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Getting a legal abortion is much safer than giving birth, suggests a new US study published. Researchers found that women were about 14 times more likely to die during or after giving birth to a live baby than to die from complications of an abortion.
Experts say the findings, though not unexpected, contradict some state laws that suggest abortions are high-risk procedures.
The message is that getting an abortion and giving birth are both safe, said Dr Anne Davis, who studies obstetrics and gynaecology at the Columbia University Medical Center in New York, and wasn't involved in the new study.
"We wouldn't tell people, 'Don't have a baby because it's safer to have an abortion' – that's ridiculous," she said. "We're trying to help women, who are having all reproductive experiences, know what to expect."
An induced abortion – like any other medical procedure – requires getting informed consent from the woman, said Dr Bryna Harwood, an ob-gyn from the University of Illinois in Chicago who also didn't participate in the new research.
That means women understand and acknowledge the risks of their different options.
What makes it complicated, Harwood added, is when the law interferes and requires doctors to state information that isn't always balanced or medically sound – usually exaggerating the risk of abortion.
The researchers on the new study combined government data on live births and pregnancy- and abortion-related deaths with estimates on legal abortions performed in the US from the Guttmacher Institute, which conducts sexual and reproductive health research and education.
Death during childbirth
Dr Elizabeth Raymond from Gynuity Health Projects in New York City and Dr David Grimes of the University of North Carolina School of Medicine, Chapel Hill, found that between 1998 and 2005, one woman died during childbirth for every 11,000 or so babies born.
That compared to one woman of every 167,000 who died from a legal abortion.
The researchers also cited a study from the Centers for Disease Control and Prevention which found that, from 1998 to 2001, the most common complications associated with pregnancy – including high blood pressure, urinary tract infections and mental health conditions – happened more often in women who had a live birth than those who got an abortion.
In their report, published in the Journal Obstetrics & Gynecology, Raymond and Grimes write that the findings aren't surprising given that women are pregnant for a lot longer when they decide to have a baby and so have more time to develop complications.
Harwood said previous studies have also shown the safety of legal abortions.
Most abortions have typically been done surgically, she said. But since the abortion drug mifepristone was approved for use in the United States in 2000, the number of medically-induced abortions has been on the rise.
Both methods are now considered equally safe, she said, with the main risk – though very small – coming from medication- and procedure-related infections.
Risks of abortion
Depending on the state, however, doctors legally must go over the risks of abortion in language that may be misleading, researchers said, with skewed lists of possible complications. Others require a 24-hour waiting period in between the counselling and the abortion itself.
Harwood said that laws regarding what's said between the doctor and a woman seeking an abortion often hamper doctors' attempts to inform patients in a balanced way.
"It is certainly an impediment to have the state dictate my informed consent process beyond the usual," Harwood said. "Abortion care and pregnancy care should not really be any different than consenting people for any other procedure."
Davis agreed that state-mandated discussions have no place in abortion counselling. She said she was glad to see the new report, which helps dispel "misinformation" and "lies" about abortion risks included in some state laws – such as the idea that abortion is linked to cancer.
"Women who are having abortions are having a safe, common surgical procedure or taking medication for the same reason," she said.
"They should feel confident that the medical care they're having is safe, long-term and short-term."
(Reuters Health, Genevra Pittman, January 2012)
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