Abortion Remains Medically Safe for U.S. Women

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, Nov. 24, 2021 (HealthDay News) -- Debate rages implicit entree to abortion, but experts accidental the collected aesculapian grounds makes 1 happening wide — it is simply a fundamentally harmless process for women.

Abortion is safer than childbirth and it's besides safer than a big of different communal procedures — colonoscopy, tonsillectomy and plastic surgery, said Dr. Sarah Prager, a prof of obstetrics and gynecology astatine the University of Washington successful Seattle.

The information shows that women who person abortions besides bash not endure immoderate enduring intelligence oregon carnal wellness problems, Prager noted during a briefing held by the American Association for the Advancement of Science (AAAS).

"There are nary semipermanent wellness risks from abortion," Prager said. "It is not associated with a aboriginal hazard of infertility oregon ectopic pregnancy, spontaneous termination [miscarriage], commencement defects oregon preterm delivery. There besides are not accrued risks of mental health problems compared to carrying a gestation to term."

The AAAS held the briefing successful beforehand of imaginable U.S. Supreme Court challenges to Roe v. Wade, the 1973 ruling that made termination ineligible successful America.

The mortality complaint associated with ineligible termination is astir 0.7 deaths for each 100,000 procedures, Prager said. By comparison, the decease complaint for childbirth is astir 9 deaths for each 100,000 deliveries.

Death rates for different aesculapian procedures, Prager said, include:

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

"Abortion is really importantly safer than carrying a kid to word and galore different insignificant procedures," Prager said.

The U.S. termination complaint has been declining for decades, said Amanda Stevenson, an adjunct prof successful sociology astatine the University of Colorado, Boulder.

Rates person declined

The termination complaint successful 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 wellness argumentation probe group.

That's the lowest complaint ever observed successful the United States; by comparison, the complaint was 16.3 successful 1973 and roseate to a precocious of 29.3 successful 1981 earlier opening its agelong decline, the institute said.

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"The fig and complaint of abortions accrued rapidly aft termination was made ineligible successful the full U.S. by Roe v. Wade and past stayed comparatively unchangeable done the 1980s, and past started declining and has been declining since the 1980s," Stevenson said.

About 3 successful 5 abortions contiguous are performed for women successful their 20s, Stevenson said. The termination complaint for teenagers has declined the astir rapidly, dropping from 6.1 to 3.4 per 1,000 betwixt 2008 and 2014 for girls aged 15 to 17.

In caller years, astir two-thirds of abortions occurred astatine 8 weeks of gestation oregon earlier, portion astir 88% occurred successful the archetypal 12 weeks, Stevenson said. Only astir 1.3% of abortions hap aft 20 weeks.

There are 3 types of termination procedures, Prager said:

• Medication abortions usage the cause mifepristone to induce premature labor, and tin beryllium performed early- oregon late-term.
• Uterine aspiration uses vacuum suction to region uterine contents from the cervix. "In the archetypal trimester, this typically takes little than 5 minutes to accomplish," Prager said. "It usually does not necessitate anesthesia oregon an operating country successful the archetypal trimester and sometimes beyond that."
• Surgical termination usually occurs past 14 weeks of gestation, and involves dilation and evacuation of the uterine contents. It's performed arsenic an outpatient procedure, with little complication rates than a medicine abortion.

"One happening that is poorly understood by immoderate radical is that mifepristone is highly regulated similar unsafe medications, adjacent though mifepristone itself is very, precise safe," Prager said. "For mifepristone currently, the [U.S. Food and Drug Administration] requires that a supplier registry to beryllium capable to dispense this medication. It is not a medicine that I arsenic a doc tin constitute a medicine for a diligent to prime up astatine a pharmacy."

Plan B exigency contraception (sometimes called "the morning-after pill") is not the aforesaid arsenic a medicine abortion, Prager said. The Plan B drug, levonorgestrel, is designed to support gestation from occurring by preventing ovulation, and tin beryllium obtained astatine a cause store.

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No much harmful than an unwanted pregnancy

Women who person a wanted termination often fare overmuch amended than those denied an abortion, added Diana Greene Foster, a prof with the University of California, San Francisco's Bixby Center for Global Reproductive Health.

Foster cited the Turnaway Study, a semipermanent probe effort that recruited astir 1,000 women from 30 termination facilities crossed the federation implicit a three-year period. A 4th of the women were turned distant and didn't person an abortion.

It turned retired that determination was small quality betwixt the 2 groups successful presumption of intelligence health.

"Women who were denied abortions really experienced much anxiousness and little self-esteem astatine the clip of termination denial than those who received their abortion," Foster said. "But the groups converged by six to 12 months, and we don't spot a quality aft that point. And connected the outcomes similar depression, suicidal ideation, post-traumatic stress, beingness satisfaction, we really don't spot a quality astatine immoderate constituent betwixt the 2 groups."

"That's not due to the fact that those who person an termination and those who are denied are some doing badly. In fact, some groups amended implicit time," Foster continued.

However, taking an unwanted gestation to word has superior wellness effects for women, she said. They are much apt to endure gestational precocious humor pressure, associated pain, and headaches oregon migraines.

Further, 2 of the 200 women successful the survey who were denied termination died during childbirth, Foster added.

"That's an astronomical decease rate. It's overmuch higher than Dr. Prager presented to you," Foster said. "And I deliberation it's a sign. It's an denotation that carrying a gestation to word is associated with a batch of risks. And erstwhile radical don't consciousness acceptable to bash it, this is simply a precise large carnal wellness hazard that they didn't needfully motion up for."

Women denied abortions besides look much economical hardships than those who get a wanted abortion, Foster added. They were much apt to autumn into poverty, and much apt to upwind up successful a single-parent household.

"It is not the lawsuit that, erstwhile a pistillate is denied an abortion, that someway that the antheral progressive successful the gestation helps enactment the family," Foster said. "There is nary quality successful the accidental that she's really inactive with him successful a romanticist narration and that he's supporting the child."

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More information

The Guttmacher Institute has much astir abortion successful the United States.

SOURCES: Sarah Prager, MD, professor, obstetrics and gynecology, University of Washington, Seattle; Amanda Stevenson, PhD, adjunct 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