|
 Thirteen U.S. states have laws requiring abortions to be provided at
surgery centers, the study authors point out in JAMA. These laws
include requirements such as specific widths of doors or hallways or
separate rooms for procedures and recovery.
"The rationale for these laws is that they are necessary for the
safety of abortion patients," said study leader Sarah Roberts, a
researcher at the University of California, San Francisco, in an
email. "Our study indicates that these laws are not evidence-based."
To compare rates of complications within six weeks after an
abortion, researchers looked at claims data for women with private
health insurance who terminated pregnancies between 2011 and 2014.
Overall, they had data on more than 50,000 medical and surgical
abortions.
At surgery centers, 3.25 percent of women had complications related
to abortions, compared with 3.33 percent at other locations. This
difference was too small to rule out the possibility that it was due
to chance.
There was no meaningful difference between surgery centers and
office-based care for emergency room visits, diagnoses of
complications, repeat procedures, or use of injected or intravenous
antibiotics to treat infections.
There were no deaths.
Most abortions happened in office-based settings. About 11 percent
were performed in surgery centers.
Women were 28 years old on average, although they ranged in age from
11 to 59.
Overall, 47 percent of the patients had first trimester surgical
abortions. These procedures typically involved vacuum or suction
aspiration to remove uterine contents through the cervix, a type of
induced abortion that is common when women have a miscarriage.
Another 27 percent of the women had first trimester medical
abortions. With this option, which women can do at home, patients
take one drug that breaks down the uterine lining followed by a
second drug to empty the uterus. Then, typically they have a checkup
two weeks later to confirm that the pregnancy was terminated.
[to top of second column] |
The remaining 26 percent of women in the study had surgical
abortions after the start of the second trimester.
The study wasn't a controlled experiment designed to prove whether
or how the location of an abortion might influence safety. Another
limitation is that researchers lacked data on the exact week of
pregnancy that women had abortions, which can influence their risk
of complications.
In addition, only about 15 percent of the almost 1 million abortions
performed each year in the U.S. are paid for by private insurance,
the study authors note, so the results might be different for women
with other forms of coverage like Medicaid, the U.S. health program
for the poor.
Even so, the results underscore the safety of abortions provided in
office settings as well as surgery centers, Dr. Carolyn Westhoff of
Columbia University Medical Center in New York City and colleagues
write in an accompanying editorial.
"Abortion care made an early shift to the office setting, for the
universal reasons of convenience and cost reduction, and because the
majority of abortions are technically simple and safe," Westhoff and
colleagues write. "Office-based abortion care should remain an
available option for women."
In 2016, the U.S. Supreme Court ruled that a Texas law requiring all
abortion facilities to meet regulatory standards in place for
ambulatory surgery centers was unconstitutional.
SOURCE: http://bit.ly/2K9BFYt and http://bit.ly/2Kk9XaV JAMA, online
June 26, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content.
 |
