Miscarriage vs. Abortion: are miscarriages really abortions?

The short answer is emphatically, NO. Abortion and miscarriage as far as the common use of the words go, are not the same thing. But it is politics season and people will try their best to manipulate opinions by using a grain of truth while withholding the truth in its entirety, which ultimately results in a lie. This technique is especially effective when attached to issues that pull on our heart strings like miscarriage and abortion do.

This morning I opened instagram to find a message saying, “Did you see this post?!” The post by @_stillwerise read ” the treatment for ectopic pregnancy is abortion. The treatment for a septic uterus is abortion. The treatment for miscarriage that your body won’t release is abortion. If you can’t get those abortions, you die. You. Die.”

Nothing like a healthy dose of fear and drama mixed with lies.

Sadly, the comment section revealed woman after woman taking the bait

“OMG I was today years old, (59) when I realized that I have had two abortions…ectopic pregnancy… miscarried IVF attempt. I am in tears right now with this realization.”

“If you have retained placenta after giving birth, the treatment for that is also a DnC [sic] Aka, an abortion.”

The best way to dispel lies isn’t by simply declaring them lies and moving on. It’s by countering the lies with the truth.

According to Mirriam Webster Dictionary abortion is

1. the termination of pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus such as: a. spontaneous expulsion of a human fetus during the first 12 weeks of gestation (compare miscarriage) b. induced expulsion of a human fetus

So, there’s a broad definition and then it is broken down into variations. The first, further defined through the addition of the common term “miscarriage” the second, clearly defined as induced… chosen and only “abortion.”

Abortion is a broad term. It’s used within the medical community mainly for the sake of medical billing but with great specificity. Within the walls of a hospital no one actually has just “an abortion” and the hospital is where the rubber meets the road because those conflating abortion with miscarriage are doing so on the premise that your ability to receive care and potentially lifesaving treatment should you have an ectopic pregnancy, miscarriage or any other abnormal pregnancy issue, is in jeopardy.

Verbal differentiation of diagnosis

Within the walls of the hospital all of these things are verbally differentiated in the exact same manner the lay person differentiates them in everyday life. Your provider refers to an improperly implanted pregnancy as a tubal or ectopic pregnancy and a baby who died in utero as a miscarriage or loss. They don’t tell you “you had an abortion” they speak with specificity using the exact language you’d expect, the same language you use when you give the heartbreaking news to your family and friends.

Specificity of interventions

Additionally the provider will speak with specificity to necessary or optional interventions and treatment. They will not say “the treatment for this condition is abortion” rather they’ll tell you “we caught this in time, there is a medication we can give you so your fallopian tube doesn’t rupture”, “unfortunately, you need surgery to remove a portion of your fallopian tube”, “you can go home and wait for the tissues (baby) to pass… though it’s more unpredictable”, “you might need a D&C”, “we’ll give you medication to induce delivery”, “we could do a D&E”, “we can give you medication, there will be cramping and bleeding.” These may not be the exact phrases uttered, but they’re close and there are many options depending on the diagnosis and stage of gestation but NEVER will an honest doctor utter, “you are going to need an abortion.”

With miscarriage specifically, the hospital chart and discharge paperwork will however be the place you will see the word abortion. This is because of its attachment to coding and billing. However, again we must look at the information as a whole and again, no one goes to the hospital and has just “an abortion.” There are specifics attached to the word abortion that differentiate the exact nature of the patient admission and procedures.

Medical Coding

AAPC (American Academy of Professional Coders) in their article “Here’s the Secret to Coding Abortions: Determining the Type” recognizes and defines 9 different types of “abortion”. The word abortion is never used alone. It is always paired with one of these listed and CLEARLY DEFINED terms because definitions matter when it comes to patient care and billing for that care. Broad-brushing is not acceptable.Exactly 3 years ago today, “spontaneous abortion” is what appeared at the top of paper work when at 20 weeks, we delivered our, already with Jesus, baby boy. It stung. Even as a nurse of 15 years. Even as someone who knows I did not have an “abortion” (common use) I loved, wanted and was… still am heartbroken over his loss. Even though my going home paperwork officially read “IUFD” (intra-uterine fetal demise), it was still hard to see the word abortion on anything attached to me because of the common meaning of the word.

SPONTANEOUS abortion: An abortion that has not been induced artificially (this term is tied back to the Mirriam Webster definition 1. a. that points specifically to miscarriage).

There are two types of abortion listed that refer to a choice to terminate a pregnancy i.e. abortion (common use), a choice where the baby is alive but is purposely killed. 1. ELECTIVE abortion: Without medical justification but performed in a legal way. 2. THERAPEUTIC abortion: interruption of a pregnancy before the 20th completed week of gestation for legally acceptable, medically approved indications.

While I don’t agree with the soft language “interruption” of a pregnancy, therapeutic and elective abortions are the ones where CHOICE is attached to the definition. These are the ones that the stand alone word, abortion- in common use, refers to. These are the ones laws to protect the unborn are made to stop – primarily the elective abortion.

So, the word abortion is used in miscarriage?

Yes, in coding and billing but never alone, never without being pared with a further descriptive term. The word abortion with loss is always attached to another clearly defined word indicating exactly what happened, pointing back to the common, every day use word, miscarriage.

If there are laws against abortion, will my doctor care for me if I have a miscarriage?

Your doctor is absolutely free to continue caring for you by any necessary means should you have a miscarriage (medically coded: complete, incomplete, inevitable, missed, spontaneous abortion), ectopic pregnancy or retained placenta, in fact they would be negligent not to. If there is a doctor anywhere who is refusing these women care, which I don’t believe there is, they have not educated themselves and again, are negligent.

So, is it truthful to say someone who miscarried “had an abortion?”

Ask yourself if  giving part of the truth that is convenient to your argument on any topic while purposely leaving out details that would tear your argument down, is telling the truth… there’s only one answer, NO.

If you lost a baby by miscarriage, if you had an ectopic pregnancy or a D&C for any other reason… you did not have an “abortion.” The abortion advocate, “my body my choice” crowd hopes confuse you by using the word abortion in common everyday conversation as it is used only in medical billing and coding without adding the always present clarifying terms. Do not be confused.

The abortion advocate, “my body my choice” crowd hopes confuse you by using the word abortion in common everyday conversation as it is used only in medical billing and coding without adding the always present clarifying terms. Do not be confused.

Information is power… but you need all of the details. You can’t count on politicians or advocates of certain “rights” to give you any more than they want you to have. You must actively seek it out.

Speak Up

Lastly, if you are an OB. Speak up. There’s been so much talk about “dangerous misinformation” over the last several years. These lies spread about miscarriage are actually dangerous. Just scroll the comment section on one of these social media posts and you will find woman after woman being misled to believe they can not seek care. They deserve to know the truth, even if it ruins your ability to use miscarriages and heartbroken mothers for the benefit of elective abortion law.