miscarriage in ultrasound roomFirst I want to state for the record that this post is NOT ABOUT ABORTION. It is about abortion terminology and the topic will still be quite controversial in nature.

Should the word abortion be used to describe miscarriage? I touched on this point in my book It’s Not Just a Heavy Period; The Miscarriage Handbook, because the term miscarriage is not actually a medical term. In my book, I explain this to my readers so they understand their chart and the words used by their care providers may not reflect their feelings of miscarriage.

When we lost Gus, the diagnosis was “missed abortion.” What does that really mean anyway? The term abortion is often associated with negative connotations. When performing a search on Google with the keyword “abortion” the first ad on the page which took up the entire right side was for Planned Parenthood. The first definition that appeared was, “Abortion is the ending of pregnancy by removing or forcing out a fetus or embryo from the womb before it can survive on its own.”

I searched the next seven pages looking for anything that related abortion and miscarriage together and found nothing; only abortion support for women who were searching for options on how to end their pregnancy. With 1 in 4 women experiencing “spontaneous abortion,” aka miscarriage, one would hope that through a Google Search, they would learn something about miscarriage and not just the mainstream term used for abortion.

When researching the ICD-10 codes further, if you search “abortion” and choose “legally induced abortion,” you will find pregnancy loss listed as a Disease Synonym, along with complete abortion and complete pregnancy termination. Pregnancy loss is also listed under spontaneous abortion but not under missed abortion. When performing a Google Search for the definition of pregnancy loss; the first definition states “defined as a miscarriage or also known as spontaneous abortion and pregnancy loss, is the natural death of an embryo or fetus before it is able to survive independently.”

Ok. Natural death is a keyword here. Not sure why the ICD codes would place pregnancy loss under legally induced abortion when this is not a natural process. But here is another term that many of my friends fall under. Habitual Aborter (who wants to be called this no matter the reason)? Yet with ICD 10-coding, the name will change from “habitual aborter” to “recurrent pregnancy loss,” which in my opinion, is much more fitting as they would never call someone who legally aborts more than one baby a habitual aborter. There was no such change with miscarriage in the ICD-10 coding. It will remain “spontaneous abortion.”

So here’s the concern, many women do not want to see the term “abortion” in relation to their miscarriage. Abortion is associated with “unwanted” although that is not always the case. The term abortion is so negative; it is associated with less compassion and empathy. Seeing the word on paper might suggest to the medical professional that the woman is experiencing a medical event and nothing more. The woman may not feel as if she has the right to grieve her “aborted” baby which can lead to more confusion and a delayed healing process.

The recommendation is to change the terminology. This article suggested in 1998 that the terminology be changed but this is not a US recommendation. The Dutch and the English have already recommended or revised the terminology used for pregnancy loss and have turned away from the term “abortion” to describe what many refer to as miscarriage. Why hasn’t the US followed suit in changing this medical terminology?

In addition, many other countries use the terms womb and foetus when describing abortion and miscarriage whereas US terminology uses uterus and tissue or “products of conception, regardless of gestational age. Terminology is certainly important as it can validate a woman’s actual experience. Using the term tissue, would be incorrect beyond the first week of gestation. Gus and Ruby were not tissue they were a fetus and embryo respectively. Why does the US not recognize the words fetus and embryo when describing what forms and develops in the uterus after the union of an egg and sperm?

Moving on, I performed another search on Google, “where did the term abortion come from?” Article after article described the process for ending a pregnancy early. Doctor induced abortion, medically induced abortion, mother induced abortion, partner induced abortion, how to induce abortion, laws from centuries ago around abortion as far back as the Code of Hammurabi!

But where was the information on miscarriage? Sure, Wikipedia mentions spontaneous abortion as miscarriage and has a whole page on miscarriage but miscarriage is not a medical term. My chart will forever state, “missed abortion,” as if I “missed” some sort of an appointment. My chart does not reflect much of the emotional experience I had; the devastation of having to say goodbye to another child. It does not reflect “fetal or embryonic death.” It does not reflect stillbirth (the term for fetal death).

Miscarriage does not come with a death certificate or any certificate. No recognition of life. There is nothing; just the term abortion, putting all women who experience the loss of their pregnancy; whether it was wanted or not, forced or not, into the same category. A medical event and nothing more. Should the US medical community change abortion terminology? What are your thoughts?

– Breaking the silence of First Trimester Miscarriage

Wikipedia is not reputable or scholarly source; however, the general public sees Wikipedia as a resource and authority on what is searched there. Wikipedia was not the only source used for this post, please click on the links provided above.