Public health experts say that, in US states with abortion restrictions, women having miscarriages are no longer receiving evidence-based medical care.
Writing in a research paper published this week in JAMA, gynaecologists expressed fears that, in the wake of the 2022 supreme court decision to allow abortion bans, some doctors are afraid to prescribe medication after a miscarriage, in particular, mifepristone. Since abortion restrictions took effect in 2022, the researchers say, doctors have managed 2.2% fewer early miscarriages with medication. The number of surgical procedures did not change, suggesting that those 2.2% of women are not getting any treatment to manage their miscarriage.
The doctors based at Oregon Health & Science University, Portland, also highlight how women and girls experiencing first trimester miscarriages in abortion ban states are being treated with misoprostol only regimes – counter to best practice.
Substandard miscarriage treatment due to abortion restrictions?
Women undergoing early miscarriages usually receive a dose of mifepristone, followed by misoprostol. Doctors use the two drugs one after the other because evidence shows that that mifepristone prevents complications.
Sometimes when a spontaneous abortion – the medical term for a miscarriage, occurs, a woman’s uterus can’t clear itself out completely. This can cause complications like blood poisoning, haemorrhage or scarring that prevents future pregnancies. Women who have retained tissue after a miscarriage often need to go back to hospital for a dilation and curettage procedure to remove it.
Women who take mifepristone are less likely to suffer these potentially life-changing complications after a miscarriage and so less likely to need to have surgery further down the line.
Stats on the line
The team of doctors led by physician scientist Maria I. Rodriguez, MD, MPH1, described how they probed over 123,000 insurance claims to evaluate how policy changes have affected real world medical care that women receive. By looking at insurance records, the doctors were seeing hard data about exactly which drugs were prescribed under what circumstances without relying on anecdotes or self-reporting by medics.
They found that in states with abortion trigger bans the standard of care for early miscarriage has changed. The doctors examined claims made in states with a trigger ban between 2018 and 2022 when bans came into effect, and compared them to those made in those same states between 2022 and 2024.
They discovered that there was a 2.8% increase in women who don’t seem to have had any treatment after a miscarriage. There was a 2.2% decrease in the number of women who were prescribed medication management, and no significant change in the number of surgical procedures in the immediate aftermath.
Mifepristone Mess
In states with restrictions that prohibit abortion after six weeks gestation, the doctors found that there were 13.8% more misoprostostal only prescriptions than in states with no bans. Not only are women in those states less likely to be prescribed medication to help their bodies heal after a miscarriage, those who do get treated are being given a less effective course.
Mifepristone is the target of choice for many anti-abortion campaigners, who seek to forbid the use of this drug despite its excellent safety profile.
Read more
Rodriguez MI, Fuerst M, Schrote K. Management of Spontaneous Abortion Among Commercially Insured Individuals in the United States After Dobbs v Jackson. JAMA. Published online May 18, 2026. doi:10.1001/jama.2026.6344
