A recent ProPublica report claims that miscarriage care in pro-life Texas has become “dangerous,” but it admits that the data it utilized cannot actually confirm this.
Key Takeaways:
- ProPublica claims pro-life laws are making miscarriage care more dangerous.
- A Texas data analysis by ProPublica found an alleged 54% increase in blood transfusions for first-trimester miscarriages and a 25% increase in emergency room visits for miscarriages.
- ProPublica admitted that its findings “can’t be confirmed by the discharge data.” It turned to its preferred “doctors and researchers” to craft a pro-abortion, agenda-driven narrative.
- Abortionists have been telling women to take the abortion pill at home and go to the hospital if they have complications (which can include hemorrhaging and incomplete abortion). They are also instructed to lie to doctors and tell them they are miscarrying, skewing the data on both miscarriage and the abortion pill.
- ProPublica compares recent miscarriage complication rates to those before COVID, but does not take COVID protocols into account.
The Details:
ProPublica has long sought ways to blame pro-life laws for all kinds of things, searching high and low — solely in pro-life states, without comparison to pro-abortion states — for ‘proof’ that things in pro-life states are terrible, horrible, no good, and very bad for pregnant women.
But its claim about miscarriage care is particularly interesting, as pro-lifers have predicted for years that the deliberate misreporting of abortion pill complications (as complications of natural miscarriage) would result in a skewing of the data on both miscarriage and chemical abortion.
In its article, ProPublica launches into its argument that pro-life laws are bad for women by making a very bold, very false statement:
Before states banned abortion, one of the gravest outcomes of early miscarriage could easily be avoided: Doctors could offer a dilation and curettage procedure, which quickly empties the uterus and allows it to close, protecting against life-threatening hemorrhage.
But because the procedures, known as D&Cs, are also used to end pregnancies, they have gotten tangled up in state legislation that restricts abortion.
However, D&C procedures are not illegal in any state. Doctors are completely free to offer D&Cs to women who need them for valid medical reasons. D&Cs are only restricted in pro-life states if used for the purpose of intentionally killing a human being who is still alive in the womb. It’s a very simple concept.
Additionally, D&Cs are not typically the initial medical response to miscarriage. More on that below.
The faulty data analysis
ProPublica looked at discharge data from Texas hospitals and emergency departments between 2017 and 2023. It claimed its analysis found that Texas’s pro-life law caused a 54% increase in blood transfusions for first-trimester miscarriage — and that, overall, emergency room visits for early miscarriage rose by 25%, compared to the three years before the start of the COVID-19 pandemic.
In a separate article, ProPublica further explained, “The number of emergency department first-trimester hospitalizations were relatively stable prior to COVID-19. In 2022, the first full year after the state passed its six-week abortion ban, the number of encounters jumped by 11%. And in 2023, the year after the state criminalized abortion, they rose again, increasing by 25% from pre-COVID levels.”
Live Action News’ analysis of the data shows a 30.3% increase in miscarriage related ER visits from 2017 to 2023, with increases each year (except for in 2020, at the height of the pandemic).
Questions linger:
- Were all of these ER visits actually related to natural miscarriage, or were some related to deliberately misreported abortion pill use?
- Did the pandemic cause an increase in miscarriage complications since pregnant women were told to stay home to prevent catching COVID? The longer they avoided medical care during the pandemic, the worse their miscarriage symptoms could have become.
ProPublica overlooked these questions and called the data a “sign” that women who didn’t receive D&Cs on their first visit to the hospital were returning to the hospital in “worse condition.” But it also admitted that the data it reviewed didn’t confirm the conclusion that it made (which seems to be a pattern with this outlet; emphases added):
While that phenomenon [women returning in ‘worse condition’] can’t be confirmed by the discharge data, which tracks visits rather than individuals, doctors and researchers who reviewed ProPublica’s findings say these spikes, along with the stories patients have shared, paint a troubling picture of the harm that results from unnecessary delays in care.
As usual, it appears ProPublica is using largely anecdotal information — along with assumptions from its carefully selected experts — to create whatever narrative it was looking for. (Experts like this one, who completed a fellowship in family planning and researches trends in reproductive health to help interested parties “remove barriers to abortion care.”)
ProPublica doesn’t seem to care what the data can or cannot confirm.
ProPublica continued its misinformation:
Texas forbids abortion at all stages of pregnancy — even before there is cardiac activity or a visible embryo. And while the law allows doctors to “remove a dead, unborn child,” it can be difficult to determine what that means during early miscarriage, when an array of factors can signal that a pregnancy is not progressing.
An embryo might fail to develop. Cardiac activity may not emerge when it should. Hormone levels might dip or bleeding might increase. Even if a doctor strongly suspects a miscarriage is underway, it can take weeks to conclusively document that a pregnancy has ended, and all the while, a patient might be losing blood.
It added, “Some OB-GYNs and emergency room physicians have long been advising patients to complete their miscarriage at home, especially at Catholic hospitals, even if that is not the standard of care.” This last claim does not reference any source.
