The June 28, 2022 piece by Rita Rubin in the Medical News & Perspectives section of JAMA, “How Abortion Bans Could Affect Care for Miscarriage and Infertility,” presents a one-sided narrow view of the potential impact of the U.S. Supreme Court’s ruling on women’s reproductive care, specifically the management of miscarriages and advanced reproductive technologies.

The author interviewed several Planned Parenthood physicians, including Dr. Jennifer Villavicencio who stated: “Laws like abortion restrictions and bans are not based in science or evidence, and therefore the language does not coincide within the practice of the highest-quality, evidence-based care.” It must be said that the 1973 Roe v. Wade decision was clearly not based upon science. It was struck down because it was not constitutional and should never have been approved. Further, while the medical literature is loaded with studies in peer-reviewed journals documenting long-term risks associated with induced abortion, there is a paucity of evidence demonstrating any benefits.

Hypothetical concerns were raised about women’s access to miscarriage care, physicians facing criminal charges for treating patients with miscarriages, access to mifepristone for treating miscarriage and anecdotal reports of patients failing to receive care. It’s helpful to give some context to inform this discussion: more than 90 percent of practicing OB/Gyns do not perform induced abortions. This speaks volumes about what the vast majority of OB/Gyns consider an essential part of women’s healthcare. Induced abortion is not healthcare. It does not promote the well-being of either patient, and it has no place in the practice of medicine. From the time of Hippocrates, there was a clear understanding that the intentional killing of another human being was a violation of medical ethics. This included the life of the unborn baby in the womb. Induced abortion does not treat a disease—pregnancy is a normal healthy process unique to womankind. Most of the concerns raised in this article won’t affect the majority of obstetricians.

American College of Obstetricians and Gynecologists (ACOG) President Iffath Abbasi Hoskins, MD, FACOG, is quoted as saying: “[The Court’s June 24 decision is] going to have a devastating effect on every aspect (emphasis added) of a woman’s health care including if she is miscarrying.” The author did not provide any substantive evidence to support this assertion, which seems like a broad overstatement for the majority of practicing OB/Gyns.

The author opines that women’s access to proper care for the management of miscarriage has been compromised by the Dobbs decision and that “restrictive state abortion laws had a chilling effect on management of patients with miscarriage because spontaneous abortions can be difficult to distinguish from induced abortions.” The practice of medicine surely has clinical conundrums, but diagnosing a failed pregnancy is usually not one of them. Taking the time to perform a proper evaluation, including repeat ultrasound exams and serial beta hCGs, as indicated, typically results in a definitive diagnosis. Even pro-choice activist ACOG cautions practitioners in its Practice Bulletin on Early Pregnancy Loss, “Treatment of an early pregnancy loss before confirmed diagnosis can have detrimental consequences, including interruption of a normal pregnancy, pregnancy complications, or birth defects. Therefore, a thorough evaluation is needed to make a definitive diagnosis.”

The JAMA article raises concerns that doctors will be reluctant to treat a miscarriage surgically or medically for fear of legal repercussions. The U.S. Supreme Court decision was solely focused on induced elective abortion. Its reach simply does not extend to nonviable pregnancies. Despite the distress and anxiety expressed in the JAMA piece, the options available to practicing obstetricians for managing miscarriages are likely to remain unhindered under the new ruling. However, may abortion providers face increased scrutiny? That is certainly possible and not altogether surprising, following abortion advocates rhetoric to “never stop” and elected officials pledge to defy laws to defend abortion access.

All OB/Gyns are trained to manage miscarriage. Residency programs in obstetrics and gynecology train all physicians how to surgically evacuate a pregnant uterus. Individual physicians are permitted to opt out of procedures that involve ending a viable pregnancy. However, the surgical technique for treating a spontaneous abortion and induced abortion is the same. The difference is not about the mechanics of the procedure but about the circumstances in which it is applied. A world of difference exists between ending the life of a living embryo and simply removing what remains of a deceased embryo. If practitioners rely upon standard diagnosis and treatment options for miscarriage, it seems highly improbable there would be any grounds for claims of performing an abortion and associated legal repercussions.

The JAMA article fails to consider a broader perspective on the everyday management of miscarriage and is attempting to create a stir over what is essentially a non-issue. Physicians will not be impeded from providing routine care for miscarriage, be it expectant, medical or surgical management.

The author raises concerns about how assisted reproductive technologies might be affected by the end of Roe. Clearly, the Supreme Court’s decision in Dobbs does not address infertility treatments, including the handling of embryos. However, it is reasonable to expect that states where abortion is limited or no longer legal will likely pursue legislature to eliminate the immoral handling of human embryos, including selective reductions.

Personhood bills, if passed, may further impact in vitro fertilization (IVF) clinics and labs. This is a complex and sensitive issue. IVF has been a part of American culture for decades. As Christians, we seek the wisdom of Scripture and God’s guidance in all we do and think.

One last issue bears comment: there is no such thing as pregnant “people,” as only women can become pregnant. The author’s use of this kind of language is an example of the disinformation being propagated to confuse the public and obfuscate biological truth. Anyone who has ever delivered a baby knows full well that the only laboring “people” are females—from their chromosomes to their naturally possessed internal organs. Women are endowed with the unique ability to carry and give birth to another human being. This is a marvel!