Abortion Services Vary Widely Across the U.S.

From the WebMD Archives

By Robert Preidt

HealthDay Reporter

FRIDAY, March 16, 2018 (HealthDay News) -- The quality of abortion services in the United States can hinge on where a woman lives, a new report shows.

The report from The National Academies of Sciences, Engineering, and Medicine found that while legal abortions in the United States are considered safe, many states have rules that limit a woman's access to a safe and effective abortion.

According to the committee that drafted the report, states can limit abortion access by forbidding qualified providers from performing the procedures, misinforming women of the risks involved, or requiring medically unnecessary services and delaying care.

As outlined in the report, some examples of these rules include: mandatory waiting periods; pre-abortion ultrasound; a separate counseling visit; and forcing abortion providers to give women written or verbal information suggesting that abortion increases a woman's risk of breast cancer or mental illness, despite the fact that there is no scientific evidence to support that claim.


The report was released online March 16.

The vast majority of abortions can be provided safely in office-based settings, and 95 percent of abortions performed in 2014 in the United States occurred in clinics and other office-based settings, according to the committee that wrote the report.

In addition, there is no evidence that doctors who perform abortions require hospital privileges to ensure a safe outcome for the patient.

Still, there has been a drop in the number of abortion clinics across the country, the report found.

In 2014, there were 17 percent fewer abortion clinics in the United States than in 2011, and 39 percent of women of reproductive age lived in a county without an abortion provider, the report noted.

In 2017, 25 states had five or fewer abortion clinics, and five states had only one abortion clinic. About 17 percent of women have to travel more than 50 miles to have an abortion, the report found.

Most abortions in the United States are performed early in pregnancy, the report stated. In 2014, 90 percent of abortions occurred by 12 weeks of gestation.


Serious complications from abortion are rare, and the highest levels of safety and quality are achieved when an abortion is performed as early in pregnancy as possible, the report authors said.

The committee also reviewed the long-term health effects of abortion and concluded that it does not increase the risk of infertility, high blood pressure during pregnancy, preterm birth, breast cancer or mental health disorders, such as depression, anxiety or post-traumatic stress disorder.

There did appear to be an association between very preterm birth and the number of prior abortions. For example, an increased risk of very preterm birth of a first-born child was associated with having two or more aspiration abortions, which is a type of surgical procedure.

An analysis of abortion trends in the United States revealed that the rate fell by more than half between 1980 and 2014, from 29 per 1,000 to 15 per 1,000 women of reproductive age.

The reason for the decrease may be due to factors such as wider use of birth control, and increasing state regulations that limit women's access to legal abortion, according to the report.

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SOURCE: National Academies of Sciences, Engineering, and Medicine, news release, March 16, 2018
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