In my Master’s political science and communications courses, I remember learning that only 10% of Americans will pay attention to decision days as SCOTUS delivers its opinions to the nation. Over the past two weeks, that statistic hasn’t rung true. Looking at my own social media feed and talking with others, I’ve seen the wide valley of responses to overturning Roe v. Wade range from despair and rage to joy. 

In those conversations, there tends to be quite a bit of limited black and white thinking. Even though the data shows that a typical abortion patient is already a mother in her late 20s (often living off of a low income and is within her first 6 weeks of pregnancy), that doesn’t paint the full picture of who needs to access abortion procedures for medically necessary, life-saving.

The word “miscarriage” is a bit more palatable to talk about than “abortion.” I get it – abortion has been a politically charged issue for more than three decades. In my conversations with others, what became very clear from the start is that we’re not using the common medical language for the many variables that can happen at any point in pregnancy. And since one in four pregnancies end in miscarriage, it’s as much a part of this debate in letting states decide what is best for women’s bodies. So, let’s talk about it. 

The most common type of miscarriage is medically deemed a “spontaneous abortion” (ah, there’s our trigger word). It’s defined as a pregnancy that ends in fetal death before 20 weeks because of a lack of development. Because our nation is lax in funding research into women’s health issues, we often don’t know why our bodies spontaneously abort a pregnancy. Sometimes the body naturally carries out the process itself, but there are often tissue and problems that remain in the uterus. If that’s the case, a D&C (dilation and curettage) is needed to clear so that there’s no infection or sepsis. 

A “missed or incomplete abortion” is when the pregnancy no longer progresses, but the body never expels the tissue. It could take weeks for a person’s body to complete the cycle, ushering the same complications as a spontaneous abortion should things become infected. The same procedures are needed – misoprostol or a D&C. 

I’ve had one of both, a spontaneous and a missed abortion. Our spontaneous abortion was last fall, something that was more traumatic than I realized. It required three follow-up visits to ensure that I passed all the tissue. If I hadn’t, I’d need a D&C. Our first miscarriage before Brendan was a missed abortion. We found out at our eight-week ultrasound appointment that there was no heartbeat. And yet, the babe wasn’t going anywhere. My three options: wait it out, take misoprostol, or schedule a D&C. I chose (keyword: chose)  to wait it out at first but kept a script of misoprostol handy just in case, and I cannot understate the immense toll that waiting took on me and my husband’s emotional and mental health. It was too much, and knowing that the misoprostol can also take days to take effect, I chose a D&C. When I went in for my appointment, doctors commented that they were starting to see signs of infection and I made the best choice for my body at that moment. 

Was the choice easy? No, it was devastating. Was it necessary for my health? Absolutely. I’m fortunate to live in Washington state, one that recognizes it is my right to choose what’s best for my body. I know that choice is now in jeopardy for more than 65 million women living in states with trigger laws. As a person who gives birth, I cannot imagine anyone facing a decision to terminate a pregnancy for any reason walking into it lightly. I don’t think they skip into the doctor’s office, eagerly awaiting their appointment with joy, even though that is what is portrayed by some anti-abortion messages we consume.  From the people I know who have chosen abortion, it’s a very heavy decision. For me, even though my child didn’t have a heartbeat, it was a very fraught decision because I continually questioned what was best. Are they sure they didn’t see a heartbeat? What happens if it was a fluke? What happens to my chance at future children if I don’t go through this? 

But that’s the thing: I could choose what was best. I had the power over my own body to make that medical decision. That same autonomy would be vital if I experienced an ectopic pregnancy, a situation even more harrowing and potentially fatal than what I experienced.

I wonder if our perspective would change if those on both sides could also see the data around miscarriage and necessary medical procedures. If we included the 25% of women who experience miscarriage and their route of solving the issue, could we find common ground? Could we see that allowing people to make the best decision for their own bodies would be the best course of action? Or would it lead us into further divided discussions, keeping in mind that this only discusses the miscarriages before 20 weeks of gestation and doesn’t even touch pregnancy loss – those deaths that occur after 20 weeks,

As someone 30 weeks into a high-risk pregnancy, I was terrified of what choices I would have if this pregnancy turned south. In Washington, I’m protected until 22-25 weeks of pregnancy, and then it’s another complicated issue if I have to deliver early for any reason. For those who aren’t as far along, women are closely considering – with fear and trepidation – what would happen if they were to travel and have pregnancy complications while in a trigger law state. Jo Piazza’s piece in Marie Claire covers that very well, and it’s chilling that it’s something that she and many others didn’t have to think about more than a week ago.

As with any hot-button issue, there are more than two sides to consider. In the case of overturning Roe v. Wade, the considerations are wide-ranging and not cut and dry as many like to describe. Like many issues in our country, folks standing firmly on either side tend to turn a blind eye to the middle area, to the murky shades of grey and in-betweens. The stories of miscarriage, ectopic pregnancies, complications, and how the ability to choose has intersectional impacts on more than just the vague ‘morality’ of our nation. It’s a class issue, an economic issue, and most importantly, an equality issue. It’s a matter of basic healthcare. I hope more of us turn an eye into the grey areas as we find a way to stumble forward. 

The featured image in this article is by Stephen Andrews.

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