Abortion-Related Mortality in the United States

Abstract

OBJECTIVE To examine characteristics and causes of legal induced abortion–related deaths in the United States between 1998 and 2010. METHODS Abortion-related deaths were identified through the national Pregnancy Mortality Surveillance System with enhanced case-finding. We calculated the abortion mortality rate by race, maternal age, and gestational age and the distribution of causes of death by gestational age and procedure. RESULTS During the period from 1998–2010, of approximately 16.1 million abortion procedures, 108 women died, for 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 black 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. A majority of 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. CONCLUSION Deaths associated with legal induced abortion continue to be rare events—less than 1 per 100,000 procedures. 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.

Abortion Surveillance — United States, 2013

“…Since 1987, CDC has monitored abortion-related deaths through its Pregnancy Mortality Surveillance System (41,42). Sources of data for abortion-related deaths have included state vital records; media reports, including computerized searches of full-text newspaper and other print media databases; and individual case reports by public health agencies, including maternal mortality review committees, health care providers and provider organizations, private citizens, and citizen groups.…”

Women's experiences seeking abortion care shortly after the closure of clinics due to a restrictive law in Texas

“…However, several were delayed longer, and two experienced significant delays that resulted in obtaining abortions in the second trimester when their initial attempt to access care would have allowed for a first-trimester procedure. Although second-trimester abortion is very safe, it is associated with a higher risk of complications and death compared to first-trimester abortion [10]; later abortion is also more expensive [11]. …”

Unintended pregnancy: a framework for prevention and options for midlife women in the US

“…These rare deaths are usually the result of such things as adverse reactions to anesthesia, embolism, infection, or uncontrollable bleeding. In comparison, a woman's risk of death during pregnancy and childbirth is ten times greater [56]. The abortion mortality rate was at least as low as the mortality rate associated with plastic surgery at licensed or accredited ambulatory surgical centers in the same decade, approximately equivalent to the proportion of marathon runners who died during races in the same time period [52,57].…”

“…Mortality is extremely rare when abortion is performed by qualified, competent licensed healthcare providers and occurs early in pregnancy [56]. The risk of death associated with abortion increases with gestational age, from 0.3 per 100,000 abortions at or before eight weeks to 6.7 per 100,000 at 18 weeks or greater [56].…”