Enforcing Death Rituals after Miscarriage is Just Plain Cruel
The Indiana legislature claims it wants to protect unborn children and their parents. Last week Governor Mike Pence gave his blessing to a new bill aimed primarily at restricting abortion but also addressing miscarriage, explaining, “I sign this legislation with a prayer that God would continue to bless these precious children, mothers and families.” But knowing what I do about pregnancy and miscarriage, all I can see is increased pain and confusion in store for women who lose pregnancies in Indiana.
Previously, Indiana had a law that required hospitals to offer women who miscarried at the hospital the option of burying or cremating the remains as an alternative to disposing of the remains as medical waste. That strikes me as respectful of women’s diverse experiences with miscarriage. If a woman feels that that is the most appropriate response to her loss, she should have our support.
The new law, however, requires hospitals to bury or cremate miscarriages no matter what stage of gestation they occurred, no matter the wishes of the woman who miscarried. This is a clueless, medically ignorant rule with incredibly problematic implications. In effect, this is stomping all over women who may very well be mourning the loss of wanted pregnancies, in order to make a political point about abortion. It is unconscionable, no matter which side of the abortion debates you are on.
Let me explain why.
First, early pregnancy loss is a normal part of healthy childbearing, and a huge proportion of us will have to endure at least one as part of building our families. About 20% of recognized pregnancies miscarry, mostly in their early months. A third of American women will have a miscarriage along the way, by the time they are finished having children.
While some women find it comforting to think of their early miscarriages as babies who have died, many of us find that way of interpreting early pregnancy loss to be emotionally traumatic. Some women who miscarry give up on having families at all because they are too afraid to face another loss. I think we can all agree, across the pro-choice/pro-life spectrum, that that’s a terrible outcome.
Second, a law like this appears incoherent, even menacing, when you actually understand how pregnancy works. Identifiable pregnancy losses are only the tip of the iceberg. About half of fertilized eggs do not implant. They are swept away with the menstrual flow. Some of the remaining half implant briefly, but do not survive, and are miscarried in what look like slightly late menstrual periods. Another portion are lost as recognizable miscarriages that women can manage at home. A much smaller number are lost later in pregnancy, and require medical care.
All told, around 70% of conceptions do not become full-term babies, even without abortion.
Nearly all of us who have had children have lost at least a few conceptions this way, whether we know it or not. It is an inevitable part of having children. If we believe that hospitals need to bury every miscarriage, what about the pregnancy losses that women manage at home? Will women be required to submit to medical surveillance if they suspect they are miscarrying? Will the next law require me to account for and formally bury the remnants of any menstrual period in a month when I didn’t use birth control?
An Affront to Personal Judgment
Third, even recognized miscarriages often do not work the way the Indiana legislature has pictured. My first pregnancy miscarried at 11 weeks. But on the ultrasound, the obstetrician showed me a “blighted ovum,” which is an empty gestational sac. The doctor estimated that the embryo had stopped developing at about 6 weeks. My body had reabsorbed it, but my uterus had not yet gotten the hormonal message that the pregnancy was finished. If I had to lose that pregnancy, I was at least comforted that my body had taken care of my embryo in a way I found beautiful and fitting. Under current Indiana law, would the hospital that did my D&C have required me to bury the empty sac as a deceased person? I would have found that an extraordinarily offensive affront to my religious judgment and the wisdom I recognized in my body.
Miscarrying a wanted pregnancy is bad enough, and emotionally complicated enough, without state interference. The Indiana legislature needs to butt out.
If pro-life legislators actually care about women who miscarry wanted pregnancies, and they want to support family-building, they need to show it by adopting anti-abortion rhetoric that does not traumatize women who miscarry. It is one thing to be against abortion, and believe that the process of human generation ought to be respected. It is another to declare that a fertilized egg is a baby. That rhetorical and philosophical stance is untenable and irresponsible, and the people it hurts the most are women trying to build families.
Lara Freidenfelds is a historian of health, reproduction, and parenting in America. She is the author of The Myth of the Perfect Pregnancy: a History of Miscarriage in America and The Modern Period: Menstruation in Twentieth-Century America. Sign up for her newsletter and find links to her op-eds and blog essays at www.larafreidenfelds.com.