Abortion-Related Mortality in the United States: 1998–2010. Issue 2 (August 2015)

• Record Type: Journal Article
• Authors: Zane, Suzanne; Creanga, Andreea A.; Berg, Cynthia J.; Pazol, Karen; Suchdev, Danielle B.; Jamieson, Denise J.; Callaghan, William M.
• Is Part Of: Obstetrics and gynecology. Volume 126:Issue 2(2015)
• Publication Date: 2015-08
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/AOG.0000000000000945
• Languages: English
• ISSNs: 0029-7844

Abstract

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. LEVEL OF EVIDENCE: III Abstract : From 1998–2010, deaths associated with legal induced abortion continued to be rare events, with procedures performed at early gestational ages having the lowest mortality risk.