A false choice

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NICK EICHER, HOST: Up next, treating miscarriages.

Pro-life advocates are setting the record straight after a new study suggested pro-life laws could be keeping women from proper treatment when they miscarry.

WORLD’s Lauren Canterberry has the story.

LAUREN CANTERBERRY: Lane Koch was finishing her first trimester of pregnancy when she got devastating news.

KOCH: My OB-GYN said that “this pregnancy is not going to end in a positive result. The heartbeat is fading.”

Koch’s OB-GYN put her on progesterone in hopes of a different outcome, but also made a surprising suggestion. She told Koch she could go to a nearby hospital that performed abortions.

KOCH: Since this was not going to end in a healthy pregnancy and ultimately a baby, that I could go there and preemptively, while there was still a heartbeat, have an abortion.

Koch refused and went home with her husband to pray for their child. The couple are Christians and staunchly pro-life. Koch is now the vice president of Students For Life Action.

KOCH: We were either waiting for a miracle or waiting for the heartbeat to ultimately stop and then my body to just naturally start the miscarrying process.

A few weeks later, Koch miscarried at home.

A miscarriage is classified as a pregnancy loss before 20 weeks. 

Up to one million babies die in the United States every year due to miscarriage, usually in the first trimester. Experts estimate about 10-20% of confirmed pregnancies end in loss, though some women have a miscarriage before they even know they are pregnant.

SKOP: For thousands of years, women have had miscarriages without medical intervention.

Dr. Ingrid Skop is the vice president and director of medical affairs for the Charlotte Lozier Institute.

SKOP: So it generally can happen on its own. I would say the downside is that sometimes it’s just really hard emotionally to wait.

If a woman is bleeding heavily, at risk of infection, or would rather not wait, Skop said there are two other options.

SKOP: Surgery is probably the gold standard because it’s going to most efficiently resolve the problem.

The other option is to use the drug misoprostol, which causes the uterus to contract. Misoprostol is also the second drug used in chemical abortions. 

And now, a third option is gaining support—using the abortion drug mifepristone along with misoprostol.

SKOP: There have been a number of studies that have looked at misoprostol versus mifepristone and misoprostol and have documented slightly more efficacy with the combination drug.

Skop said those studies suggest mifepristone could help soften a woman’s cervix so it is ready for contractions caused by misoprostol.

The American College of Obstetricians and Gynecologists recommends using both drugs when available, but doing so is not necessary and does not negate traditional treatments.

A study published last month suggests that following the 2022 Dobbs decision, women in pro-life states were less likely to receive surgical or medicinal interventions for miscarriage than those in pro-abortion states. And for those who do receive medication, very few took the two-drug regimen.

Skop says that may be because pro-life doctors simply can not prescribe mifepristone.

SKOP: Doctors don’t register to get mifepristone unless they’re gonna perform abortions.

Dr. Hector Chapa is an OB-GYN in Texas with 25 years of experience. He has treated countless pregnant women in emergency situations and never prescribed mifepristone.

CHAPA: Obviously it’s not that vital to my general OB-GYN high-risk practice, because we’re doing just fine without it.

Chapa says the real problem is the use of information like last month’s study to scare women into believing they will not receive life-saving care if needed.

CHAPA: Disinformation or misinformation, really, it's just got to stop. It’s just nonsense. Let us practice the way we’ve been practicing, which is evidence-based.

Recent cases in which pregnant women tragically did not get proper treatment have fueled fear surrounding pro-life laws. But Chapa said those cases just prove doctors and patients need clear information about the laws and standard miscarriage care.

Reporting for WORLD, I’m Lauren Canterberry.

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