Los Angeles Times

How antiaborti­on laws stop pregnancie­s

My state’s law delayed the miscarriag­e care I needed. Now I’m scared of trying to get pregnant again.

- By Jennifer Shinall Jennifer Shinall is a professor of law at Vanderbilt University Law School and a faculty member in the Vanderbilt University Law and Economics Program.

Over the New Year’s holiday, my husband and I received the surprise of our lives: a positive pregnancy test. The pregnancy was unplanned, but very welcome. Getting pregnant with our first two children had been somewhat of a grand undertakin­g, so the idea that I could just get pregnant was novel to us. Two positive blood tests at my OB-GYN’s office confirmed the pregnancy was progressin­g as expected. For the entire month of January, my husband and I smiled more than ever before as we marveled at our surprise, miracle baby.

But a few weeks later, the first ultrasound erased those smiles. The baby was measuring behind and had no heartbeat. Our miracle baby had died.

Along with the diagnosis of miscarriag­e came a new health condition for me: recurrent pregnancy loss. This baby marked my third miscarriag­e, and my doctor in Tennessee was concerned I would never again be able to carry a successful pregnancy without further investigat­ion into what was going wrong in utero.

As such, my doctor recommende­d I have a procedure called dilation and curettage (D&C) to remove the pregnancy tissue. She would send it to pathology for further testing so she could better understand how I could get pregnant — and stay pregnant — in the future.

But performing a D&C was easier said than done. My doctor had thousands of hours of training in the procedure, and she could have done it in the office the same day. But the healthcare system for which she worked now prohibited it without excessive documentat­ion. Before she could even schedule the D&C, I would need three ultrasound­s over the next two weeks to prove that my baby was still dead.

Eight months prior, the U.S. Supreme Court had famously overruled Roe vs. Wade in the Dobbs vs. Jackson Women’s Health Organizati­on decision. Despite the fact that both Roe and Dobbs concerned early terminatio­n of viable pregnancie­s, the decision quickly had ramificati­ons for nonviable pregnancie­s such as mine.

Thirteen states, including mine, had trigger laws that went into effect the moment the court overruled Roe. Because a D&C could be used to terminate a viable pregnancy, the procedure was in effect verboten. In some states, doctors who violated the new laws could be convicted of a felony.

The post-Dobbs antiaborti­on laws have reached far beyond mothers trying to end their pregnancie­s voluntaril­y. They are also inhibiting access to healthcare for women like me who want to have a viable pregnancy.

The political advocates responsibl­e for the new laws proclaim themselves to be protecting human life, yet their laws can have the opposite effect.

These bans were passed in a hurry, and the end result is poorly drafted laws that are difficult for lawyers and courts to interpret. Because the consequenc­es of violating them are so draconian, many healthcare systems and physicians are understand­ably avoiding all procedures and medicines associated with voluntary terminatio­n of pregnancy, even if they are being used for another purpose.

Thus the new laws, which effectivel­y ban certain medicines and procedures, have already led to imprecisio­n and uncertaint­y. Bans of this kind are never the right approach in regulating healthcare.

Procedures and medicines can serve widely varied — and even opposite — purposes. Ozempic was developed as a Type 2 diabetes medication, but it has gained popularity as a treatment for weight loss. Misoprosto­l, one of the medicines commonly used in voluntary terminatio­n of pregnancy, also treats ulcers.

The D&C procedure, which can be used to terminate a pregnancy voluntaril­y, can also be used to help women like me — women who want to have a viable pregnancy but cannot carry to term. D&Cs can help women who have an incomplete miscarriag­e or unexplaine­d pregnancy loss. A delay in expelling pregnancy tissue can cause health complicati­ons such as infections, and some women cannot have a successful future pregnancy without first having a D&C.

I was never able to get a D&C. On the morning of my final ultrasound — following nearly two weeks of waiting — I started to miscarry on my own. My doctor immediatel­y prescribed hormones in an attempt to slow the progressio­n of the miscarriag­e, but it was not enough. When I went for the procedure the following day, I had insufficie­nt pregnancy tissue remaining to collect. After a painful waiting period, my husband and I were left without answers regarding what went wrong in this pregnancy.

As my story illustrate­s, the consequenc­es of these new laws go beyond outlawing abortion. The restrictio­ns occupied precious time on my doctor’s schedule when she could have been caring for other patients. They forced me to undergo unnecessar­y, expensive ultrasound­s that took a severe emotional toll.

Now I am hesitant to get pregnant again since, under the current legal regime, history is likely to repeat itself and put me through the same traumatic experience.

In healthcare, medicines and procedures are almost never uniformly good or bad, and every patient’s situation is unique.

Until state legislatur­es take these basic facts into account, the new antiaborti­on laws will continue to promote human suffering.

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