Miscarriage and "abortion" terminology

[2xx1xy1JD]

In my state of paranoia following my first miscarriage, I was scared that someone would see my chart with the words "missed abortion", and jump to the wrong conclusion in ignorance.

Apparently, I'm not the only one who has had a reaction to the terminology:

http://community.babycenter.com/post/a2 ... d_abortion

http://www.whattoexpect.com/forums/grie ... orter.html

Common terms include:

Missed abortion [type of miscarriage where the fetus is not expelled and needs to be surgically removed]

Threatened abortion [vaginal bleeding where miscarriage is a possibility, but the fetus is still alive]

Habitual aborter [someone who has had 3 or more miscarriages]

Now, since stupid and hateful can form a bad combination - are there any documented cases where pro-lifers mistakenly targeted women based on these terms being in their medical charts?

[notsocommon]

The only people who should be looking at a medical chart are those who have an authorized reason to do so, then the contents are to be kept strictly private. You can rain all kinds of hell diwn on someone who blabs your meducal info.

Also, I would hope that a medical orofessional knows what those terms mean

[maybeizfundie]

Where would they get access to the charts?

Undoubtedly some people are ignorant that the term is used for miscarriage, but IME those who are pro-life activists are aware of this. I know many women who are pro-life and have experienced miscarriage, and really dislike the abortion terminology applied to them, because their loss was not a choice or an intentional termination. Personally, I have "habitual aborter" on my chart, referring to my several miscarriages, and I don't like it, but it is what it is. Those are the words they use, no point dwelling on it.

[2xx1xy1JD]

The rational side of my mind realizes that medical charts are protected by privacy laws.

What makes me paranoid, though, are the ways in which privacy can be violated, and how someone who is both hateful and stupid can misuse information.

How did Operation Rescue get access to the charts of that doctor in Kansas? How did that person on LifeSiteNews supposedly know the details of a woman aborting twins?

[devilsadvocate]

The only people who should be looking at a medical chart are those who have an authorized reason to do so, then the contents are to be kept strictly private. You can rain all kinds of hell diwn on someone who blabs your meducal info.

Also, I would hope that a medical orofessional knows what those terms mean

Yeah, some random person finding your medical chart would be a major violation of HIPAA. The privacy of medical records is taken very seriously these days and there can be heavy fines if medical records aren't kept private on a "need to know" basis.

How do pro-lifers find out about doctors that they end up investigating for botched abortions or other allegations of misconduct? Through observing things like when an ambulance shows up at the clinic, talking to patients and their families or other people who know of the situation, etc. They don't necessarily have the patient's actual chart when they're making complaints to the medical licensing boards and such.

I'm a pro-lifer and I have known for a long time that "abortion" is just a medical term for the end of a pregnancy. I do think in some cases it is insensitive to use the term when a woman doesn't agree with abortion, but it's just a term.

[tigerchild]

I can relate to that fear, especially when it tends to come with so much shame-based baggage (at least it did for me, given my family background). Though to be honest now I use abortion as the medical terminology where appropriate (I think in most cases it makes more sense to refer to a miscarriage as a miscarriage since it will tell people what you mean more readily than medical jargon) and in lieu of 'reduction' or whatever. I refuse to let the anti-abortion people turn it into a word of shame for me.

Keep in mind the culture of Kansas when you wonder how OR could have gotten those medical records with impunity. I think the author of the LSN site made it all up. There's limited things you can do as an outsider if corruption is happening elsewhere, and nothing you can do about hateful people violating their own supposed principals (like not being dishonest scumbags) in order to try and manipulate people's emotions. I don't know where you live, and if it would be high risk that local authorities would turn a blind eye to someone stealing medical records. But in any case, you're not going to be able to redact your records to remove a certain word anyway. Given the amount of miscarriages that happen every day, I would say your chances of some crazy "pro-life" group of zealots getting a hold of your medical record and slamming you are slim to none, even if they were to scan all the records in your state.

