Why Access to Miscarriage Treatments Is Important

McKenna Princing Fact Checked
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Miscarriage is often surrounded by misinformation, secrecy and shame. But it doesn’t have to be. In fact, having a miscarriage is a common experience: As many as 1 in 5 pregnancies ends in miscarriage.

Sometimes, it’s safe to let the body handle the miscarriage on its own. Other times, treatment is needed. However, those vital treatments are under threat in some states because they are the same ones used to induce abortions.  

Here’s what miscarriage treatments entail and why access to them is so important.  

What is a miscarriage? 

A miscarriage is the naturally occurring, spontaneous loss of the fetus that happens before 20 weeks of pregnancy. (After 20 weeks, it’s called a stillbirth.) About 80% of miscarriages occur in the first trimester, and most happen within the first seven weeks of pregnancy — often before someone even realizes they’re pregnant. Miscarriages between seven and 20 weeks are less common but still happen: Between 10% and 25% of pregnancies end this way. Often, people who experience a miscarriage at this stage know they are pregnant.

“Despite how common it is, miscarriage can still feel isolating and, for some, emotionally traumatizing,” says Dr. Emily Godfrey, a UW Medicine family medicine physician who specializes in reproductive healthcare.

It’s important to note that a miscarriage is not the pregnant person’s fault. Most miscarriages are caused by chromosome or genetic abnormalities that render the fetus unviable. Medical conditions, infections and exposure to environmental toxins are other causes. In most cases, there isn’t anything someone could have done to prevent the miscarriage.  

And, in many cases, miscarriage treatment is a necessary step toward preserving fertility. Most people who experience a miscarriage will be able to get pregnant again and carry to term. 

How are miscarriages treated? 

Someone who is experiencing a miscarriage has three main options: 

Watching and waiting 

The watch-and-wait method, also called expectant management, involves waiting to see if the uterus will shed pregnancy tissues on its own, naturally ending the pregnancy without any medical intervention.  

“This method can sometimes be unpredictable, but sometimes it’s really what patients want: a non-invasive, natural option,” Godfrey explains.  

Most of the time, this method works, though it can take up to 8 weeks and people may experience symptoms like cramping and bleeding during that time. If someone is more than 13 weeks pregnant, this method is usually not recommended due to the potential for excessive bleeding. 

Medications 

Two medications are used together to treat miscarriage. They are called mifepristone and misoprostol

First, the person takes a single dose of mifepristone, which blocks pregnancy hormones. Twenty-four hours later, the person typically takes four doses of misoprostol, which helps the body pass the miscarried pregnancy tissue within a few hours. The person can usually take these medications safely at home and manage the rest of the miscarriage on their own.  

Uterine aspiration 

This is a short, five-minute outpatient procedure performed by a doctor. The doctor numbs the person’s cervix and then inserts a thin, syringe-like device that uses suction to remove the miscarried pregnancy tissue from the uterus. The person is able to go home shortly after the procedure.  

On the day of the procedure, it is usually advised that the person rest, though they can return to most normal activities the following day. They may experience spotting or cramping for a few weeks after the procedure. 

Why miscarriage treatments are under threat in some places  

Uterine aspiration and the medications used to treat miscarriages are also ways doctors perform an abortion in patients who choose to end their pregnancy. Because of this, the treatments may not be available in states where abortion is illegal or may not be easily accessible in states where abortion rights are threatened.  

"The current political climate and draconian state laws can add an unnecessary element of fear on top, just as a patient may try to seek treatment,” Godfrey says.  

Someone experiencing a miscarriage is already experiencing something out of their control, so restoring some small sense of agency over their body can be helpful. And rarely, someone may develop complications, or their body may not complete the miscarriage on its own. This can result in dangerous infections or bleeding. 

“When abortion is outlawed, the lifesaving treatments for miscarriage often go away, too,” Godfrey says. “So those who are miscarrying are systematically denied modern medicine options to choose from to treat their miscarriage.” 

Barbara Clements contributed to this article. A version of this story originally appeared on the UW Medicine Newsroom.