregnancy loss, abortions, and pregnancies. What do these drugs do? To some extent, the management of spontaneous abortion also depends on the type. However, it is generally shown that incipient medical and surgical management is equally effective. Two notable exceptions are excessive bleeding and infection, in this case, surgical treatment is preferred. [1] [2] [5] The expectant management of missed abortions also shows a variable success rate of 25 to 76%. Therefore, surgical or even medical treatment of bad abortions is generally accepted as the preferred method of treatment.
[3] Imminent and unavoidable abortions can be managed expectantly, unless the patient wishes medical or surgical intervention. Even an incomplete abortion can be managed with expectation. [1] [2] [5] However, it can take up to eight weeks for 80% of women to undergo a full abortion with expectant treatment alone. As a result, the medical management of incomplete abortions is becoming increasingly common. [2] After SB8, many Texas pharmacies stopped dispensing these drugs because they are also used for abortions. Pharmacists do not know if the patient will use the drug for abortion or miscarriage, so they refuse to fill prescriptions. The concern is that if the drug is used for abortion, the pharmacy or its staff could be held liable for “aiding and abetting an abortion under SB8 or for failing to comply with the onerous regulation of medical abortion in Texas under SB4. In other countries that ban abortion, we know that medical and surgical procedures may not be offered for missed or incomplete miscarriages for weeks or months, prolonging miscarriages, increasing medical risks, and worsening grief and physical side effects. The events of early pregnancy follow a predictable pattern, and any deviation from this sequence relates to spontaneous abortion.
For example, a gestational sac with an average diameter of at least 25 mm should contain a viable embryo, and an embryo with a crown tail length of at least 7 mm should have detectable cardiac activity. In addition, the development of the yolk sac follows the appearance of the gestational sac and is usually accompanied by the presence of an embryo with cardiac activity. Several States have proposed requiring the reporting of miscarriages. Kansas has proposed mandating miscarriages and stillbirths to the state, while Virginia has attempted to impose reporting of pregnancy loss to law enforcement, including the mother`s name and the location of the remnants of pregnancy. Mandatory reporting could compromise confidentiality between patient and provider, forcing some women to delay seeking care until they find themselves in emergency situations. Many medical groups, including ACOG, the American Medical Association and Physicians for Reproductive Health, oppose the criminalization of self-administered abortion and oppose mandatory reporting by clinicians when self-administered abortion is suspected. Mischell said this is already happening in states like Texas, which ban abortion after six weeks. Early pregnancy loss takes many different forms. With a missed abortion, there is an asymptomatic or “missed” death of the embryo or fetus without sufficient uterine contractions to expel the products of conception. [3] In contrast, the threat of abortion is characterized by symptomatic and “threatened” expulsion of the products of conception, but the cervix remains closed and the embryo or fetus remains viable. [4] Unavoidable abortion differs from the threat of abortion by the presence of an open cervical opening, indicating the “inevitable” passage of the products of conception. [5] In incomplete abortion, there is an “incomplete” passage of the products of conception through the cervical process.
[6] “These laws do not directly address miscarriages,” Lindgren said.