How treatment of miscarriages is upending the abortion debate

For decades, the abortion wars have centered on whether a woman should be able to decide when and if she has a child. But with increasingly strict restrictions on reproductive rights being enacted across the United States, these debates are charting new, unfamiliar territory — medical care for women who have had miscarriages.

Up to one in four women who know they are pregnant will miscarry, according to the National Library of Medicine. Although most miscarriages resolve naturally, some require medical intervention that is similar to an elective abortion.

Democrats, who believe abortion led to strong outings in the 2020 and 2022 elections, are now showcasing the dangers of miscarriages as another reason to support abortion rights — and Democrats.

A seven-figure April ad buy in battleground states by President Biden's reelection campaign highlights the story of a happily married pregnant Texas woman named Amanda Zurawski.

"At 18 weeks, Amanda's water broke and she had a miscarriage," the ad reads, with white lettering against a black background. "Because Donald Trump killed Roe v Wade, Amanda was denied standard medical care to prevent an infection, an abortion."

The 60-second ad concludes "Donald Trump did this," after showing Zurawski and her husband, Josh, looking through a box of items that they had bought in anticipation of the birth of their first child, including a baby book and the outfit they planned to dress her in to bring her home from the hospital.

The Biden campaign launched this ad a day before the Arizona Supreme Court upheld a near-total abortion ban dating back to 1864, a ruling that former President Trump, the presumptive 2024 GOP presidential nominee, Arizona Senate hopeful Kari Lake and other Republicans have struggled to explain as they simultaneously celebrate the U.S. Supreme Court overturning a federal right to abortion.

But the ad also reflects a reframing of how abortion is discussed as a moral issue. Democrat Bill Clinton famously said the procedure should be "safe, legal and rare" during his successful 1992 presidential bid.

But now even liberals say the emphasis on "rare" failed to recognize the medical necessity of some abortions, such as those performed after a miscarriage. Clinton's framing also carried a connotation of shame for a woman seeking an abortion, whatever the reason.

"That framework was harmful and perpetuates stigma," said Kelly Baden, vice president of public policy at the Guttmacher Institute, a nonprofit research organization that supports abortion access. "Every situation is complex and every situation is unique. People would rather err on the side of having government stay out of it all together rather than have politicians practice medicine."

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