Trends in induced legal abortion morbidity and mortality
Binkin, N.J.
Clinics in Obstetrics and Gynaecology 13(1): 83-93
1986
ISSN/ISBN: 0306-3356 PMID: 3709015 Document Number: 276187
Mortality from induced legal abortion declined 8-fold in the US between 1972 and 1981. This decline is attributable to improvements in the safety of the procedure, changes in the characteristics of women undergoing abortion, and improved recognition and management of complications. A total of 175 legal abortion deaths were reported in the 1972-81 period, making abortion mortality 1/7 that of childbearing mortality. Older age, minority race, and increased gestational age at the time of abortion are associated with an increased risk of abortion mortality; however, women in these categories now comprise a declining proportion of total abortions. The most significant of the changes contributing to decreased mortality has been the changing gestational age at the time of abortion and shifts in the methods of abortion after 12 gestational weeks. During the 1972-81 period, the percentage of abortions performed at 8 weeks' gestation or earlier increased from 34% to 51% while the percentage of procedures performed at 13 weeks or later fell from 18% to 10%. The greatest declines in terms of causes of abortion mortality have been registered for infection and pulmonary embolus. Although systematic morbidity data are lacking, it appears that the gestation week-specific decline in major complications may not have been as great as for mortality.