Across the country, abortion bans appear to have made it harder for people experiencing miscarriages to receive appropriate treatment — or even receive treatment at all — a new study suggests.

The study is the first national look at the connection between abortion bans and miscarriage care. 

“Pregnancy care is a continuum,” said Dr. Maria Rodriguez, an OBGYN and professor at Oregon Health and Science University, and the study’s lead author. “If you restrict access for one type of care, it’s going to affect all of them.”

The study, published Monday in the medical journal JAMA, tracks miscarriage care for people in states with and without abortion bans, examining tens of thousands of patient cases between 2018 and 2024. Researchers focused on miscarriages in the first trimester of pregnancy and care received by people with private insurance. 

In states that banned abortion at or before six weeks of pregnancy, patients were less likely to be given the best standard of care medication to facilitate their miscarriages: a two-drug regimen of mifepristone and misoprostol that is identical to the one used in abortions. Patients experiencing miscarriages can also be treated with a procedure known as dilation and curettage — which is also identical to the one used in abortions. 

In states with abortion bans, some pregnant patients were forced to continue carrying their nonviable pregnancies while waiting for a miscarriage to occur on its own, which in some cases can bring greater medical risks such as infections that might threaten a patient’s fertility. For some, being forced to continue carrying a nonviable pregnancy can also exacerbate the grief associated with miscarriage.

Those who received medication in states with abortion bans were more likely to receive an alternative regimen: only the drug misoprostol, which can also work to manage a miscarriage but is less effective and can have greater side effects compared to the two-drug option.

“Having helped many women through one, for a lot of them it’s like the death of hope. They have so much invested in hoping for this pregnancy,” Rodriguez said. “When it’s over, it’s devastating, and in these devastating situations that are very intimate and personal, the best thing we can do to support women is give them clear information and choices so they can handle it the way we know to be best for them.”

Since the Supreme Court’s 2022 decision to overturn Roe v. Wade — allowing states to outlaw abortion – medical professionals and pregnant patients in states with abortion bans have been sounding the alarm that those same laws were forcing delays in urgent medical care for people experiencing pregnancy complications, in some cases threatening their lives. Researchers who study reproductive health outcomes have also warned that the spread of bans could make it harder, if not impossible, for people to receive appropriate treatment for miscarriages.

Now, this study shows those fears have been realized.

States with abortion bans saw an increase of 2.8 percentage points for patients told to wait for their miscarriages to occur naturally, what doctors call “expectant management.” There was a 2.2 percentage point decrease in patients receiving medication for their miscarriages. And when miscarrying patients did receive medication, states with abortion bans saw a 13.8 percentage point increase in people being treated with misoprostol only.

This study likely underestimates the impact abortion bans have had on miscarriage care, because it doesn’t consider people insured by Medicaid, which largely covers low-income people and insures about 1 in 5 Americans, or those without coverage altogether, Rodriguez said. 

The findings underscore how heightened restrictions on medication abortion could also affect miscarriage care.

And abortion opponents have made nationwide restrictions on medication abortion a top priority, fueled by the trend of medical providers mailing mifepristone and misoprostol to patients in states with abortion bans. On Thursday, the Supreme Court blocked a lower federal court’s order that would have prevented health professionals from mailing mifepristone. 

But other legal challenges persist. Anti-abortion activists are pressing the Trump administration to impose new restrictions on mifepristone. Earlier this month, Oklahoma enacted a law making it a felony to distribute drugs used to induce abortions, even though the procedure is already illegal in the state. Missouri and Florida are also pursuing cases that seek restrictions on mifepristone. 

Louisiana has also passed a state law that classifies mifepristone and misoprostol as controlled substances — a legal classification that doctors in the state have said could threaten healthcare for people experiencing miscarriages.

“If we continue down this vein of legislating or restricting more and more women’s health, there’s going to be more and more impacts,” Rodriguez said. “There’s going to be far-reaching effects of these bans on miscarriage care.”