The most jarring part of my miscarriage was learning what doctors call it: spontaneous abortion. My body was doing something entirely natural, and it shared a name with one of the most contested medical procedures in the country. I started wondering what that would mean in a place where abortion is illegal. How would I prove my body did this on its own?
I went looking for answers and found that the medical world is already uncomfortable with the term. Many American professional organizations now recommend “miscarriage” or “intrauterine pregnancy loss” instead. The language is changing because patients experience the old term as stigma. But it is also changing because the stakes are no longer theoretical.
Miscarriage is the most common complication of early pregnancy. Roughly 10% to 20% of clinically recognized pregnancies end in early pregnancy loss, and that figure likely underestimates the true rate, since many losses are never diagnosed. Studies that tracked hormone levels daily estimate a higher incidence of about 38%.
The word “recognized” matters. Many losses happen before a person knows she is pregnant. Others happen in the weeks when she has been taught to tell no one. About 80% of miscarriages occur in the first trimester, according to the American College of Obstetricians and Gynecologists (ACOG).
The cause is usually chromosomal. It is not something the pregnant person did. It is also very hard to determine afterward. ACOG itself says it is difficult to determine the cause of a miscarriage or stillbirth. I know this from experience: after mine, nobody could tell me why it happened or how to avoid it next time.
Hold onto that fact, because everything below depends on it. A miscarriage is common, usually unexplainable, and looks medically similar to other outcomes. That combination makes it dangerous when the law treats pregnancy loss as potentially criminal.
Pregnancy Justice, a legal group that tracks these cases, found something alarming. In the first year after Dobbs, from June 2022 to June 2023, 210 people faced criminal charges for conduct associated with pregnancy, pregnancy loss, abortion, or birth. That was the most the group had found in a single year since it began tracking.
Twenty-two of those cases involved pregnancy loss. That means miscarriages, stillbirths, or the deaths of babies born prematurely.
It is worth being precise about what this does and does not show. Most of these women were not charged under abortion bans. They were charged under existing statutes such as homicide, abandonment of a body, and abuse of a corpse. Pregnancy Justice also cautions that it can’t say whether the increase reflects a changed legal climate or better counting. The researchers suspect it may be both.
But the report’s central finding is the one I want you to remember. The majority of cases occurred in states that have written fetal personhood into their civil and criminal laws. Alabama alone accounted for 104 of the 210 cases. The report puts it bluntly: without fetal personhood, pregnancy criminalization could not exist.
If a fertilized egg is legally a person, then every pregnancy loss is the death of a person, and deaths of persons get investigated. When the cause of a miscarriage is usually unknowable, investigators are left with only the woman’s behavior to scrutinize.
In 15 of the cases, the supposed evidence included a failure to get prenatal care. Think about that in the middle of a maternal health care crisis. Not being able to reach a doctor becomes evidence of a crime.
More than 90 percent of the cases involved statutes that don’t require prosecutors to show any harm to a fetus, only that a woman’s conduct posed some risk to her pregnancy. That is a very low bar for someone’s freedom.
Amari Marsh had a miscarriage at home in March 2023. She was scared and didn’t know what was happening. Prosecutors eventually charged her with murder by child abuse, which carries 20 years to life. She spent three weeks in jail and 13 months on house arrest with an ankle monitor before a grand jury cleared her.
Experts say that in pregnancy loss cases, serious charges are often dropped or reduced after autopsies, but by then many of the harms of incarceration have already occurred. Being cleared eventually does not give back the weeks in jail or the year with a monitor on your ankle.
Moira Akers of Maryland is another example. She was sentenced to 30 years for murder after a stillbirth. Prosecutors relied on a “lung float test,” along with her internet searches about abortion and her decision to skip prenatal care. Medical examiners say the lung float test is deeply flawed. In February 2025, the Maryland Supreme Court ordered a new trial.
The harm also reaches medical care. Miscarriage is sometimes dangerous. When a pregnancy has failed but the tissue is not passing, infection is a risk. Septic miscarriage is rare, but it is a recognized complication. When doctors and hospitals fear legal exposure, women can wait too long for treatment. One woman, Brittany Watts, says she waited hours without treatment on two separate hospital visits before leaving, and then ended up in jail after returning in need of care. Her claims are part of an ongoing lawsuit, so I’ll note they are allegations.
The idea that life begins at conception sounds ancient, but as official church doctrine it is surprisingly recent. Greek thinkers disagreed about it. Some held that life begins at birth, and the Pythagoreans leaned toward conception. Aristotle argued that a human soul arrives only weeks into a pregnancy, at about 40 days for a male embryo and later for a female one.
That view shaped Christian thought for centuries. Augustine, Jerome, and Thomas Aquinas are among the theologians who believed life began at a later point, called quickening or ensoulment. English common law followed a similar line. Abortion before quickening was not an indictable offense.
To be fair, the church condemned abortion throughout this period. Even theologians who accepted delayed ensoulment, like Aquinas, still called abortion a grave moral evil. The difference was in how it was treated. Before ensoulment it was not considered homicide.
The shift came in 1869. Pope Pius IX issued a declaration imposing the most severe penalty on all abortions, which is regarded as erasing the distinction between animated and unanimated fetuses and effectively decreeing that life begins at conception. Not much is known about his reasoning. Even then, the Vatican later stated that its moral teaching did not depend on settling when the soul enters the body. A 1974 declaration explicitly set that question aside.
So for most of recorded history, “life begins at conception” was one view among several, including inside the church that now champions it. Fetal personhood laws take a belief that was formalized less than 160 years ago and write it into criminal statutes.
Fetal personhood laws take a woman in the middle of a traumatic medical event and treat her like a suspect instead of a patient. And when the loss is over, she often gets no answers.
Medical guidance now supports evaluation after two losses instead of three. The American Society for Reproductive Medicine’s 2026 update recommends chromosome testing of the miscarriage tissue as a first step. That means a person who has one miscarriage typically gets no workup at all. And even after testing, more than half of patients with repeated miscarriages may never learn the cause.
What we do know points away from blaming the woman. Roughly half of first-trimester miscarriages involve an embryo with the wrong number of chromosomes. Even if a woman’s own biology plays a role in a miscarriage, it isn’t hers to answer for. The eggs she carries began forming before she was born, built from genes she inherited and in a body that her mother’s body nourished. She had no choice about her genetic material, and no control over the conditions in which it developed. Research suggests many eggs are predisposed to chromosomal errors from the earliest stages of their development. No one can be held responsible for the quality of material they never chose and never controlled. Sperm can contribute too, and sperm DNA fragmentation testing can be considered for otherwise unexplained recurrent loss. Yet the story most women absorb is still that they must have done something wrong.
That silence has a cause. The National Institutes of Health has historically underfunded miscarriage research, and private funding has been limited. The lack of research has reinforced a culture of silence and shame around miscarriage.
Now consider the argument made by people who say life begins at conception. When every conception is counted, including the ones lost before anyone knows, natural loss far outnumbers voluntary abortion. Even a pro-life training site concedes that miscarriages cause many more deaths than induced abortions, on their own view of life. Some pro-life thinkers answer that abortion is morally different because it is deliberate and preventable. That is a real argument, but it doesn’t explain the silence. If you truly believed that most human lives are lost to miscarriage, you would be demanding research, testing, and answers.
Instead, the energy goes toward laws that make a woman who has lost a pregnancy a possible suspect. If you believe life begins at conception, ask where the movement is on the majority cause of lost conceptions.
