Just a matter of semantics? : Why Jessa Duggar's miscarriage is blowing up on social media

Bronwyn Rideout - 13 March 2023

Due to a special request by chair Craig, I have delayed part 2 of my article on Geoff Botkin to write about a member of the Duggar family. I previously referenced the Duggar family in my article about Bill Gothard and the Institute in Basic Life Principles. They are an ultra-conservative, super-sized Christian family with 19 children that were z-grade reality television celebrities. But nowadays? They are best known for the notoriety of their eldest son, Josh Duggar.

Jessa Dugger is the fifth child and third daughter in the mega-brood and has been part of each of the family’s TV fiefdom since she was 11 - she is now 30 years old. Her participation in this media empire persisted even after the revelation that she was one of the four siblings molested by her brother Josh.

Jessa has been married to ordained minister Ben Seewald since 2014 and over the course of her marriage has shed some of the trappings of her parents independent fundamentalist Baptist beliefs in favour of Seewald’s Southern Baptist Calvinism (for example, she now wears pants), which has given some fans hope that she may, possibly, someday, disavow the whole fundamentalist kit and kaboodle.

Until then, Jessa remains a devout Christian and has a history of participating in activities such as this 2015 pro-life March.

A missed miscarriage can take as long as four weeks to pass. Absence of a fetal heartbeat and measurements taken at a scan can help determine when the baby/fetus passed. A series of blood tests for pregnancy hormones taken over 48 hours may be required to determine if your hormones are rising or dropping. Due to having a postpartum haemorrhage after the birth of her first son, she and Seewald decided against both expectant (letting the body expel the pregnancy tissue naturally) and medical (taking a medication called Misoprostol) management. Instead, she had a surgical procedure called a dilation and curettage (D&C), which removes tissue in the uterus after a miscarriage.

However, while twitter users may have the facts wrong, their beliefs are not wholly baseless.

In the aftermath of the Supreme Court decision to repeal Roe v. Wade, women who lived in states with the most restrictive laws found that their access to fundamental antenatal care was restricted due to fears doctors had about their liability or risk of investigation if they treated a miscarriage. This is because the same treatments used for miscarriage are also used for abortion. An article by NPR which was published soon after, as we know now, Jessa learned of her missed miscarriage. Kaitlyn Joshua is a black woman and community organiser in Louisiana, a state with the highest maternal death rates in the country with black women at a higher risk than white. Despite heavy bleeding, staff at two separate hospitals refused to treat her because the correct medical term they would need to use to label Kaitlyn’s miscarriage, spontaneous abortion, would trigger investigations.

According to NPR, Louisiana does offer exceptions when the fetus is deemed too sick to survive birth and one that allows abortion procedures to treat miscarriages. In the case of the latter, a physician would be required to give a diagnosis in writing, as well as an ultrasound, to prove that the pregnancy had ended or was in the process of ending.

So what happened to Kaitlyn? The chief medical officer at the first ER Kaitlyn went to claimed that bleeding in the first trimester was normal and diagnosing a miscarriage is complex and can take days or weeks. This statement is not untrue - a fetal heartbeat can be heard as early as 5-6 weeks with an ultrasound; so a health practitioner may recommend waiting a week depending on how early a person reports a missed miscarriage. However, the pain and bleeding reported by Kaitlyn appears to have warranted a higher-level of care and investigation.

The second ER was more vague although her records indicate that staff recognised that she was having a miscarriage/spontaneous abortion. As doctors and lawyers quoted in the NPR article point out, the new abortion laws are vague and impact decision-making even in situations where the provision of medical and surgical care during a miscarriage is ring-fenced. The Washington Post reported a similar story, only this time Marlena Stell was directly told by her doctor that their refusal to perform a D&C was due to the restrictions placed on the procedure by Texas law. Again, use of D&C for the treatment of miscarriage is legal in Texas and eventually, after three unnecessary scans, Stell was able to have a D&C.

The irony is that rather than saving babies, Mothers like Marlena and Kaitlyn are so traumatised from their experience and distrustful of their state’s healthcare system that they are delaying having more children.

Jessa and her family are obviously grieving the loss of a wanted child and despite their politics, the current discourse around them is definitely inaccurate and unfair. Instead, the discussion should shift to how the politics of Jessa, her extended family, and the aftermath of the growth of the so-called moral majority threaten health care both here and abroad. This is best demonstrated by the Mexico City Policy, aka the global gag rule in which Republicans make a point to reinstate the second they cross the threshold of the Oval Office. Implemented by Ronald Reagan in 1985, the Mexico City Policy allows the USA to defund NGOs that provide family planning services, contraception, or even use live-saving medications like Misoprostol as a treatment for post-birth bleeding. The USA is one of, if not the, biggest funder of NGOs and other programmes worldwide so the withdrawal of financial support is devastating. The controversy around the medication used in abortion is such that the company that once held the patent to Misoprostol, Searle, refused to pursue expanding its on-label usage to include abortion.