TREATING A MISCARRIAGE IS NOT A CRIMINAL ACT!
I have seen numerous political ads on TV, recently, alleging that doctors who treat women after a spontaneous miscarriage are at risk of criminal prosecution if they surgically remove the remaining products of conception. I have even seen an ad where people who are allegedly physicians corroborate that assertion. Well, they are either confused, not physicians, or lying for political gain. Whether you’re pro-life or pro-choice is not the concern, here. It’s about telling the truth about what these ads allege. Let me set this issue straight.
First, I must address terminology:
The fetus, placenta, and amniotic fluid within a pregnant uterus are known as the “products of conception.”
“Abortion” in the context of medical practice is the term for ending, or terminating a pregnancy. The two categories of abortion are “spontaneous” and “therapeutic.”
A miscarriage is the spontaneous and unprovoked expelling of the products of conception by the uterus. The situation is called a “spontaneous abortion.” It occurs usually when something is wrong with the pregnancy.
When only part of the products of conception are expelled, parts remain that are called “retained products of conception.” This is also called an “incomplete abortion.” In other words, the pregnancy terminated spontaneously without provocation and some of the products remain in the uterus. This non-viable tissue remaining in the uterus needs to be removed ASAP or it will cause bleeding or uterine infection. It is removed during a medical procedure.
When a pregnant woman in her first trimester begins cramping and/or bleeding, the term for this is a “Threatened Abortion.” The pregnancy is threatening to terminate itself and expel the products of conception. The fetus is not viable and is threatening to abort. In this context (a miscarriage), abortion is not defined the way lay people usually think of. In this instance, it means the loss of a pregnancy as a result of a physical complication or abnormality of the pregnancy. Something has caused the fetus to expire and now the body is naturally expelling it. This is a medical complication of pregnancy that needs to be addressed. There is no liability on the part of the physician. He/she is performing a necessary medical procedure to remove the retained products of conception.
In the political context (Roe vs. Wade), abortion takes on a different definition, the second of the two categories above. This situation is called a “Therapeutic abortion.” Here, there is no known abnormality of the pregnancy, and there may or may not be a fetal heart beat. The patient, for reasons only she knows, has chosen to end her pregnancy. The products of conception are therapeutically removed from the uterus. Therapeutic abortion is the procedure most people think of as abortion and have argued about for the last 51 years.
The ads mentioned above imply spontaneous abortion and therapeutic abortion are the same. They are not! They also imply doctors could face criminal charges if they treat incomplete abortions just as they could for therapeutic abortions. There is no ethical similarity. The removal of retained products of conception from an incomplete spontaneous abortion is a well-established, legal, uncontroversial, and necessary medical procedure. There is no criminality about it, and to imply there is is deceptive and disingenuous. Treating an incomplete abortion does not have the same relevance as a therapeutic abortion. In this scenario, it is an accepted, necessary medical procedure free of controversy or political stigma. It is no different than removing an infected appendix. It has to be done.
I wish these ads would go away, or at least be honest about what they’re saying. It upsets me when politicians mislead the public into thinking a routine medical procedure that has been done every day for decades is somehow now not legitimate and is being used as a political pawn. It implies that if you have a miscarriage, your doctor may be charged for a crime if he treats you. That’s just not true. Stop, now!
They won’t, of course, but fortunately, this baloney will stop after the election November 5th.
William M. Gilkison MD