Theft or misuse of pictures is another story--but if you find ones of you online at any time, you can demand that they be taken down. I've had to do that when someone stole pictures of my twins for her fake baby drama site. Generally though you can be photographed in public spaces without your permission--but if someone is using those photos in a false/misleading way you can probably sue them or demand that they take them down immediately or you will see and most people will comply.

[2xx1xy1JD]

I should clarify my post a bit.

This isn't a current, personal paranoia.

It was something that was on my mind 14 years ago, when I had my first miscarriage. Several things were happening around the same time. First, I was quite traumatized by the miscarriage itself, which was diagnosed when I was in my 17th week and thought that I was past any danger point. Second, I was reading about the murder of Dr. Slepian while I was in the hospital. That murder had occurred less than 2 weeks prior, and Buffalo is not far from Toronto. Third, I was dealing with a crazy client at the time, who was constantly twisting information (including medical information) in the worst possible way when it came to making allegations against his ex. This individual was also portraying himself as pro-life and as a staunch Christian, while in reality being a crazy, hateful, sexist and abusive guy. There had been a previous act of craziness that resulted in a SWAT team being involved. He scared the living shit out of me. Fourth, a law school classmate of mine was murdered, along with her husband, in her own bed less than 2 weeks later.

When I returned to work, crazy client had put in a request for a new lawyer. I readily agreed, citing "medical reasons". The Legal Aid director called me, since she knew I loathed the file, to make sure that this was legit. I told her the full story, but made her promise to keep the details confidential, as I had crazy visions of this guy wanting to see my medical records to confirm that I really had a medical emergency, and then engaging in some sort of anti-abortion terrorism.

Every so often, I try to process some of my thoughts and feelings from that time, and ask myself, "did I go crazy?" Today, I readily admit that I was hyper-sensitive and had irrational feelings of guilt. At the same time, though, I don't think that I was 100% crazy. When I read about witch hunts against abortion doctors and allegations by Operation Rescue and protestors efforts to identify patients, I think that some of my fear was justified and that it is possible that they could end up targeting women who actually wanted to have a living child (but either miscarried, or had a baby die in utero, or had a serious medical condition, or had a non-viable pregnancy, etc.)

[YPestis]

Well anyone who confuses a miscarriage for a voluntary abortion know they would look like assholes regardless of whom they showed the files to. Pro-choicers would see it as an egregious violation of HIPAA, yet another heartless behavior by those that don't know anything about women's health. Pro-lifers would be mortified that someone who had a miscarriage was "accused" of having an abortion.

In med school, it initially surprise me a bit how 'abortion' is used. Then I realized the term was politicized so that people are afraid of using it, even though doctors and nurses have been using it in this fashion long before the abortion debate entered the Supreme Court.

I glossed over the OP's links. I feel sad for those women who suffered miscarriages and felt like they were being accused of "killing" their babies because of the "abortion" usage. However, instead of being angry at the medical community for using "abortion" correctly and in the way that it has long been used, they should be angry at people who misused the term to imply "abortion" means an voluntary act.

[Sydney Fox]

I should clarify my post a bit.

This isn't a current, personal paranoia.

It was something that was on my mind 14 years ago, when I had my first miscarriage. Several things were happening around the same time. First, I was quite traumatized by the miscarriage itself, which was diagnosed when I was in my 17th week and thought that I was past any danger point. Second, I was reading about the murder of Dr. Slepian while I was in the hospital. That murder had occurred less than 2 weeks prior, and Buffalo is not far from Toronto. Third, I was dealing with a crazy client at the time, who was constantly twisting information (including medical information) in the worst possible way when it came to making allegations against his ex. This individual was also portraying himself as pro-life and as a staunch Christian, while in reality being a crazy, hateful, sexist and abusive guy. There had been a previous act of craziness that resulted in a SWAT team being involved. He scared the living shit out of me. Fourth, a law school classmate of mine was murdered, along with her husband, in her own bed less than 2 weeks later.

