US abortion restrictions are hindering access to miscarriage care, study finds

Abortion restrictions in the US have made miscarriage care harder to access. After the June 2022 Dobbs decision overturned Roe v Wade, pregnancy care became divided by state lines. In states where abortion bans took effect, miscarriage management shifted away from medications, particularly mifepristone, and toward expectant or wait-and-see approaches. This reduced patient options and fell below US standards of care. A study of 123,598 privately insured patients found that trigger-ban states had a 2.8 percentage point increase in expectant management and a 2.2 percentage point decrease in medication management. Medication-treated patients in ban states were more likely to receive misoprostol-only treatment, which is considered safe but is not the standard of care in the US.

"Since the June 2022 Dobbs v Jackson Women’s Health Organization decision overturning Roe v Wade, pregnancy care has fractured along state lines; it’s getting increasingly harder to access healthcare for miscarriages in US states with abortion restrictions. In states where abortion bans went into effect following Dobbs, miscarriage management is shifting away from medications, especially mifepristone, and toward a wait-and-see approach, restricting the options for patients experiencing miscarriages and falling beneath standards of care in the US."

"The study, published by the Journal of the American Medical Association on 18 May, looked at a total of 123,598 people with private insurance. Some 54,181 of the patients lived in states with restrictions on abortion after six weeks that were triggered by the Dobbs decision, while 69,417 lived in comparison states. States with trigger bans saw a 2.8 percentage point increase in expectant management meaning more patients were sent home to wait and see what would happen with their miscarriages and a 2.2 percentage point decrease in medication management meaning fewer people were prescribed standard-of-care medications for managing miscarriages."

"What we found was that people had fewer choices to the type of care they got, and they were receiving lower-quality care as well. “We wanted to understand how, when you restrict access to abortion, that might affect people who are having a pregnancy loss or an early miscarriage,” said Maria Rodriguez, lead author of the study, professor of obstetrics and gynecology, and director for the Center for Women’s Health at Oregon Health & Science University."

"Patients who were prescribed medication, but lived in ban states saw a 13.8 percentage point increase in misoprostol-only treatment, which is safe but is not the standard of care in the US and may"

Read at www.theguardian.com