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Abortion Safer for Women Than Childbirth, Study Claims
Risk of death, though small, is 14 times higher in full-term pregnancy
By Serena Gordon
MONDAY, Jan. 23 (HealthDay News) -- Since the U.S. Supreme Court legalized abortion in 1973, opponents have questioned the safety of medical procedures used to terminate pregnancy. Now, a new study contends that having a legal abortion is safer than carrying a baby to term.
The risk of death associated with a full-term pregnancy and delivery is 8.8 deaths per 100,000, while the risk of death linked to legal abortion is 0.6 deaths per 100,000 women, according to the study. That means a woman carrying a baby to term is 14 times more likely to die than a woman who chooses to have a legal abortion, the study finds.
"Regardless of one's sentiments about abortion, legal abortion is very safe, and dramatically safer than continuing the pregnancy," said the study's lead author, Dr. David Grimes, a clinical professor in the department of obstetrics and gynecology at the University of North Carolina School of Medicine at Chapel Hill.
Sunday was the 39th anniversary of Roe vs. Wade, the landmark case that struck down state laws prohibiting abortion.
Grimes and his colleagues had several reasons for undertaking the study, published in the February issue of Obstetrics & Gynecology. One is that medical abortion, in which a woman can take a pill early in pregnancy, instead of surgical abortion, "has changed the landscape of abortion, and the mortality information needed to be updated."
Another reason is that in many states, women are given information before getting an abortion. "There's been a proliferation of these women's-right-to-know pamphlets, and some of them are misleading, if not downright incorrect or patently wrong," Grimes said.
A pamphlet given out in Texas lists more complications for abortion than it does for pregnancy, he explained. "Someone without a medical background might infer that abortion is more dangerous than continuing a pregnancy," he said.
To estimate the risk of death, the authors combined information from several national datasets gathered between 1998 and 2005. One, from the U.S. Centers for Disease Control and Prevention, listed the number of pregnancy-related deaths in women delivering live babies. Another CDC dataset gave the number of legal abortions performed in the United States. Information on deaths from legal abortion came from an estimate provided by the Guttmacher Institute, which conducted an annual survey of U.S. hospitals, clinics and physicians' offices that provide abortions. The Guttmacher Institute also provided information from abortion patient surveys, and the researchers searched published studies for additional estimates of mortality.
From known live births, they found there were 2,856 deaths in women between 1998 and 2005. That translates to a risk of death of 8.8 per 100,000 pregnancies, according to the study.
For legal abortion, 64 deaths were reported in the same time frame. That translates to a risk of 0.6 deaths per 100,000 pregnancies, the study authors said.
In addition, the authors found that complications -- such as postpartum hemorrhage, infections and high blood pressure disorders -- were more common in women choosing to continue their pregnancies. This is, in part, because a woman with a full-term pregnancy has that much more time for pregnancy-related problems to develop, the authors said.
Dr. Donna Harrison, director of research and public policy at the American Association of Pro-Life Obstetricians and Gynecologists, disagreed with the authors' conclusions. This study's findings are "speculation," she said.
"Abortion mortality is not systematically collected. What Dr. Grimes' paper most clearly illustrates is the immediate need for reporting requirements for abortion deaths in all 50 states," Harrison said.
"Abortion carries significant risks to the mother in addition to death, and women need to have good and accurate information," Harrison said. "Since we don't have an objective academic format yet, the information provided should probably be left up to the state medical boards and agreed to by the state legislature."
Dr. Mitchell Creinin, professor and chair of obstetrics and gynecology at the University of California, Davis, said that pregnant women considering their options "are often scared by the rhetoric."
"If a state is going to feel a responsibility to be involved in this private matter, we need to ensure that the material is factual," said Creinin, who wrote an accompanying editorial in the same issue of the journal. "If it comes from the state or the government, people assume it's true," he added.
On its website, the Guttmacher Institute describes its mission as advancing "sexual and reproductive health and rights through an interrelated program of research, policy analysis and public education designed to generate new ideas, encourage enlightened public debate and promote sound policy and program development."
The U.S. National Library of Medicine has more information on medical abortion.
SOURCES: David Grimes, M.D., clinical professor, department of obstetrics and gynecology, University of North Carolina School of Medicine, Chapel Hill, N.C.; Donna Harrison, M.D., director of research and public policy, American Association of Pro-Life Obstetricians and Gynecologists; Mitchell Creinin, M.D., professor and chair, department of obstetrics and gynecology, University of California, Davis; February 2012, Obstetrics & Gynecology
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