Study Links Abortion Bans to Shifts in Miscarriage Treatment

A new study found that states with abortion bans experienced changes in miscarriage treatment patterns after the Supreme Court’s 2022 Dobbs decision. 8 percentage point rise in expectant management in those states compared with states without bans. The analysis examined nearly 124,000 first-trimester miscarriage cases from a commercial insurance database.

Data covered January 2018 to May 2022 before the decision and July 2022 to September 2024 after the decision.

Miscarriage treatment can involve expectant management, medication, or surgery. Medication management most often uses both mifepristone and misoprostol, which together produce complete expulsion of pregnancy tissue more often than misoprostol alone.

8 percentage points more likely to receive misoprostol alone rather than the two-drug protocol. The study included 14 states with bans at six weeks or earlier and 17 states without bans.

“Miscarriage is the most common complication of pregnancy, and the finding from this analysis demonstrate how vulnerable the patients are to breaks in the system,” said obstetrician and gynecologist Courtney Schreiber at the University of Pennsylvania’s Perelman School of Medicine, who was not involved in the research.

Study coauthor Maria Rodriguez, an obstetrician and gynecologist at Oregon Health & Science University School of Medicine, said the increase in expectant management was limited to states with abortion bans. She added that laws restricting abortion care affect other aspects of pregnancy treatment.

The study was published May 18 in the Journal of the American Medical Association.