When I returned to work, crazy client had put in a request for a new lawyer. I readily agreed, citing "medical reasons". The Legal Aid director called me, since she knew I loathed the file, to make sure that this was legit. I told her the full story, but made her promise to keep the details confidential, as I had crazy visions of this guy wanting to see my medical records to confirm that I really had a medical emergency, and then engaging in some sort of anti-abortion terrorism.

Every so often, I try to process some of my thoughts and feelings from that time, and ask myself, "did I go crazy?" Today, I readily admit that I was hyper-sensitive and had irrational feelings of guilt. At the same time, though, I don't think that I was 100% crazy. When I read about witch hunts against abortion doctors and allegations by Operation Rescue and protestors efforts to identify patients, I think that some of my fear was justified and that it is possible that they could end up targeting women who actually wanted to have a living child (but either miscarried, or had a baby die in utero, or had a serious medical condition, or had a non-viable pregnancy, etc.)

I don't think you're being paranoid. Not everyone understands the terminology, even those who should. My SIL had a missed abortion. At 12 weeks gestation there was no heartbeat and my SIL was given the option of waiting for the fetus to pass, or to have a D&C. She initially wanted to wait, but then decided she wanted to just get it over with. Her doctor told her to go to the hospital, where she would leave instructions for SIL to be admitted. When SIL got to the hospital admitting, she explained that she had had a missed abortion. The woman doing the admitting was confused and asked her if she had missed her appointment for an abortion. SIL, at this point extremely upset, had to explain to the woman that "the baby died and didn't come out." Stupid admitting woman. You'd think that she'd have heard that term before since she worked in a hospital. If this can happen in a hospital, I can imagine some random pro-lifer getting the wrong idea as well.

[tigerchild]

Of course the fringe people want to target all women who "might" have had a miscarriage under 'suspicious' (to them) circumstances. That's why their crazy legislators include things in their personhood laws about how all fetal death, including any kind of pregnancy loss, be reported (and thus open any woman with any kind of loss to investigation/prosecution).

However, even in the more pro-life than pro-life states, those suggested laws tend to die because nobody wants to go there. Yet. I have some faith that people with half a brain would see the potential complications there and avoid it, and have been pleasantly surprised to see that happen. Who knows what the future will bring though. I just choose not to dwell on that contemplation because I spent enough time in fundie hate hell growing up, I don't want to devote that much more time worrying over it now, if that makes sense. Admittedly that is easier for me because I am relatively safe in my area from any kind of zealot takeover of government.

[Austin]

No woman should have to explain either way.

[YPestis]

Miscarriages are so common that only a small selection of men would ever consider investigating "suspicious" miscarriages. Most women of child bearing age must realize that places undue burden on them every time they bleed or go to the OB. Many men would probably see it as a gross violation of privacy. And most people have enough common sense to realize this will prevent women from coming in for prenatal care if they think they run the risk of criminal persecution. It's only a few whacked out, uninformed, ignorant right wing men who are so ignorant of women's health (and yet so engrossed in its legislation of it) that would ever think to want this law.

[starfish]

I think it's normal to be a bit paranoid about medical records. Remember fundie fave Phill Kline,

the attorney general for Kansas and then district attorney for Johnson Co. D.A.'s office?

And not to mention, the boss of Crystal Paine's husband Jesse.

He launched all kinds of crazy investigations into Planned Parenthood of Kansas and Overton Park, and willy-nilly subpoened their medical records looking for the boogey man. He's now a visiting professor at --wait for it---Liberty University. My understanding is that he took the boxes and boxes of medical records home. He and his crack(pot) staff left them in their garage, etc. His staff also photographed women going into Dr. Tiller's office and subpoened guest records from a nearby hotel.

Here's a few bullet points from RH:

•After Kline gained access to women’s medical records, it was discovered that these private records were taken to a Kline staffer’s home and also photocopied for unknown reasons at a local print shop.

•Shockingly, right-wing talking head Bill O’Reilly somehow, miraculously, had all the information from those private medical records that Kline so diligently sought.

•Bill O’Reilly then used those records to create his own personal platform in order to demonize Dr. George Tiller. He railed against Dr. Tiller night after night, for months on end, calling him heinous names, which clearly worked to incite violence against Dr. Tiller.

