FACT CHECK: Miscarriage study by abortion advocates attacks pro-life state laws

A new study claims that women in states with abortion restrictions are more likely to struggle to find treatment for miscarriages, or are experiencing delayed treatment. But there are some issues with this claim.

Key Takeaways:

• A new JAMA study was published this month claiming that women in pro-life states were more likely to receive delayed miscarriage care.

• The study claims this is because mifepristone, known as the abortion pill, can be more difficult to obtain in some pro-life states.

• The study found a very slight increase in expectant management as opposed to active treatment; however, the reasons for this are unclear.

• The researchers behind the study have a strong pro-abortion bias, and there is little evidence to back up their claims, as other experts have noted.

The Details:

The study, published in the Journal of the American Medical Association (JAMA), was authored by Maria I. Rodriguez, Megan Fuerst, and Kaitlin Schrote; all three are researchers in the Department of Obstetrics and Gynecology at Oregon Health and Science University. More specifically, they are members of the Center for Reproductive Health Equity, a think tank and research center dedicated to promoting and protecting abortion.

In the "cross-sectional" study, the authors examined insurance claims for "123 598 individuals aged 15 to 45 years with spontaneous abortion at fewer than 77 days’ gestation from January 1, 2018, through September 30, 2024."

They claimed they found that pro-life states shifted "away from evidence-based care," putting "hundreds of thousands" of women at risk. The study claimed that they found "a 2.8 percentage point increase in expectant management and a 2.2 percentage point decrease in medication management."

"To date, these findings provide the first large-scale, national claims-based evidence that abortion restrictions have altered the clinical management of spontaneous abortion in the United States," the authors wrote. 

Furthermore, the researchers claimed that the alternative — using solely misoprostol to treat miscarriage as opposed to mifepristone and misoprostol together — is dangerous and ineffective.

Interestingly, abortion activists were lauding misoprostol-only chemical abortions as a potential solution should certain safety restrictions for mifepristone be reinstated. Numerous abortion activists and leaders within the abortion industry boasted that using misoprostol only for abortion was not only safe, but effective.

So which is it? is misoprostol ineffective and dangerous for miscarriage, yet safe and effective for induced abortion?

The Other Side:

Though the researchers claim expectant management is not the standard of care, and can lead to complications like hemorrhage and retained body parts, even the pro-abortion American College of Obstetricians and Gynecologists (ACOG) lists expectant management as an accepted treatment option for first trimester miscarriage (emphasis added):

With adequate time (up to 8 weeks), expectant management is successful in achieving complete expulsion in approximately 80% of women. Limited data suggest that expectant management may be more effective in symptomatic women (those who report tissue passage or have ultrasound findings consistent with incomplete expulsion) than in asymptomatic women.

Furthermore, studies that included women with incomplete early pregnancy loss tend to report higher success rates than those that included only women with missed or anembryonic pregnancy loss.

Ingrid Skop, an OB/GYN and the Vice President and Director of Medical Affairs for the Charlotte Lozier Institute, told Live Action News that pro-life laws do not keep women from receiving treatment for miscarriage.

“It’s important to remember that no pro-life law in the U.S. prevents a woman from being treated for a miscarriage," she told Live Action News, adding:

"Miscarriage treatment isn’t an abortion. If a prescriber is REMS-certified to prescribe mifepristone, there is absolutely no legal reason it cannot be used to treat a miscarriage in a pro-life state.

However, most OB/GYNs, myself included, don’t perform abortions and aren’t registered to prescribe mifepristone, so we use misoprostol alone for medical management of miscarriages because it’s a common and effective option.

Lastly, the study fails to distinguish women’s preferences, as there may be compelling reasons that women choose expectant management over medications or surgery. This study is the latest attempt to blame pro-life laws for variations in medical care, instilling fear in pregnant women unnecessarily.”

Skop also noted that the study did not show any change in the surgical management of miscarriage (D&Cs), and pointed to a study showing that as late as 2024, only 3% of medically managed miscarriages used mifepristone. Skop previously explained why this might be:

"An FDA Risk Evaluation and Mitigation Strategy requires a provider to be registered to prescribe mifepristone, so it is not widely available, because few ob/gyns perform elective abortions. Thus, although there is limited data indicating that the addition of mifepristone may improve the efficacy of misoprostol in completing tissue evacuation during a miscarriage, it is not often used clinically.”

There's another not-so-obvious reason why more women could be handling miscarriages by expectant management, according to Skop: when women visit ERs for miscarriages, research shows they are less likely to be offered any kind of active miscarriage management than they would be at an OBGYN's office.

Since many pregnant women don't have their first appointment to see an OBGYN until eight weeks of pregnancy or later; ectopic pregnancies or miscarriages occurring before this point would then be handled in an ER.

Regarding the JAMA miscarriage study, Dr. Michael New also explained at National Review that, while the study is "analytically rigorous," it is still flawed:

It wrongly assumes that all of the state-level pro-life laws took effect when the Supreme Court’s Dobbs decision was issued in June 2022. This is not the case. The Texas Heartbeat Act took effect in September 2021 — ten months before Dobbs.

Additionally, Idaho, Kentucky, and Tennessee did not start to consistently enforce their abortion bans until August 2022. West Virginia did not start to consistently enforce an abortion ban until September 2022. Finally, North Dakota’s pro-life law did not take effect until April 2023.

In addition, the differences between pro-life and pro-abortion states are marginal, hardly large enough to claim hundreds of thousands of women will see their lives at risk.

Moving Goal Posts:

Shortly after the Dobbs decision in June 2022, the media began circulating stories of women who allegedly couldn't get immediate surgical (D&C) treatment for miscarriages (which is not typically a first-line miscarriage treatment except in cases of emergency) because of the existence of pro-life laws, and the claim was that women were being left untreated. This, however, turned out to be false; many women had been treated with misoprostol... even in states that restrict abortion.

That's because the laws of pro-life states legally distinguish between induced abortion and miscarriage. And doctors should obviously know the difference between intentionally killing a living baby vs. providing a treatment to remove the remains of an already deceased one.

Now, it appears that pro-abortion advocates and the media are attempting to claim that women can't get drugs for miscarriage, even though misoprostol isn't restricted under the FDA's REMS, has a stated use for treating stomach ulcers, and has been routinely prescribed for miscarriage treatment in pro-life states.

The Bottom Line:

This appears to be another instance of abortion advocates trying to use fear as a weapon, in an attempt to smear pro-life states as anti-medicine and dangerous for women.