The committee was not able to find high-quality research to evaluate the risk of ectopic pregnancy, miscarriage or stillbirth, or long-term mortality associated with abortion. However, it did find an increased risk of preterm birth before 28 weeks’ gestation in a nulliparous women who had had two or more aspiration abortions, compared with women with no abortion history. The risk of preterm birth is greater in women if the interval between their abortion and their next conception is less than 6 months. The same risk exists for short intervals between pregnancy in general, the committee noted.
Overall, they wrote, “serious complications are rare and occur much less frequently than during childbirth.”
The committee identified several kinds of state-level regulations that are obstacles to effective abortion care in the United States. Such regulations “may limit the number of available providers, misinform women of the risks of the procedures they are considering, overrule women’s and clinicians’ medical decision making, or require medically unnecessary services and delays in care.” Some laws “prohibit the abortion method that is most effective for a particular clinical circumstance” (for example, D&E).
Access to care varies widely geographically, and 17% of women must travel more than 50 miles to obtain an abortion. Regulations that required counseling, whether the woman desires counseling or not, are cited as an example of inferior patient-centered care.