Some key things to note:
- Texas does allow abortions when a woman faces a life-threatening situation. However, intentionally killing a preborn child is not necessary to save a woman’s health or life. Read more on that here.
- It’s not “difficult to determine what [dead] means,” but early in pregnancy, it can be difficult to find a heartbeat. When there is no embryonic or fetal heartbeat detected, doctors sometimes wrongly conclude that the preborn baby has died and that a miscarriage has begun. However, that’s not always true. Other factors must be considered, such as the size of the baby compared to how many weeks since a woman’s last period, and whether or not the mother is experiencing physical signs of miscarriage, such as bleeding. Sometimes it is simply too soon to detect a heartbeat, and one can be detected at a follow-up ultrasound. The Mayo Clinic notes, “If the result of the [ultrasound] isn’t clear, you might need to have another ultrasound in about a week.”
- Allowing a miscarriage to complete naturally is the standard of care. A D&C is not the instant, go-to response to an early miscarriage. According to the American Pregnancy Association, about half of the women who miscarry do not undergo D&Cs. “Women can safely miscarry on their own with few problems in pregnancies that end before 10 weeks,” it states on its website. “After 10 weeks, the miscarriage is more likely to be incomplete, requiring a D&C procedure.”
– The Cleveland Clinic says that “watchful waiting is the only treatment for a threatened miscarriage.” If the miscarriage has started, waiting for it to complete naturally “may be recommended.”
– The Mayo Clinic states that “Most often, expectant management is used in the first trimester” and could take up to “eight weeks.”
Why isn’t a D&C the immediate standard of care for miscarriage? Because it comes with its own set of risks, and the patient is administered either local or general anesthesia. Possible risks include hemorrhage, infection, perforation or puncture of the uterus, laceration or weakening of the cervix, scarring of the uterus or cervix, and others. If scarring of the uterus occurs, it may increase the risk of infertility; a D&C may also increase the chance of future preterm birth.
Medical neglect
ProPublica referenced the stories of two women — one who died and one who survived after significant blood loss during a miscarriage.
Porsha Ngumezi
- Had grapefruit-sized clots and had been given two blood transfusions when the on-call OB/GYN prescribed misoprostol to help complete the miscarriage, which was the method Porsha preferred over a surgical D&C.
- The doctor explained that a D&C would be necessary if the misoprostol didn’t work.
- Tragically, Porsha did not survive, but it wasn’t because of the pro-life law. Read more of her story here.
Sarah De Pablos Velez
- Was at a routine appointment when doctors said her pregnancy wasn’t viable.
- ProPublica said she was sent home and was not offered treatment for a miscarriage. But it doesn’t sound like a miscarriage had actually begun or that doctors offered her progesterone in an attempt to prevent a miscarriage.
- After bleeding began, she ended up in the ER twice, was sent home, and collapsed in her bathroom. She required two blood transfusions.
- This doesn’t point to a faulty law, but possibly to negligent medical care.
Neither of these stories proves that the pro-life law in Texas is making miscarriage care dangerous. Preventable complications and deaths occur nationally, even in pro-abortion states. If ProPublica truly wanted to help women to obtain better miscarriage care in general (instead of merely attempting to promote a pro-abortion narrative), why not look at states with differing levels of abortion restrictions (or no restrictions at all)? This would give a clearer picture of any possible problems with miscarriage care.
But as we’ve said before, ProPublica is not looking for pregnancy complications in pro-abortion states, so no comparisons are made.
The data are skewed
Live Action Research Fellow Carole Novielli has explained that for decades, the abortion industry has been instructing women to lie about abortion pill complications. What might this have to do with increased rates of miscarriage or miscarriage complications?
This: Women are told to visit the ER if they experience abortion pill complications — and to falsely tell the physicians they are naturally miscarrying. As a result, data on miscarriage care and the safety of the abortion pill have been heavily skewed. (In addition, it makes little sense for them to lie, as women cannot be legally prosecuted for obtaining abortions — not even in a state like Texas.)
The abortion pill is known to cause hemorrhaging, and its failure rates increase as gestational age increases. These complications could present as a missed miscarriage.
When women claim they are naturally miscarrying but in reality have taken the abortion pill, this means two things:
- Those abortion pill complications will never be reported as such to the manufacturer, to the state (if required), or the FDA — and therefore, the data collected on miscarriage and the abortion pill would be skewed (making the abortion pill look less risky as well).
- The data would erroneously reflect an increase in miscarriages — as well as increased cases of miscarriage hemorrhaging and incomplete miscarriage — that were actually related to the abortion pill. And we’d never know it.
The Bottom Line:
Years of faulty reporting on miscarriage and abortion pill complications have skewed data on both, leading to a false sense of safety surrounding the abortion pill and the false belief that women are being given poor quality miscarriage care.
And all the while, pro-abortion groups have been busy using that skewed data to promote their pro-abortion agenda.
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