An ethics board from Kansas recommended that Phill be suspended indefinetly, but the Kansas Supreme Court has the ultimate say. I hope they do take away his license. He lives in VA now and says he has no plans to return to Kansas.

[SisiL78]

I recall reading that the number that anti choice folks use stating that one t third of women have an abortion is because they include miscarriage in those statistics. I always thought the idea that a third of women had an abortion seemed super high. I've looked up how many places in my mid somewhat liberal city perform abortions and it wasn't high. They was no way they could service that many women even over a long period of time. On the other hand I've had several friends with ectopic pregnancies, missed abortions and spontaneous abortions the past few years.

I apologize for typos as i'm on my phone

[Maggie Mae]

I glossed over the OP's links. I feel sad for those women who suffered miscarriages and felt like they were being accused of "killing" their babies because of the "abortion" usage. However, instead of being angry at the medical community for using "abortion" correctly and in the way that it has long been used, they should be angry at people who misused the term to imply "abortion" means an voluntary act.

I agree with this. Part of me has wanted to start using it more, because well, science. I'm really tired and frustrated with the anti-choice movement and the way they use the most emotionally charged language and propaganda to influence women. I wish I could be someone who was just like "oh, well, to each their own," but they are actively trying to take my rights away.

[Three and Done]

I am solidly pro-choice, thisclose to a degree in Health Sciences, and plan to enter the RN program next fall. I have already completed a large number of the required courses for a nursing degree, and voraciously read large amounts of medical information all of the time.

That being said, I was still quite upset to see the word "abortion" in my medical chart/admitting instructions when I had to have a D & C for an incomplete 12 week miscarriage.

The word "abortion" has become so emotionally and politically charged in our country that it creates intense feelings of anger/sadness/guilt when applied to those who truly WANTED to carry that child, yet lost it to miscarriage. We had no control over what our bodies did, yet we feel demonized by the implicit shame involved.

[Rosa]

If the number included miscarriages and ectopics, it would be way more than 30%. It's for induced abortions.

The 1 in 3 number comes from the statistic that 2% of women have an abortion in a given year, and then that incidence is multiplied by years of fertility. The % goes up with age. " at current rates, one in 10 women will have an abortion by age 20, one in four by age 30 and three in 10 by age 45."

You can see it in this Guttmacher report, with citations to peer-reviewed and public health sources:

http://www.guttmacher.org/pubs/fb_induc ... ion.html#2

Oh, and a story: a friend of mine had an abortion in high school. Her boyfriend's mom worked at the local hospital, looked up her file, and made a fuss. Luckily her parents were supportive.

This shit does happen. Now there are some consequences for unauthorized record lookup/sharing, but they are after the fact even when they happen.

[browngrl]

I've thought about this quite a bit actually. I work for a fertility clinic (reading ultrasound exams) and I often see pregnancies that are no longer viable. Although I realize that all doctors will know what "abortion" means, I usually elect not to use that term because it is so emotionally charged and I fear the patient will read the report and be hurt. I will almost always use more neutral terms like "early pregnancy failure" or "the embryo has demised" or "findings consistent with recent miscarriage". The medical information is clear (IMO) and I hope that this wording is less inflammatory.

[Alecto]

As someone who had an abortion, the fact folks are pearl clutching over the phrase abortion on their charts is a bit offensive, as it propagates the whole "Abortion is horrible and I had a miscarriage, not an evil abortion." If we want to end the horrible stigma on women who have abortions, it might help for pro-choice allies to release their own biases and negative reaction to the word abortion. I hope one day the word abortion is no more negative than "appendectomy."

[meda]

As someone who had an abortion, the fact folks are pearl clutching over the phrase abortion on their charts is a bit offensive, as it propagates the whole "Abortion is horrible and I had a miscarriage, not an evil abortion." If we want to end the horrible stigma on women who have abortions, it might help for pro-choice allies to release their own biases and negative reaction to the word abortion. I hope one day the word abortion is no more negative than "appendectomy."

