{"id":754,"date":"2024-09-24T07:37:00","date_gmt":"2024-09-24T07:37:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=754"},"modified":"2024-09-24T07:37:00","modified_gmt":"2024-09-24T07:37:00","slug":"miscarriage-or-abortion-the-crisis-in-14-states-post-dobbs","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=754","title":{"rendered":"Miscarriage or Abortion? The Crisis in 14 States Post Dobbs."},"content":{"rendered":"<p>By MIKE MAGEE<\/p>\n<p><em>\u201cWhat did they know, and when did they know it?\u201d<\/em><\/p>\n<p>These are the questions Americans have become accustomed to asking of their leaders, dating back to Nixon and extending to Trump, and all Presidents in between. But now the same questions have surfaced, to the extreme discomfort of conservative Justices, as death and destruction of lives begins to mount in the wake of the Dobbs decision.<\/p>\n<p>As predicted, graphic cases of young women bleeding out in parking lots after being refused life-saving acute care for miscarriage in\u00a0<a href=\"https:\/\/reproductiverights.org\/maps\/abortion-laws-by-state\/\">14 states<\/a>\u00a0across the nation are being documented and described. These stories are not only affecting the lives of couples across the land, but also threatening the \u201cpolitical lives\u201d of downstream Republicans facing an upcoming election.<\/p>\n<p>The responsible\u00a0Supreme Court Justices (Alito, Thomas, Gorsuch, Kavanaugh, and Barrett) and their legions of Ivy League clerks had scoured the literature far and wide before making the decision to eliminate women\u2019s reproductive freedom in the U.S. and inflict lasting harm to their life-saving relationships with their local doctors.<\/p>\n<p>Their review had to include Blue Cross &amp; Blue Shield\u2019s timely publication,\u00a0\u201c<a href=\"https:\/\/www.bcbs.com\/news-and-insights\/report\/trends-in-pregnancy-and-childbirth-complications-in-the-us\">Trends in Pregnancy and Childbirth Complications in the U.S.<\/a>\u201d\u00a0That report, surveying over 1000 pregnant women ages 18 to 44 in April, 2020, was, in part, designed to understand the impact the Covid epidemic had had on prenatal care nationwide. But what it revealed was that pregnancy complications were up 16% over prior years, in part due to \u201csocial barriers such as availability of appointments, lack of transportation or nearby providers.\u201d<\/p>\n<p>A comparison of 1.8 million pregnancies in 2014 versus 2018 demonstrated a severely compromised women\u2019s health support system. 14% did not receive prenatal care in their first trimester, and 34% missed scheduled prenatal visits with 1 in 4 of these suffering complications in pregnancy. The BC\/BS summary \u201cunderscores the importance of focusing on the health of pregnant women in America, especially as health conditions increase in this population\u2026\u201d<\/p>\n<p>The Conservative Justices were forewarned. Yet they still elected to throw fuel on a maternal health system which was already in flames. They were also aware of a 2021 study that confirmed that miscarriage was\u00a0<a href=\"https:\/\/www.webmd.com\/baby\/features\/why-black-mothers-higher-risk-miscarriage\">43% more likely in Black women<\/a>\u00a0than in their white counterparts.<\/p>\n<p>On\u00a0<a href=\"https:\/\/www.politico.com\/news\/2022\/05\/02\/supreme-court-abortion-draft-opinion-00029473\">May 2, 2022<\/a>, Justice Alito and his allies engineered the release of a draft of a majority opinion in part to freeze attempts by Chief Justice Roberts to secure a compromise. The leaked document labeled<em>\u00a0Roe v. Wade<\/em>\u00a0\u201cegregiously wrong from the start.\u201d\u00a0 As predicted, the ruling spawned chaos.\u00a0 When 14 Red states established total bans on all abortions, miscarrying women seeking help in ER\u2019s literally had to fight for their lives. Their doctors were criminalized. Was this an abortion gone bad?<\/p>\n<p>A miscarriage, or pregnancy loss before 20 completed weeks, is not an uncommon affair. Approximately 15% of pregnancies end in miscarriage, mainly the result of chromosomal or genetic abnormalities. That amounts to some\u00a0<a href=\"https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db507.htm#:~:text=The%20number%20of%20births%20and%20the%20general%20fertility,(3,667,758)%20and%202021%20(3,664,292)%20(Figure%201,%20Table%201).\">540,000 women<\/a>\u00a0in crisis, which most believe is under-counted.\u00a0<a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/9688-miscarriage\">80%<\/a>\u00a0of miscarriages occur in the first 13 weeks of pregnancy.<\/p>\n<p>25% of pregnant women experience some\u00a0<a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/25055-threatened-miscarriage\">vaginal bleeding<\/a>\u00a0in the first trimester. For most (6 in 10) this is self-limiting and they go on to deliver a healthy baby. But for 4 in 10 (or 10% who present with bleeding) they go on to miscarry. All pregnant women who experience vaginal bleeding in early pregnancy need to have a medical examination. Doctors and midwifes check blood work, perform a physical examination, and do an ultrasound examination.<\/p>\n<p><a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/9688-miscarriage\">Most pregnancy loss<\/a>\u00a0(95%+) occurs before 20 weeks gestation. If miscarriage occurs before 13 weeks, there is a good chance of clearing the blood clots and uterine tissue with medication and no surgical intervention. But if bleeding is severe, or the loss is occurring beyond 13 weeks, dilation and curettage (D&amp;C) is both necessary and at times life-saving. Under anesthesia, the cervix is dilated and any remaining pregnancy-related tissue is gently scraped and suctioned from inside the uterus. Patients are then closely monitored for several weeks for any evidence of continued bleeding or infection.<\/p>\n<p>What did the Justices know, and when did they know it?<\/p>\n<p>They knew that Miscarriages were a medical emergency and exceedingly common.<\/p>\n<p>They knew that 80% occur during the first trimester, and that existing state abortion laws on the books would restrict access to acute life-saving treatments in 14 states.<\/p>\n<p>They knew that pregnancy loss was far more common in non-whites and in rural underserved communities.<\/p>\n<p>They knew that the medical community opposed overturning Roe v. Wade in overwhelming majorities, and predicted maternal loss of life if the Justices proceeded.<\/p>\n<p>They read, two years after their deadly decision, the Commonwealth Report which stated that \u201cThe United States continues to have the highest rate of maternal deaths of any high-income nation, despite a decline since the COVID-19 pandemic. And within the U.S., the rate is by far the highest for Black women. Most of these deaths \u2014 over 80 percent \u2014 are likely preventable.\u201d<\/p>\n<p>They knew all this, and they did it anyway.<\/p>\n<p><em>Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of <a href=\"http:\/\/www.codeblue.online\/\">CODE BLUE: Inside America\u2019s Medical Industrial Complex<\/a><\/em>. (Grove\/2020)<\/p>","protected":false},"excerpt":{"rendered":"<p>By MIKE MAGEE \u201cWhat did they know, and when did they know it?\u201d These are the questions Americans have become accustomed to asking of their leaders, dating back to Nixon and extending to Trump, and all Presidents in between. But now the same questions have surfaced, to the extreme discomfort of conservative Justices, as death&#8230;<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-754","post","type-post","status-publish","format-standard","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/754"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=754"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/754\/revisions"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=754"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=754"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=754"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}