About 3.7 million babies are born in the country each year, around half of which are considered the result of planned pregnancies. But those numbers tell only part of the story — the version that ends in a nursery, in baby names, in onesies and birthday parties.

Less discussed are the pregnancies with very different outcomes: Miscarriages, which occur in up to 1 in 3 pregnancies, are often the most commonly discussed form of pregnancy loss. But for many people, miscarriage isn’t the only nonviable pregnancy. There are situations that threaten the health of pregnant people themselves, such as ectopic pregnancies, a life-threatening condition. There are the pregnancies terminated because of medical complications and health concerns that are often only discovered in the second trimester. Stillbirths represent yet another form of loss, defined by the Centers for Disease Control and Prevention as when a fetus dies after 20 weeks of pregnancy.

And the standard medical treatment for any of these conditions often relies on access to abortion.

Abortion bans have jeopardized access to care for miscarriages and other pregnancy-related complications. The stakes associated with losing a pregnancy are high, with increased medical and legal risks, especially in the 14 states where abortion is now almost entirely outlawed and the two more that ban the procedure for people past six weeks of pregnancy.

Pregnancy loss in America has long been a lonely experience.

A 2015 study found that a majority of American adults believed that miscarriage occurred in 5 percent of pregnancies or fewer. About 47 percent of people who had a miscarriage said they felt guilty; 41 percent said they felt like they had done something wrong. It’s a consistent theme across different kinds of pregnancy loss; a smaller study also published that year found that Americans who terminated their pregnancies because of fetal anomalies often blamed themselves for their diagnoses, and reported social isolation because of the stigma surrounding abortion.

In the United States, at least, the silence could be changing after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which gutted federal abortion protections. The impact has forced conversations about pregnancy loss into the open.

“People didn’t talk about abortion or miscarriage or medically complicated pregnancy,” said Greer Donley, an associate professor of law at the University of Pittsburgh who studies abortion and pregnancy loss. “The thing with Dobbs is — in my opinion one silver lining — is that people are talking about this a lot more.”

Some anti-abortion lawmakers have argued that their bans shouldn’t affect people experiencing a miscarriage or an ectopic pregnancy. But even in states with harsh restrictions, the ability to get appropriate care varies from physician to physician. The KFF survey found that 30 percent of OB-GYNs in states with abortion bans will not under any circumstances even refer patients to another doctor or even a website that could help them terminate a pregnancy, at least in part because of concerns over the legal risks.

Read the full article about pregnancy loss by Shefali Luthra at The 19th.