Objective or Subjective? Pregnancy and Infant Loss Awareness Month
October was Pregnancy and Infant Loss Awareness Month. An estimated 10–20% of known pregnancies end in miscarriage, and over one million first- or second-trimester miscarriages occur annually in the U.S. Despite this, a large majority of Americans believe that miscarriage is as rare as occurring in 5% of pregnancies. Every day there is a woman in our country receiving what might be the most perplexing news she has ever heard – the news that the growing life inside her has been halted. Without her consent and without her knowledge, her body now carries what might look like a small death from the ultrasound, but in reality, is an entire future ripped away from a unique individual and a growing family. Wanted or unwanted, the spontaneous and unexpected ending of a pregnancy can be traumatizing to women and their families. During October and throughout the rest of the year, we comfort those we love and extend love to families around the world who are suffering from pregnancy loss. And yet, when it comes to a non-spontaneous abortion (an elective abortion), our cultural heart has gone cold. We have allowed the intentionality and circumstances around the thing to change what that thing is. But the truth is, scientifically and factually, these two things are the same – spontaneous abortion (miscarriage) and elective abortion.
Roughly the same number of abortions occur in the U.S. annually as miscarriages – almost one million. That means it’s safe to say almost two million American women suffer from pregnancy loss annually. But what does “suffering” really look like? As subjective as suffering can be, it’s best that first we look at what is literally happening in the brain and the body during pregnancy loss. Immediately after pregnancy loss, the brain hormone supporting progesterone production, hCG, drops rapidly within days of the pregnancy tissue being removed. Such a sudden and sharp decline in hCG can cause fatigue, nausea, and emotional symptoms that mirror the baby blues. This can be particularly frightening considering 10–20% of women experience clinically diagnosed postpartum depression after childbirth. Technically, this emotional response is no different. In addition, the sudden loss of progesterone can cause increased irritability and anxiety. The depressive symptoms are aggravated by a sudden drop in estrogen and oxytocin, which reduces serotonin production, bringing about a truly “empty” and disconnected feeling. All of these changes are a result of pregnancy loss. It does not matter whether, culturally or personally, we see such a pregnancy as just tissue or as a growing baby; the brain feels the loss and suffers all the same.
Now let’s examine the statistics. There has been a plethora of studies done internationally on the emotional response to pregnancy loss (both elective and spontaneous), although the U.S. lacks severely in this department due to having no serious abortion reporting laws. In 2020, the American Journal of Obstetrics & Gynecology published an article by Imperial College London and Tommy’s National Centre for Miscarriage Research that showed an 85% increase in moderate to severe anxiety after miscarriage. Other studies note women being 1.5 times more likely to suffer from anxiety after miscarriage and twice as likely to suffer from depression. Parallel to this, an article published in the National Library of Medicine studying negative mental health outcomes in women who had undergone an induced abortion versus carried to term (1995–2009) found that there was an 81% increased risk of mental health problems in the case of induced abortion. Additionally, there are a variety of other U.K. studies that indicate a range of 54–80% increases in depression, suicidality, and other mental health issues in the years following an abortion.
The only real distinctions between an elective abortion and a miscarriage are procedure and intent. In the first trimester, the most common abortion procedure is a medication abortion. In a medication abortion, Mifepristone blocks progesterone, the fetus’s main source of sustenance, which makes the uterus uninhabitable. Twenty-four to twenty-eight hours later, Misoprostol causes the uterus to contract and dispel the tissue. In plain language, this type of abortion procedure essentially starves the unborn human to the point of death and then induces premature labor. Less popular in the first trimester is an aspiration or suction abortion, in which the cervix is dilated and the tissue is suctioned out via a device that resembles an electric vacuum. Further-along pregnancies require a D&E abortion, which almost exactly resembles a suction abortion, except the cervix needs to be dilated medically before the procedure. In contrast, in the case of miscarriage in the first 13 weeks of pregnancy, the body often knows exactly what it needs to do and passes the tissue naturally, although there are cases in which a D&E procedure is necessary for safety purposes. Nature is formidable and often unpredictable, and there are a number of tragically natural causes of miscarriage. Elective abortion, on the other hand, is anything but natural.
Of course, many people will argue that distinctions between the two, such as culture, context, economics, and emotional outcome, are valid reasons to cry for those who miscarry and empower those who choose to abort. In a morally constructive worldview, a mother feeling an initial sense of relief rather than heartbreak after the loss of her baby changes the loss entirely – an unborn child suddenly becomes a clump of cells, a growing human being becomes “pregnancy tissue,” and so on. As tempting as it might be to justify abortion based on how a person feels about their pregnancy, it is that morally constructivist train of logic that leads to justifying human rights violations and violence throughout history. The culture of rape or arranged marriages in other countries – should we justify certain rape or arranged marriage simply because some societies do not shudder at the thought like we do? Is it okay there but not here? Of course, these things are morally corrupt, regardless of culture or how certain parties might feel about it.
When we apply that same logic to pregnancy loss, we begin to look at abortion as moral realists. Certain things are always wrong, always sad, always morally corrupt. The death of a human being in the womb is a loss, and that loss is objective, not subjective. Between elective abortion and miscarriage, the baby is the same, the brain chemistry is the same, the outcome is the same. Furthermore, the unnatural and intentional killing of human beings in the womb should break our hearts even more.
