Side Effects, Physical Health Consequences, and Mortality Associated with Abortion and Birth after an Unwanted Pregnancy

INTRODUCTION:

The safety of abortion in the United States has been documented extensively. In the context of unwanted pregnancy, however, there are few data comparing the health consequences of having an abortion versus carrying an unwanted pregnancy to term.

METHODS:

We examine and compare the self-reported physical health consequences after birth and abortion among participants of the Turnaway Study, which recruited women seeking abortions at 30 clinics across the United States. We also investigate and report maternal mortality among all women enrolled in the study.

RESULTS:

In our study sample, women who gave birth reported potentially life-threatening complications, such as eclampsia and postpartum hemorrhage, whereas those having abortions did not. Women who gave birth reported the need to limit physical activity for a period of time three times longer than that reported by women who received abortions. Among all women enrolled in the Turnaway Study, one maternal death was identified-one woman who had been denied an abortion died from a condition that confers a higher risk of death among pregnant women.

CONCLUSION:

These results reinforce the existing data on the safety of induced abortion when compared with childbirth, and highlight the risk of serious morbidity and mortality associated with childbirth after unwanted pregnancy.

Table 2Reported Side Effects and Health Problems by Study Group (N = 868)

Variable	Turnaways (n = 143)	Near Limits (n = 452)	First Trimesters (n = 253)	pValue††
Limitations on physical activity, n (%)
Limitations on physical activity reported in days (mean, SD)	10.1 (11.69)∗	2.9 (2.6)	3.2 (3.6)	<.001
Side effects or health problems, n (%)
Any reported side effects/health problems, n (%)	16 (11.2)	55 (12.2)	28 (10.3)	.84
Potentially life-threatening condition reported, n (%)	9 (6.3)∗	5 (1.1)	1 (0.4)	<.001
Side effect/health problem reported, n (%)
Abdominal cramping	0 (0)	12 (3)	6 (2)
Abnormal bleeding	2 (1)	10 (2)	6 (2)
Nausea/vomiting/gastrointestinal upset	0 (0)	3 (1)	8 (3)
Pain	0 (0)	16 (4)	9 (3)
Preeclampsia‡‡	3 (2)	1 (0.5)	0 (0)
Infection‡‡	1 (1)	3 (1)	1 (0.5)
Dizziness	0 (0)	3 (1)	2 (1)
Weakness or fatigue	0 (0)	4 (1)	3 (1)
Breast changes	0 (0)	4 (1)	1 (0.5)
Low blood pressure	1 (1)	1 (0.5)	0 (0)
Normal/light bleeding	0 (0)	2 (0.5)	3 (1)
Anemia	1 (1)	0 (0)	0 (0)
Blood transfusion‡‡	2 (1)	0 (0)	0 (0)
Bruises secondary to procedure/equipment	0 (0)	3 (1)	0 (0)
Disrupted caesarean wound‡‡	1 (1)	0 (0)	0 (0)
Eclampsia/seizure‡‡	1 (1)	0 (0)	0 (0)
Edema	0 (0)	4 (1)	0 (0)
Fever	0 (0)	4 (1)	0 (0)
Fractured pelvis	1 (1)	0 (0)	0 (0)
Headache	0 (0)	2 (0.5)	1 (0.5)
Hypokalemia	1 (1)	0 (0)	0 (0)
Postpartum hemorrhage‡‡	1 (1)	0 (0)	0 (0)
Retained placenta‡‡	1 (1)	0 (0)	0 (0)
Allergic reaction to anesthesia‡‡	0 (0)	1 (0.5)	0 (0)
Hemorrhoids	0 (0)	1 (0.5)	0 (0)

∗p < .05 for comparisons between near limits and other study groups.

†Uncorrected p-value is based on multiple comparisons with “near limits” as the reference group.

‡Denotes a potentially life-threatening condition.

Full article at:  http://goo.gl/R8tOQY

By:  Gerdts C1, Dobkin L2, Foster DG2, Schwarz EB3.

• 1Ibis Reproductive Health, Oakland, California. Electronic address: cgerdts@ibisreproductivehealth.org.
• 2Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, California.
• 3Department of Medicine, University of California, Davis, Sacramento, California. 

More at:  https://twitter.com/hiv_insight

And: http://twitter.com/Prison_Health