Navigating the Medical System and Reproductive Care: From Legal Concerns to Treatment for Loss

Trigger warning: This post contains references to pregnancy loss, termination, and traumatic medical situations. Please use your discretion when reading. 

Pregnancy loss is a deeply personal and often heart-wrenching experience. Unless you’ve gone through it, you likely can’t even begin to imagine the emotional toll it can take. 

But what we often don’t think about is the medical aspect. Pregnancy loss isn’t just emotional, it’s also very physical, and can require medical treatment. 

Unfortunately, in a medical system that historically overlooks and under prioritizes women, pregnancy loss and reproductive care aren’t always handled well. And with restrictive legal regulations on the horizon, women are struggling to access the care and treatment they need. 

It’s a complex world—but it’s important for us to understand the legal and medical implications so we can continue to advocate for our health. 

This week on The Momwell Podcast, I’m joined by Colleen Long and Rebecca Little, authors of I’m Sorry for My Loss, to unpack the current state of reproductive care and how women are being impacted. 

‍

Medical Treatment and Reproductive Care

Coming from a background in journalism and writing, Colleen and Rebecca have seen how the legal landscape has impacted medical reproductive care, often leaving women falling through the cracks. 

They wrote I’m Sorry for My Loss to address how real people are affected by the political system and restrictive reproductive laws, especially when it comes to pregnancy loss, maternal health, and maternal mortality. 

Colleen and Rebecca believe that reproductive care is linked to all of these pieces—and that women aren’t being protected and prioritized.

Part of this is because of the political polarization around women’s health care. But political discussions often overlook the nuances and shades of grey in reproductive care. Rebecca pointed out that politics benefits from black and white language, but emotions do not. 

The reality is that pregnancy loss and termination are often complicated—and women might find themselves in situations they never planned for or envisioned. 

Politics benefits from black and white language, but emotions do not. 

Rebecca experienced this firsthand in multiple pregnancies, including having to terminate twins at 23 weeks due to a fatal heart condition. She later grappled with what to call her situation. Medically, it was defined as an abortion—a term that holds a stigma many moms don’t want to associate with. 

Colleen pointed out that the procedures used to treat miscarriage and abortion are the same—D&C (dilation and curettage), D&A (dilation and aspiration), or for later pregnancies, D&E (dilation and evacuation). 

These procedures can be risky without trained medical personnel. Rebecca said that without proper training, the risk of hemorrhage and injury goes up. That’s why it’s vital for women to be able to access quality care with trained professionals. 

The Legal Status of Reproductive Care

Legal regulations surrounding reproductive care can delay critical treatment and turn already difficult situations into dangerous ones. For instance, making abortion medications a controlled substance—often used to stop hemorrhaging—creates unnecessary hurdles. Vital minutes are lost navigating red tape when immediate access could save a woman’s life during a medical emergency.

Women in states with restrictive abortion laws might not be able to get the care they need. One woman Colleen and Rebecca met while researching their book was denied a D&C procedure because the doctors didn't know whether she had purposefully taken medication to stop the pregnancy or whether it was natural. 

‍

Legal regulations surrounding reproductive care can delay critical treatment. 

‍

Some of the most restrictive laws are “heartbeat laws” which state a pregnancy can’t be terminated once a heartbeat is detected. Colleen said these laws are tricky because true heartbeats don’t develop until much later in pregnancy. What we think of as “heartbeats” are often actually just electrical impulses, which can be detected as early as 12 weeks.  

Colleen said that this misunderstanding can lead to doctors being unable to treat women, even during miscarriages. Electrical impulses can still be flickering while the supportive tissue is being lost—but if this is legally considered cardiac activity, doctors in states with heartbeat laws can’t intervene. 

Some women are forced to carry pregnancies to term, even in cases where the fetus lacks vital organs to sustain life. This trauma takes an immense toll on their mental health. Under these restrictions, women can lose autonomy over their bodies and their health care, while doctors find themselves wondering when and how they can provide treatment. 

Reproductive Care and the Future of IVF

When the Dobbs decision overturned Roe v. Wade in 2022, many people started fearing what might happen to fertility rights. Those fears were confirmed in February 2024 when the Alabama Supreme Court ruled that frozen embryos are people. 

This ruling created confusion for patients and clinics alike. With frozen embryos now granted human rights, many IVF clinics temporarily halted treatments, unsure how to handle embryos that are not implanted.

IVF remains legally protected for now, but the future is unclear. 

Previously, women could select embryos for transfer based on viability, donate unused embryos to other families, or choose to store them indefinitely. After the ruling, there was a lot of fear and uncertainty. IVF remains legally protected for now, but the future is unclear. 

Colleen and Rebecca pointed out that when the Dobbs decision came through, politicians were buzzing, but they weren’t considering the far-reaching implications. The discussion was always centered on elective abortion. 

But reproductive care includes so much—access to contraception, fertility rights, birthing rights, and more. There’s a lot at stake, and Colleen said that the ripple effects of restrictive reproductive laws will continue to grow. 

Long-Reaching Effects for Reproductive Care

Those ripple effects impact women’s health in general as well. Colleen pointed out that while abortion has been siloed away from other health care, the laws around it affect everything. 

Doctors have to face legal questions that can keep them from acting, even in case of medical emergencies or the life of the mom. Colleen said that while politicians often blame doctors, indicating that they are choosing inaction for political purposes, the truth is that there are a lot of unanswered questions. 

‍

Restrictive laws compound the stress on women facing pregnancy loss. 

‍

Rather than facing potential jail time or legal ramifications, many doctors, especially young and upcoming ones, might relocate to other states. This could leave fewer options for qualified health care in restrictive states—not just in terms of reproductive care but for all women’s health. 

Rebecca pointed out that maternal mortality is rising—and that a lack of medical care for women in restrictive states could cause the maternal mortality rate to escalate even further. 

Ripple effects of restrictive reproduction laws also impact women’s mental health. Colleen pointed out that any pregnancy loss is difficult emotionally. These restrictive laws compound the stress on women facing pregnancy loss, creating more stigma, fear, and uncertainty around an already complex and emotional situation. 

Navigating Complex Emotions Around Loss

The discussion of reproductive care is complex, with religious, personal, cultural, medical, and legal pieces all playing a role. Meanwhile, moms are the ones struggling with the realities and coping with the effects. 

There are often a lot of mixed emotions involved in these complicated situations—and complex emotions can be hard to navigate. 

It’s important to remember that feeling multiple things at once is okay.

It’s important to remember that feeling multiple things at once is okay. You might be grieving the loss of a pregnancy that wasn’t viable, but relieved at having received treatment. You might be grappling with conflicting beliefs that countered the situation you found yourself in. You might be confused about how you even feel. 

Nothing about these topics is black-and-white or straightforward—not emotionally, not legally, not medically, and not politically. But the more of a nuanced conversation we can have (and the more we consider the long-term effects on comprehensive reproductive care), the better we can collectively advocate for women. 

‍