Yes to this, in spades.

[Sola]

Well the medical term for a miscarriage is a spontaneous abortion (as opposed to a medical or surgical one). So anyone who has had a miscarriage, it will say in their notes that they have had a pregnancy aborted and it will generally specify whether that abortion was a spontaneous, medical or surgical abortion.

But, it isn't anyone's business anyway what it says on your chart.

[emmiedahl]

When I was in my miscarriage phase (I had 4 healthy children, 5 miscarriages, and then my youngest), I remember hearing one of the nurses call me a habitual aborter. It carries a little sting when you would have loved to see the pregnancy through. But that is the medical term, and tbh it did not bother me as much as hearing my 12 week old fetus referred to as Products of Conception. I already was pretty sure I knew the gender and had named the fetus, so it was hard to come to terms with the difference between my view of a baby lost and their view of tissue that needed removed.

Unfortunately, in a difficult hormone-ridden situation there is no way to spare feelings completely. I never considered that some pro-life asshole might see the chart and come attack me. But I could totally see it happening. They are always trying to make the politics as personal as possible. This was in a hospital where a friend of mine electively aborted, so it is most likely a place that some crazy is actively trying to infiltrate.

[tigerchild]

As someone who had an abortion, the fact folks are pearl clutching over the phrase abortion on their charts is a bit offensive, as it propagates the whole "Abortion is horrible and I had a miscarriage, not an evil abortion." If we want to end the horrible stigma on women who have abortions, it might help for pro-choice allies to release their own biases and negative reaction to the word abortion. I hope one day the word abortion is no more negative than "appendectomy."

Yes. I'd also like to state that I find the sentiment of "well, this is hurtful to those who actually WANTED to carry the child" extremely offensive. No really. Fuck anyone who would say that about people they don't even know. A lot of people who get "late term abortions" are getting them because of significant disabilities and/or conditions that would make the (Very brief) life of the child fraught with pain. Those children were wanted. Just because their parents might have had to courage to ensure that their child endured as little suffering as possible, as best as they could or felt able to, does not mean that they didn't WANT that baby. I met many parents like that while going through my own hell. I always had far more respect for them than I did for my decision. Nobody has any right to judge other people's intentions negatively that they don't even KNOW.

[emmiedahl]

Yes. I'd also like to state that I find the sentiment of "well, this is hurtful to those who actually WANTED to carry the child" extremely offensive. No really. Fuck anyone who would say that about people they don't even know. A lot of people who get "late term abortions" are getting them because of significant disabilities and/or conditions that would make the (Very brief) life of the child fraught with pain. Those children were wanted. Just because their parents might have had to courage to ensure that their child endured as little suffering as possible, as best as they could or felt able to, does not mean that they didn't WANT that baby. I met many parents like that while going through my own hell. I always had far more respect for them than I did for my decision. Nobody has any right to judge other people's intentions negatively that they don't even KNOW.

I don't think anyone here has implied that having a late term abortion because of medical complications is not a painful and harrowing experience. I have never had that experience so while I can empathize, I can only report my own personal experience of being hurt by certain medical terminology. My feeling pain over something does not mean that someone else did not feel pain or even feel more pain.

[Three and Done]

I don't think anyone here has implied that having a late term abortion because of medical complications is not a painful and harrowing experience. I have never had that experience so while I can empathize, I can only report my own personal experience of being hurt by certain medical terminology. My feeling pain over something does not mean that someone else did not feel pain or even feel more pain.

I totally agree with emmiedahl.

I did not mean in any way to disparage those who have had an abortion. I too had one at a time in my life when I was incapable of raising a child for many reasons.

My only point was that the word "abortion" has become so fraught with an emotional and political charge that it has seeped into the psyche of many women that they have done something "wrong" when the "abortion" was a miscarriage.

For myself personally, I was already asking what I had done wrong to kill my baby. (My abusive ex heavily contributed to my paralyzing guilt.) Wondering what others thought if/when they saw that notation made facing the situation even more difficult.