In medical terminology, a miscarriage is classified as a “spontaneous abortion.” This does not mean it is the same thing as an elective abortion. The word “abortion” in medicine simply refers to any pregnancy that ends before the fetus can survive outside the womb, regardless of whether that ending was natural or intentional. A miscarriage is a naturally occurring event, while an elective abortion is a deliberate procedure or medication-induced termination.
Why Doctors Use the Word “Abortion”
The clinical term “spontaneous abortion” has been used in medicine for well over a century to describe the unplanned loss of a pregnancy before 20 weeks. The American College of Obstetricians and Gynecologists notes that in the first trimester, the terms “miscarriage,” “spontaneous abortion,” and “early pregnancy loss” are used interchangeably, with no consensus in the medical literature on which is preferred.
This terminology shows up in places that can catch people off guard. The World Health Organization’s international classification system codes every miscarriage under the category “Spontaneous abortion,” with sub-codes for whether it was complete or incomplete and whether complications occurred. If you look at your medical records or an insurance claim after a miscarriage, you may see this language. It does not mean your doctor recorded your pregnancy loss as an elective abortion.
Your medical chart may also use related terms like “missed abortion” (when the pregnancy has stopped developing but tissue hasn’t passed), “incomplete abortion” (when only some tissue has passed), or “inevitable abortion” (when symptoms like bleeding and cramping indicate a miscarriage is underway and cannot be stopped). All of these refer to types of miscarriage, not elective procedures.
How Miscarriage Differs From Elective Abortion
The key distinction is cause. A miscarriage happens on its own, most often because of chromosomal abnormalities that prevent the embryo from developing normally. An elective abortion is a decision to end a pregnancy using medication or a procedure. The intent and the circumstances are entirely different, even though the medical process of the body passing pregnancy tissue can look similar in both cases.
This overlap in the physical process is exactly what creates confusion. The medications used to manage a miscarriage, mifepristone and misoprostol, are the same ones used in medication abortion. The surgical procedure used to complete a miscarriage, suction dilation and curettage (D&C), is the same procedure used in some elective abortions. From a clinical standpoint, the body doesn’t distinguish between tissue that needs to be passed after a natural loss and tissue removed during an elective procedure. The tools and treatments are identical because the medical task is the same.
Types of Miscarriage and When They Happen
Miscarriage is common. An estimated 10 to 20 percent of known pregnancies end in early miscarriage, and 3 to 4 percent end in second-trimester loss. Some pregnancies end so early that the loss happens before a person even knows they’re pregnant. These are called chemical pregnancies and typically occur within the first five weeks.
A missed miscarriage is a loss with no obvious symptoms like bleeding or pain. Many people continue to feel pregnant and experience pregnancy symptoms. This type is often discovered during a routine ultrasound when no heartbeat is detected. Once a heartbeat is visible at six to seven weeks, the risk of miscarriage drops to around 10 percent. By eight weeks with a confirmed heartbeat, the chance of the pregnancy continuing rises to about 98 percent, and by ten weeks it reaches 99.4 percent.
When a miscarriage is incomplete, meaning some pregnancy tissue remains in the uterus, treatment may be necessary to prevent infection. Options include waiting for the body to pass the tissue naturally, taking medication to help the process along, or having a D&C. A combination of mifepristone and misoprostol is more effective than misoprostol alone and carries a lower risk of needing follow-up surgery.
Why This Terminology Matters Right Now
The overlap between miscarriage care and abortion care has taken on new significance since the U.S. Supreme Court’s Dobbs decision in 2022. Because the medications and procedures are identical, abortion bans and restrictions in some states have limited the range of treatment options available to people experiencing miscarriage.
The threat of criminal penalties for clinicians who provide abortions in states with bans has created what researchers describe as a chilling effect on clinical care. There have been multiple documented cases of people experiencing health-threatening situations with imminent fetal loss who were unable to obtain medical treatment until their condition deteriorated to the point of life endangerment. While all state bans include exceptions for life-threatening emergencies, those exceptions do not necessarily account for the wide range of circumstances people face during pregnancy loss.
Laws that grant legal personhood to a fetus can further complicate the picture. Because a miscarriage may be conflated with a self-managed abortion, some people, particularly people of color who already face biases in healthcare and legal systems, have become hesitant to seek care during a pregnancy loss out of fear of investigation or criminalization. This is one of the clearest real-world consequences of using the same word, “abortion,” for two fundamentally different events.
What to Know About Your Medical Records
If you’ve had a miscarriage and see “spontaneous abortion” in your chart, on a billing statement, or in insurance paperwork, that coding reflects standard medical terminology. It does not indicate an elective procedure was performed. The international diagnostic code for miscarriage (ICD-10 category O03) is labeled “Spontaneous abortion” and is distinct from codes used for elective termination.
If this language in your records concerns you, especially if you live in a state with abortion restrictions, you can ask your provider to also include the term “miscarriage” or “early pregnancy loss” in your clinical notes. Many providers have already shifted toward using these terms in patient-facing communication precisely because the word “abortion” carries social and legal weight that the clinical definition never intended.