My miscarriage felt like an abortion. Today, I would be a suspect.

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What does a miscarriage look like? What does an abortion look like? What secrets are known only to a woman and her toilet? Apologies to the disgusted, but let me tell you the story of a miscarriage – how much like an abortion it can be. And how dangerous both can be when a woman does not have safe access to medical care.

I sat in my sunny bathroom above the urine-soaked toilet and stared at the object in my right hand in denial. It couldn’t happen. It was going to ruin my life. Or at least the short-term plans I had made for it.

You’d be forgiven if you think I’m describing the day I found out I had an unwanted pregnancy. I’m not. In the same place, about two months earlier, I had been overjoyed when I peed on a stick and got a positive pregnancy test. That is why, this afternoon, what I was holding filled me with horror.

There was blood on the toilet paper.

I called my husband in a panic. I called my doctor in even greater panic. She assured me it was probably nothing. I had had an ultrasound two days earlier and everything seemed perfect. My husband and I had been dizzy at the sight of the little fetus dancing on the screen. And we were reassured by the conventional wisdom that a good ultrasound after 10 weeks is almost as good as holding a baby, since the risk of losing a pregnancy drops to single digits once you’ve passed that milestone.

But as the day progressed, things got worse. At bedtime, I had cramps and clots. We called the doctor again. The nurse on duty told us the best we could do was go to the emergency room.

The moment we arrived, I knew in my heart that my pregnancy was over. As we walked through the sliding doors, I pulled my baseball cap over my eyes to hide my tears from the room full of strangers and walked towards the screening counter. I leaned forward and said in a flat, hoarse whisper, barely holding back the sobs, “I think I’m having a miscarriage.”

Unfortunately for everyone that night, at the same time, a pedestrian who had been hit by a truck arrived in the ER, and we were sent to the orange plastic chairs to wait. Realizing the woman sounded like she was going to live, I angrily told my husband that I hated her for cutting the line. (Please consider: I didn’t really mean it and I wasn’t at my best.) The moment they called my name, I felt like a clawed beast had firmly grabbed my belly and pulled it down to the ground. . And just as I stood up, I felt a sudden spurt and watched in terror as the blood soaked into my jeans from my hips to my knees.

I remember the next half hour in a series of nightmarish clips. The nurse pushed me into the room and closed the door as I screamed and strangers gaped. My husband helped her pull my blood soaked jeans off my legs as they laid me down on the exam table. The doctor rushed in and said she couldn’t diagnose a miscarriage until they found a fetus outside my body. The nurse and doctor were snooping around the blood clots surrounding me on the bed until I heard the nurse say quietly, “I found it.” The doctor holding a small pink drop the size of half my little finger and dropping it into a plastic cup.

For most women, what comes next is you clean up, get dressed, and go home to settle your grief. But my miscarriage was not typical. When we got to the cleaning and dressing part, I found that I was so soaked in blood that the hospital rags they gave me were totally useless. As soon as I wiped away the blood, more took its place. And it kept happening. We called the nurse back. She glanced at the bed, left the room, and quickly returned with the doctor. I was having an incomplete miscarriage, bleeding uncontrollably.

The doctor ordered emergency dilation and curettage, or D&C, a cleaning procedure that is essentially the same as an abortion. On the way to the operating room, I continued to bleed so profusely that the preoperative nurses could not even discern my external anatomy. The surgeon discovered that a significant amount of tissue had not detached from my uterine wall, hence the bleeding. She removed it, the bleeding stopped and I was cleared to go home and mourn.

In a frustrating epilogue, the doctors were never able to determine why my miscarriage happened. Against all medical probability, my healthy pregnancy simply failed. Sometimes, even in our age of modern medicine, these things happen without any evidence of what went wrong.

This story has become a sad and long buried chapter in my life. I had three healthy babies. But since the Supreme Court ruling overturning Roe vs. Wade was leaked, making real the possibility of fetal assault laws being applied to women presenting to the ER with symptoms of miscarriage, I was troubled by a chilling thought: If I had the same miscarriage today in the wrong part of the United States today – or if I was poor or a woman of color – would I be suspected of terminating my own pregnancy?

Like many women in Texas, I had a safe and legal abortion. What happened to our condition?

The fact is, no one can distinguish a medical abortion (one performed with prescription drugs) from many types of miscarriage. Both typically present with increasing bleeding, cramping, and eventual passage of the products of conception. Currently, there is no empirical way to tell whether an expelled pregnancy was medically induced or an unfortunate coincidence. All doctors need to do is take the patient’s medical history and the story she tells them herself.

To date, at least half a dozen states either ban self-directed abortion or do not exempt pregnant women from prosecution under fetal injury laws. These laws, enacted with the aim of bringing justice to women who lose sought pregnancies because they are victims of violence, could be perverted to make women themselves criminals instead.

What would the facts of my miscarriage look like to a not-so-biased stranger? Would the triage nurse see my eyes hidden in my baseball cap as a sign of desperation or deviousness? My hoarse whisper like someone trying to keep his composure or his defiant brutality? Would the staff view my complaints about the traffic accident victim as exactly the kind of selfish coldness that someone indifferent to the health of her pregnancy would show? How about the perfect ultrasound a few days earlier? Or the fact that the first time a medical professional saw me, I was already covered in blood? Or the later medical reports that found no clear reason for my pregnancy loss?

My doctor would surely support me, I thought. But then I remembered that I left that maternity ward because they could never keep their patients straight. Nobody ever knew me or why I was there. They were so overworked that the official cause of my first miscarriage (it was my second) was still listed as unknown because someone forgot to update my file. So, to a detached observer, it would appear that I had two pregnancies that suddenly ended under similar circumstances. If they looked at my work history, they would also see that I had received a promotion that year. And if they talked to people at a meeting I attended shortly before I got pregnant, they would say that I said loudly, drunk, and repeatedly that having children in this moment would be a disaster for me.

Would all this be enough to arouse suspicion?

I can’t begin to describe what the days after a miscarriage are like for a couple who desperately wanted that baby. It is abject mourning. It’s a roaring hell of pain and lost dreams. Imagine having to prove to the law that you didn’t do this to yourself while your ears are still ringing from the explosion. At a time when a woman needs compassion the most, to treat her as a suspect would be inhumane.

I am worried for American women when I consider the complications I had from my miscarriage. In rare circumstances, a woman undergoing a medical abortion could experience the same complications. I needed immediate medical help, and so did she. But would she be too afraid of getting in trouble to go to the hospital?

This is how women bleed to death on their bathroom floors.

Today, I am as amazed as most of the world that America has taken this giant leap backwards. Women should not be put in the position of advocating for the things their bodies do naturally or fearing to seek that care because their reproductive decisions began outside of current restrictions. Some things should stay between a woman, her doctor and her toilet.

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