A new study evaluated abortion statistics in the United States with particular attention paid to deaths related to the procedure. They found that, although a large number of abortions are performed each year, the procedure is associated with a low mortality rate. The findings were published on the August edition of the journal Obstetrics & Gynecology by researchers at the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
The study authors note that over the past 35 years, approximately 50% of pregnancies in the United States were unintended. Among these, about 40% were terminated by induced abortion, with an estimated 1.1 million legal induced abortions performed in the nation in 2011. Since its legalization in 1973, the mortality rate from legal induced abortion has remained very low, at about 1 abortion-related death per 100,000 abortion procedures. Changes in the population of women of reproductive age as well as changes in abortion techniques and methods, such as the approval in 2000 of mifepristone for early medical abortion, may potentially affect mortality from abortion. Since 1972m the Division of Reproductive Health at the Centers for Disease Control and Prevention has conducted national epidemiologic surveillance of mortality associated with legal induced abortion. All potential deaths from abortion receive in-depth investigation: abortion mortality rates are reported annually in the CDC’s Abortion Surveillance Reports, and more comprehensive analyses are published periodically in peer-reviewed publications that cover the years 1972–1997. To provide the most recent, complete information on deaths related to legal induced abortion, the investigators have summarized key epidemiologic and clinical information on these deaths in the US from 1998 through 2010.
For the study, the researchers reviewed abortion-related deaths through the national Pregnancy Mortality Surveillance System with enhanced case-finding. They calculated the abortion mortality rate by race, maternal age, and gestational age and the distribution of causes of death by gestational age and procedure.
The investigators found that during the period from 1998–2010, of approximately 16.1 million abortion procedures, 108 women died, yielding a mortality rate of 0.7 deaths per 100,000 procedures overall, 0.4 deaths for non-Hispanic white women, 0.5 deaths for Hispanic women, and 1.1 deaths for African American women. The mortality rate increased with gestational age, from 0.3 to 6.7 deaths for procedures performed at 8 weeks or less and at 18 weeks or greater, respectively. Most of the abortion-related deaths at 13 weeks of gestation or less were associated with anesthesia complications and infection, whereas a majority of abortion-related deaths at more than 13 weeks of gestation were associated with infection and hemorrhage. In 20 of the 108 cases, the abortion was performed as a result of a severe medical condition where continuation of the pregnancy threatened the woman’s life.
The authors concluded that deaths associated with legal induced abortion continue to be rare events: less than 1 per 100,000 procedures. They recommended that primary prevention of unintended pregnancy, including those in women with serious pre-existing medical conditions, and increased access to abortion services at early gestational ages may help to further decrease abortion-related mortality in the United States.
Take home message:
This study notes the staggering number of abortions performed in the United States each year. A wide variety of effective contraceptive methods are available, which is far preferable to a procedure that any woman would prefer not to undergo.