HEALTH: U.S. Women Remain Medically Safe to Have an Abortion

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By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Nov. 24, 2021 (HealthDay News) — Debate rages over access to abortion, but experts say the collected medical evidence makes one thing clear — it is a fundamentally safe procedure for women.

Abortion is safer than childbirth and it’s also safer than a host of other common procedures — colonoscopy, tonsillectomy and plastic surgery, said Dr. Sarah Prager, a professor of obstetrics and gynecology at the University of Washington in Seattle.

Prager pointed out that abortion-seeking women do not have any persistent mental or physical problems. This was during an American Association for the Advancement of Science briefing.

“There are no long-term health risks from abortion,” Prager said. “It is not associated with a future risk of infertility or ectopic pregnancy, spontaneous abortion [miscarriage], birth defects or preterm delivery. There also are not increased risks of mental health problems compared to carrying a pregnancy to term. “

The AAAS held the briefing in advance of potential U.S. Supreme Court challenges to Roe v. Wade, the 1973 ruling that made abortion legal in America.

The mortality rate associated with legal abortion is about 0.7 deaths for every 100,000 procedures, Prager said. By comparison, the death rate for childbirth is about nine deaths for every 100,000 deliveries.

Prager stated that

Death rates are available for all medical procedures.

Colonoscopy, 3 deaths for every 100,000 procedures.
Plastic surgery, 1 to 2 deaths per 100,000 procedures.
Tonsillectomy, 3 to 6 deaths for every 100,000 procedures.

“Abortion is actually significantly safer than carrying a child to term and many other minor procedures,” Prager said.

The U.S. abortion rates have been falling for decades, according to Amanda Stevenson, an assistant professor of sociology at the University of Colorado in Boulder.

Rates have declined

The abortion rate in 2017 was 13.5 abortions per 1,000 women of childbearing age, down 8% from 2014, according to the Guttmacher Institute, a non-profit reproductive health policy research group.

That’s the lowest rate ever observed in the United States; by comparison, the rate was 16.3 in 1973 and rose to a high of 29.3 in 1981 before beginning its long decline, the institute said.


“The number and rate of abortions increased rapidly after abortion was made legal in the whole U.S. by Roe v. Wade and then stayed relatively stable through the 1980s, and then started declining and has been declining since the 1980s,” Stevenson said.

About three in five abortions today are performed for women in their 20s, Stevenson said. The abortion rate for teenagers has declined the most rapidly, dropping from 6.1 to 3.4 per 1,000 between 2008 and 2014 for girls aged 15 to 17.

In recent years, about two-thirds of abortions occurred at eight weeks of pregnancy or earlier, while about 88% occurred in the first 12 weeks, Stevenson said. Only about 1.3% of abortions happen after 20 weeks.

There’s three types of abortion, Prager stated:

Medication abortions use the drug mifepristone to induce premature labor, and can be performed early- or late-term.
Uterine aspiration uses vacuum suction to remove uterine contents from the cervix. Prager stated that this procedure typically takes less then five minutes in the first trimester. It usually doesn’t require anesthesia or an operating area in the first trimester, but sometimes it does. “
Surgical abortion usually occurs past 14 weeks of gestation, and involves dilation and evacuation of the uterine contents. This procedure is performed outpatient and has lower complications than a medication abortion.

“One thing that is poorly understood by some people is that mifepristone is highly regulated like dangerous medications, even though mifepristone itself is very, very safe,” Prager said. The [U.S. Food and Drug Administration] currently requires that a provider register in order to be able dispense this medication. It is not a medicine that I can prescribe to a patient for them to pick up at the pharmacy. “

Plan A emergency contraception, sometimes called “the morning after pill”, is not the same thing as medication abortion. Prager stated. Plan B drug levonorgestrel is available at drug stores and it prevents pregnancy.


No more harmful than an unwanted pregnancy

Women who have a desired abortion are often more successful than those who don’t, according to Diana Greene Foster, a professor at the University of California San Francisco’s Bixby Center for Global Reproductive Health.

Foster cited the Turnaway Study, a long-term research effort that recruited nearly 1,000 women from 30 abortion facilities across the nation over a three-year period. One quarter of the women who were rejected did not receive an abortion.

It turned out that the mental health of both groups was very similar.

“Women who were denied abortions actually experienced more anxiety and lower self-esteem at the time of abortion denial than those who received their abortion,” Foster said. “But the groups converged by six to 12 months, and we don’t see a difference after that point. We don’t see any difference in the outcomes, such as depression, suicidal ideation and life satisfaction. “

“That’s not because those who receive an abortion and those who are denied are both doing badly. Foster said that both groups actually improve over time.

However, taking an unwanted pregnancy to term has serious health effects for women, she said. They are more susceptible to suffering from gestational high bloodpressure, joint pain, headaches, or migraines.

Further, two of the 200 women in the study who were denied abortion died during childbirth, Foster added.

“That’s an astronomical death rate. Foster stated that it is much higher than what Dr. Prager had presented to you. It’s a sign. This is a sign that carrying a full-term pregnancy carries a lot of risk. People don’t feel ready for it. This is a serious health risk they have not signed up for. “

Women who are denied an abortion also have to deal with more economic hardships that those who get a wanted one, Foster said. They were also more likely to become poorer and to be raised in single-parent households.

“It’s not true that a woman denied an abortion means that the man who is involved in the pregnancy supports the family,” Foster stated. Foster said that there is no difference in the possibility that she is still in a relationship with him and that he supports the child. “


More information

The Guttmacher Institute has more about abortion in the United States.

SOURCES: Sarah Prager, MD, professor, obstetrics and gynecology, University of Washington, Seattle; Amanda Stevenson, PhD, assistant professor, sociology, University of Colorado, Boulder; Diana Greene Foster, PhD, professor, Bixby Center for Global Reproductive Health, University of California, San Francisco; American Association for the Advancement of Science media briefing, Nov. 18, 2021

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