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By Lisa Rapaport
(Reuters Health) – Women who undergo abortions in clinics or doctors' offices may not be more likely to experience serious complications than patients who have these procedures in surgery centers, suggests a US study.
Thirteen US states have laws requiring abortions to be provided in surgical centers, study authors point out in JAMA. These laws include requirements such as the specific width of doors or corridors or separate parts for procedures and recovery.
"The rationale for these laws is that they are necessary for the safety of aborted patients," said Sarah Roberts, a researcher at the University of California at San Francisco, in an email. "Our study indicates that these laws are not evidence-based."
To compare rates of complications in the six weeks following an abortion, the researchers examined claim data for women with private health insurance who discontinued pregnancies between 2011 and 2014. Overall, they had data on more than 50,000 medical and surgical abortions.
In the surgical centers, 3.25% of women had abortion-related complications, compared with 3.33% elsewhere. This difference was too small to exclude the possibility that it was due to chance.
There was no significant difference between surgical centers and office care for emergency room visits, diagnoses of complications, repeated procedures or the use of injected or intravenous antibiotics for treat infections.
There were no deaths.
Most abortions occurred in office environments. About 11 percent were performed at surgical centers.
Women were on average 28 years old, but their ages ranged from 11 to 59 years old.
Overall, 47% of patients had surgical abortions in the first trimester. These procedures usually involved suctioning or suctioning to remove the contents of the uterus through the cervix, a type of induced abortion that is common when women have a miscarriage
Another 27 percent of women had medical abortions in the first trimester. With this option, which women can do at home, patients take a drug that breaks down the uterine lining followed by a second medication to empty the uterus. Then, they usually have an exam two weeks later to confirm that the pregnancy has been interrupted.
The remaining 26% of women in the study had surgical abortions after the start of the second trimester.
The study was not a controlled experiment designed to prove if or how the location of an abortion could influence safety. Another limitation is that researchers lacked data on the exact week of pregnancy that women had abortions, which may influence their risk of complications.
In addition, only 15% of the nearly 1 million abortions performed each year in the United States are paid for by private insurance, the study authors note that the results could be different for women with d & # 39; Other forms of coverage like Medicaid, program for the poor.
Even so, the findings highlight the safety of abortions provided in workplaces as well as surgical centers, Dr. Carolyn Westhoff of Columbia University Medical Center in New York and colleagues write in an accompanying editorial.
"Abortion care has moved quickly to the office, for universal reasons of convenience and cost reduction, and because the majority of abortions are technically simple and safe," write Westhoff and colleagues. "In-office abortion care should remain an option available to women."
In 2016, the US Supreme Court ruled that a Texas law requiring all abortion facilities to meet regulatory standards in place for outpatient surgery centers was unconstitutional.
SOURCE: http://bit.ly/2K9BFYt and http://bit.ly/2Kk9XaV JAMA, online June 26, 2018.
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