In his State of the Union address last February, President Donald Trump spun a dubious narrative about multiple new state legislations regarding abortion. 

“There could be no greater contrast to the beautiful image of a mother holding her infant child,” he began, “than the chilling displays our nation saw in recent days. Lawmakers in New York cheered with delight upon the passage of legislation that would allow a baby to be ripped from the mother’s womb before birth. These are living, feeling, beautiful babies who will never get the chance to share their love and dreams with the world. 

“And then,” Trump added, “we had the case of the Governor of Virginia where he basically stated he would execute a baby after birth.”

These statements grossly mischaracterized the two laws Trump was referring to. Most potently, Trump focused on the extremely rare cases of abortions performed after 21 weeks when, in fact, nearly 90 percent of abortions happen within the first twelve weeks of pregnancy and only 1.3 percent occur after 21 weeks.

The words of his address also misconstrued the actual text of the laws. The New York law merely decriminalizes abortion and permits abortions after 24 weeks only if the mother’s health is at risk or if the fetus is not considered viable. This measure brought New York’s state law in line with Roe v. Wade, the 1973 Supreme Court decision that legalized abortion at the federal level. 

The Virginia law Trump references did not pass, but if it had, it would have made it easier for women to access abortion services by, for example, only requiring one doctor rather than three to approve the procedure.

“Perhaps by minimizing the mother, it is easier for Trump to emphasize the futures of unborn babies, rather than having to contend with the very real mother whose future also remains untold…”

Yet on a deeper level, the president’s statements distort and threaten to entirely omit another truth. The figure at the center of these stories—the mother—appears a mostly as mute and passive player with minimal agency or emotion. The purportedly barbaric doctors and the “beautiful babies” seem more alive, more emotive than their mothers. Perhaps by minimizing the mother, it is easier for Trump to emphasize the futures of unborn babies, rather than having to contend with the very real mother whose future also remains untold—and who, even though she might have made the decision herself, is experiencing a kind of pregnancy loss.

This wasn’t the last time Trump spun such a far-fetched tale. At a rally in Wisconsin a few months later, he offered a variation of his previous reference to the Virginia law: “The baby is born. The mother meets with the doctor. They take care of the baby. They wrap the baby beautifully, and then the doctor and the mother determine whether or not they will execute the baby.” 

The mother appears here as a more prominent figure than in his first telling, though with an insidious turn: here, she is represented as brutal and barbaric, complicit even. Statements like these draw upon centuries of hardened tropes of the hysterical, manipulative, cold-hearted actions of women—of mothers, even (we need go no farther than the ubiquitous, one-dimensional “evil stepmother”).

The mother figures in these narratives of hypothetical abortions under the law appear as one of two things: an empty, passive womb or a mad, violent Medea. 

Women have abortions for a variety of reasons: financial insecurity, medical risks for mother or child, lack of partner or family support, conception following rape and incest, and more. And over half of abortions are sought by women who already have children. 

So why are there so few versions of these stories told in public view when they should be as varied as the women who experience them? Of course, shame and fear of stigmatization bar many women from telling their stories, though efforts like the popular hashtag #YouKnowMe and projects like #ShoutYourAbortion attempt to alleviate these social pressures. 

And yet, maybe stories of abortion are so few because women have not historically been the ones writing them. Instead, they have had to work within the language of a medical establishment that has chosen the terms for them, an establishment that often discounts the experiences of women.

In the modern medical world, what we now call a “miscarriage” was once referred to in the medical community as “spontaneous abortion,” related to but clinically distinguished from a medically “induced abortion.” The fact that these two processes were seen as different expressions of the same physiological process (i.e. the removal of an embryo or fetus from the womb), reflected in the shared naming, undermined the specific medical needs of women facing each kind of pregnancy loss.

Yet in 1985, at the suggestion of British gynecologist Richard Beard, “spontaneous abortion” gradually became more commonly referred to as “miscarriage” in the medical community, eventually filtering out to society more broadly. By distinguishing the two, the medical establishment could better account for the particular emotional responses experienced by women who have miscarriages, which may be distinct from those of women who have planned, induced abortions. It created a space for women to share their stories of miscarriage, an all-too-common experience that has been (and still is) too often ushered into silence.

