Two of the three women at the clinic last week who were having “abortions,” were actually having D&C’s (the medical name for the procedure used during most first trimester abortions) to deal with incomplete miscarriages.
Both were wanted pregnancies, and both had been experiencing vaginal bleeding for a number of weeks. Both basically had their pregnancies terminated via natural causes, aka a miscarriage. Miscarriages are very common, and physicians estimate that between 10-15% of pregnancies end in miscarriage during the first 8 weeks. Some women may never know they are pregnant, but simply have a late period that could actually be a miscarriage.
Some miscarriages complete on their own, requiring no medical intervention. But some miscarriages might not complete fully (aka the contents of the uterus may remain) and necessitate medical intervention. The medical procedure for a miscarriage is basically the same as for a first trimester abortion.
A good percentage of the women I’ve supported in my abortion doula work aren’t actually choosing to terminate pregnancies–they are having medical procedures to treat their already-in-process miscarriages. These women are often ignored by the abortion debates which assume anyone getting what we call an “abortion” procedure is actually choosing to terminate.
Often the women who are having miscarriages in some ways need more support than those choosing to terminate. Like one woman I worked with last week, the pregnancy was very much wanted, and she was very sad to have lost it. While a woman choosing to terminate might feel relief once the procedure is over, a woman with a miscarriage might instead feel the immense sadness that comes from the reality that she is no longer pregnant.
A question remains about what would happen to these women if abortion were outlawed, or made inaccessible. Even if there were miscarriage exceptions in the law, it’s very possible that due to the burden to “prove” a miscarriage, plus the risk involved in providing the procedure, these women would be unable to get the procedure they need.
We saw the beginnings of this impact in Nebraska, where a woman was forced to carry a pregnancy to term despite the fact that they knew the child would die upon being born. For women who don’t want to go through the waiting and delivery with an unviable pregnancy, this is tantamount to torture.
In the case of early miscarriages that don’t complete on their own, we’re talking putting the mother’s life at risk–particularly if the limitations on abortion mean that doctors aren’t even learning to do these procedures.
I’ve talked before about the impacts of anti-abortion legislation on women who want to parent, and every time I work with someone at the clinic who is having an “abortion” to resolve an incomplete miscarriage, I’m reminded of this fact.
Radical Doula 
I just had a conversation with someone the other day who experienced a second trimester loss and was talking about the need for some kind of pregnancy loss doula, who would accompany a woman through the termination and/or labor process, and also be available for postpartum emotional support over the next weeks/months. It sounds like what you’re doing is part of what we were thinking about…I would love to see ways for full-spectrum doulas to get connected to women experiencing a loss, especially because some of those women will end up as hospital inpatients, vs. outpatient clinics where there might be abortion doulas available. Do you know of any organizations that focus specifically on this?
I definitely think it’s a role that makes sense Rebecca. In the Doula Project, we only interact with folks who need some sort of procedure, whether it be in the first or second trimester.
But that does mean we’re missing all of the folks who miscarry, but don’t actually need a procedure. I don’t know of any organizations that focus on this specifically.