this post was submitted on 02 Oct 2024
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The proportion of pregnancies that end in miscarriage is MUCH higher than that. Many "pregnancies" (read: fertilized ova) don't implant in the uterus or implant and fail to progress which ends up looking like a heavy period that's a little late. Judging the start of "life" as fertilization is absolutely inane because of how many fertilized ova just don't make it past 16 cells or so.
You're describing "implantation failure", which is definitely more common than 1 in 5, but it is also not considered a miscarriage and it virtually never results in a medical emergency. This is generally viewed as a failure to become pregnant, not a failure of a pregnancy.
A miscarriage is when the embryo does implant, but the pregnancy fails. This include ectopic pregnancies where the embryo is able to implant and begin growing, but the implantation occurs outside of the ovaries (usually in the Fallopian Tubes). A miscarriage is almost always a medical emergency, especially an ectopic pregnancy.
1 in 50 pregnancies are ectopic, and this is the most dangerous diagnosis you can have in a red state. The embryo remains "alive" and "healthy" (as far as the law is concerned), but it is doomed to miscarry since it is implanted outside of the ~~ovaries~~ uterus (and there is no real way to re-implant the embryo). But, because the embryo is still "alive", red state policies treat the termination of an ectopic pregnancy as an illegal abortion, so doctors are forced to wait until it escalates into a medical emergency (which it 100% will), because treating it proactively before it becomes an emergency doesn't pass the "medically necessary" requirements that Republican men with no understanding of female anatomy wrote into law.
But again, waiting until a woman is bleeding out or going septic is waiting too late, so women die.
Great write up but implantation in viable pregnancies should be occurring in the uterus, not the ovaries.
You are correct. Fixed.
I was referring to the many instances in which the blastocyst does implant, but fails to grow past the initial stages of development. Progression to the point of differentiation of tissues is the hurdle that many fertilized ova fail to clear. Failure of implantation is still important to discuss in the political context given that there are so many people with an absolute absence of biology education that think that life begins at fertilization.
I would be interested in a source on this claim, because 20% is roughly the number I'm getting from multiple reputable sources.
Regardless, pregnancy complications when the embryo is still a blastocyst isn't something that typically represents a medical emergency, so it's not really what anyone is talking about in regards to women being denied lifesaving medical care.
The issue comes from the fact that if there's any amount of implantation and the very earliest stages of development, a pregnancy test will come back positive and there are many diagnostic tests (most imaging modalities) and many procedures (such as non-obstetrical emergency surgeries) that will get delayed or sometimes even denied because of the positive pregnancy test. Every AFAB that comes through an ER that might need imaging gets a point-of-care pregnancy test that has to come back negative for something like a CT scan unless it is a very dire situation because of the radiation risk to a developing embryo.
Obstetrical procedures like abortions are not the only ones that are gate-kept for AFAB patients because of the policies surrounding risks to developing embryos or fetuses.
Edit to add: The studies do say that the estimated incidence of clinically unrecognized pregnancies is approximately 20%, but given the myriad risk factors that can feed into that outcome, things like exposures, stresses, SES, and access to medical care may increase that incidence rate in some populations.