State Abortion Policies Affect Care for Pregnancy Loss

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Today, the CDC published new statistics showing that there were more than 20,000 fetal deaths (pregnancy losses at or after 20 weeks gestation, also called stillbirth) in 2022. Roughly half occur between 20 and 27 weeks gestation, and half are later in pregnancy. As with disparities in other areas of maternal and infant health, the rates are highest among women who are Black, Native Hawaiian or other Pacific Islander, and American Indian or Alaska Native.

Management of miscarriages and stillbirth often involves the same procedures and medications that are used for an abortion. However, there have been many documented cases of women in states with abortion bans or gestational limits who were denied care during a pregnancy loss. Many physicians fear criminalization if state authorities challenge whether their patients qualify under the narrow and vague exceptions in state bans, some of which only allow abortions when needed to preserve the life of the pregnant person. In a national KFF survey, 40% of OBGYNs in states with bans said they have been constrained in caring for patients who are miscarrying since the Dobbs decision, and six in ten (61%) are concerned about their legal risk when making decisions about patient care and the necessity of abortion (See Figure).

At the Presidential debate this week, former President Trump repeated an erroneous talking point – that Democrats support abortion in the 9^th month of pregnancy and even after the baby is born. There are no abortions during or after birth. Many people feel pain and stigma when experiencing a pregnancy loss, particularly later in pregnancy, so it’s important to focus on the care they need in these difficult circumstances.