Although the move seems progressive, the change was not made to better advocate for women. In fact, leading up to the lexical change, developments in medical technology, ultrasounds in particular, allowed doctors to clinically distinguish induced abortions from spontaneous ones, which under previous examination methods presented quite the same. Moreover, as legal sentences for women who sought abortions were lifted in the late 1960s in the U.K. and in the early 1970s in the U.S., women could speak more freely to their doctors without fear of reprisal. But since the word “abortion” still carried substantial stigma, rescuing one group of women from it and saddling the other with it was no neutral move; even Beard admitted that the term “abortion” was still “socially unacceptable.” The change in medical language merely reflected developments in medical science. The intention behind it was never to speak more profoundly to the experiences of women, in miscarriage or abortion.

In effect, the similarities between abortion and miscarriage in terms of related emotional responses, physiological processes, and possible surgical inventions (miscarriages sometimes require a surgical abortion procedure to “complete” the full removal of the uterine lining) were sharply discounted with the change in medical lexicon. 

There are certainly some differences between the experience of abortion and miscarriage, the most obvious being that one may be a choice on the women’s behalf and the other an unwelcome reality. But even the emotions can be similar. It is not uncommon for a woman to choose an “induced abortion” while also experiencing grief and pain over the decision to do so. And while relief is a common emotion felt by women who have abortions, it is also possible that women who miscarry feel similarly. In fact, in her study on miscarriage in 19th-century America, historian of medicine Shannon Withycombe found that women who miscarried felt a complex set of emotions, even relief or joy. 

“The distinction in language of ‘miscarriage’ from ‘abortion’” in the 1980s, British physician Andrew Moscrop suggests, “facilitated the splitting of two groups of women who could potentially be very differently constructed.” This history begs the question: To what extent did the medical establishment’s choice of classification deprive women who have abortions and miscarriages of the opportunity to seek alliances with each other based on the commonalities between their experiences? What might be possible politically and socially, then, if the physiological and emotional similarities between these two experiences were re-invoked? 

“The stories of women who have abortions or miscarriages are the stories of would-be mothers, connected by related physiological experiences and a matrix of seemingly contradictory emotions: grief, shame, ambivalence, and even relief.”

At a time when women’s reproductive health and autonomy are arguably being usurped and, more particularly, when fears are arising as to whether women who miscarry can be prosecuted under a new anti-abortion law in Georgia that assigns legal status to six-week-old fetuses, the answer to the question “what is in a name?” has taken on added import.

As so-called “crisis pregnancy centers” are undermining women’s health clinics in many places, the need for medically sound spaces that address women’s health is crucial. These centers are non-licensed clinics that mislead women on the consequences of abortion and sex, impede access to safe abortions, and often shame women into continuing a pregnancy they may not want. 

Perhaps the argument against the building challenge to the federal right to abortions is not only the right to bodily autonomy, but also the reminder that abortions (both spontaneous and induced) are something many people with a uterus will experience in their lifetime. Statistically, roughly one in four cis-women have an induced abortion before age 45, and the percentage of pregnancies that result in miscarriage hovers around 10-20 percent. Taken together, women who miscarry or have an abortion comprise a sizable group (even considering there is likely some overlap between the individuals represented by these statistics). 

Thinking of these two groups together could allow for more generative, dynamic, and multifaceted debates that reshape our understanding of pregnancy loss as a whole, undermining the stark misrepresentations peddled by anti-abortion advocates and offering proponents of access to safe abortions a fuller narrative that acknowledges the complexities around “choice” and speaks to pregnancy loss more broadly. In reality, some organizations, such as The Doula Project, already that take this position, but approaches like this remain largely peripheral to mainstream medical discourse.

The stories of women who have abortions or miscarriages are the stories of would-be mothers, connected by related physiological experiences and a matrix of seemingly contradictory emotions: grief, shame, ambivalence, and even relief. By emphasizing their similarities and how the history of medical language has distorted these similarities, perhaps we can insert the woman—the would-be mother—into the history and future of pregnancy loss. 

Further Reading 

Linda L. Layne, Motherhood Lost: A Feminist Account of Pregnancy Loss in America (New York: Routledge, 2003).

Margaret Sanger, Motherhood in Bondage. Columbus (Ohio State University Press, 2000).

Shannon Withycombe, Lost: Miscarriage in Nineteenth-Century America (New Brunswick: Rutgers University Press, 2018). 

Image credit: Ultrasound image. Prenatal picture of a human embryo, 4 month. Permission to upload given by the physician and the mother. (Wikimedia Commons | CC BY-SA 2.5)