In the most comprehensive look yet at the safety of abortion, researchers at UC San Francisco have concluded that major complications are rare, occurring less than a quarter of a percent of the time, about the same frequency as colonoscopies.
The study, published online in Obstetrics & Gynecology, analyzed data from more than 50,000 women enrolled in the Medi-Cal fee-for-service program who obtained abortions from 2009 to 2010, and looked for complications that occurred within six weeks of the procedure.
The rate is similar to what has been found in previous studies, but this is the first study in which researchers have based their conclusions on complete data on all of the health care used by women who have received abortions. Since some women must often travel long distances to find abortion providers, they tend to receive follow-up care at facilities closer to where they live. For many women, this means their local emergency department. But, up until now, no study has systematically examined emergency department use for post-abortion care.
The researchers said they expect the study will contribute to the national debate over abortion safety. Many state legislatures have recently passed laws that have the effect of reducing access to abortion by requiring providers to have transfer agreements or admitting privileges with hospitals or to construct their clinics so that they meet the requirements of an ambulatory surgical center. But the researchers said that these restrictions were likely to make women travel further to get abortions or induce them on their own using unsafe methods, both of which may increase the risks for women.
"Our study had very complete follow-up data on all of the women in it, and we still found a very low complication rate," said Ushma Upadhyay, PhD, MPH, an assistant professor at Advancing New Standards in Reproductive Health (ANSIRH), a program of the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF. "Abortion is very safe as currently performed, which calls into question the need for additional regulations that purportedly aim to improve safety."