On Friday, June 24, the Supreme Court struck down protected abortion rights, leaving individual states to immediately begin setting their own policy. While access to safe abortions is now in turmoil for millions of women, there are other reproductive health concerns impacted by the decision, one being miscarriage.

Dr. Marta Perez, who has an informative and educational YouTube channel on all things pregnancy, birth, and reproductive health, released a short video after the ruling to explain how a person having a miscarriage could be impacted moving forward.

Perez explained there are three main ways to manage a miscarriage, including using an abortion pill, a miscarriage pill, or surgery. If during a miscarriage, the body doesn’t naturally expel its contents, it can require medical intervention.

Dr. Perez’s video explains what medical management is and how abortion pills play a crucial role in helping a patient remain safe during a miscarriage. If not, prolonged bleeding, anemia, or infection can result, putting the mom’s life in danger. According to the Guttmacher Institute, more than half of all abortions in the U.S. are medication abortions.

To speed up the process when a pregnancy is no longer viable, “The most effective regimen is to use two medications, mifepristone, also known as the abortion pill, and misoprostol, also known as the miscarriage pill,” Perez explained. “Mifepristone has restrictions on its use for the sole reason of its use in elective abortion and political interference in the FDA. Therefore many prescribers may not be licensed to prescribe mifepristone, meaning that many patients do not have access to the most effective regimen and use misoprostol alone.”

Another option for managing the miscarriage process involves surgical intervention. “A D&C can be done in the operating room under general anesthesia,” Dr. Perez wrote in the Instagram video caption. “There is also a device called a manual vacuum aspirator (MVA) that allows the same treatment but does not need [operating room] equipment; it can be done bedside under regional anesthesia in an outpatient medical office. An MVA is commonly used for early first trimester abortions. Because abortion care is siloed outside routine OB-GYN care and training, many OB-GYNs are not familiar with using MVAs, so the only option may be a D&C; operating room scheduling is more complex and may take a few days or a week, delaying care.”

In states where abortion services that include mifepristone, misoprostol, and/or surgery are banned, people who miscarry and also need these treatments will be impacted. Not only is this a concern from a health and safety perspective, but prolonging the miscarriage process can cause further emotional distress to the person experiencing it.

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