By Jenny Giang-Griesser, MD
During the past six years as a family medicine physician in Seattle, providing obstetrical care has been one of the most gratifying parts of my job.
But for all the joy that comes from delivering babies, I am just as often bearing witness to the grief when it doesn’t go as planned. Each time I diagnose a miscarriage, I am forced to then compound the pain by asking patients to decide what they want to do next about their loss. Despite countless hours advising others on their options, I never truly understood the burden of my questions until I had to make the same choice for myself twice in the same year.
Recently, my own obstetrician performed an ultrasound that confirmed what I already suspected. My previously healthy fetus no longer had a heartbeat and I had miscarried two weeks prior. I was offered the same three options I give my patients when they experience pregnancy loss: Wait for my body to pass the pregnancy on its own, speed up the process with medications, or surgically remove the pregnancy. I ultimately chose medications again, so I could mourn privately at home with my husband.
Unfortunately, things didn’t go as planned.
A few days after taking the medications, my bleeding slowed, so I made plans to see a friend. I thought creating some sense of normalcy would ease the heartache of losing another deeply desired pregnancy. But shortly after stepping out of my car, I started bleeding profusely. As blood clots the size of my fist rapidly poured out of my body, my friend rushed me to the same hospital where I currently practice.
The last thing I remember in the emergency room was fainting, as blood continued to soak through my clothing and the towel beneath me. My care team later informed me that I was in hemorrhagic shock. I had lost nearly 50% of my total blood volume and my organs were showing signs of injury by the time I arrived at the hospital. Within an hour, the obstetrician on-call had seen me and reserved an operating room for the lifesaving surgery I needed.
When my miscarriage unfolded, I was confident I could access the care I needed for pregnancy loss, the same care provided for an abortion. There was no legal debate in determining if my life was in enough danger, before I could undergo the procedure I needed to save my life.
In the post-Dobbs era, over half of the country has implemented restrictions or bans on abortion care. As a result, we are repeatedly witnessing delays in care for medical complications from miscarriage and abortions. Unsurprisingly, the U.S. ranks 55th worldwide (the worst of all developed nations) in our maternal and infant mortality rates, despite the fact that we spend the most of any other country on medical care.
One thing anti-abortion discourse has successfully accomplished is confusing the general public on the differences between abortions and miscarriages. Both have nearly identical physical and emotional symptoms, and the way in which we treat both involves the same medications and procedures. Yet, our country has successfully stigmatized abortions as a morally selfish act of murder, and regards the other as a tragic occurrence out of one’s control. As a direct consequence, banning abortion care inevitably punishes women who suffer pregnancy losses as well.
Now that I’m no longer in the immediate survival period of “just getting through” my miscarriage, I’m finally starting to piece together how differently this could have ended. My experience as a physician did not protect me from requiring emergent interventions to manage my own loss, but I am fortunate that Washington state still safeguards access for abortion care.
For the families of Naveah Crain, Josseli Barnica, and Porsha Ngumezi, whose stories were also nearly identical to my own, their families are instead mourning the unimaginable death of their loved ones from pregnancy complications. It’s hard not to imagine how different the outcomes could have also been, had they lived in a state where abortion—and miscarriage—care is legal.
I wish that we didn’t live in a country where a woman’s choice over her own reproductive rights are left to the whims of leaders who relentlessly act to endanger the lives of people like my patients and myself. The reality is that pregnancy can be unpredictable and dangerous; without federal protections for abortions in place, where you live can absolutely cost you your life. Abortion care, and thus miscarriage care, is essential to the health and safety of our nation’s birthing patients and their children. I am alive today and still able to provide pregnancy care to my patients because of the state that I live in, but I fear what lies ahead for us with the current presidency.