2018/12/14 · 01:20

Abortion-related emergency department visits in the United States: An analysis of a national emergency department sample (Upadhyay et al)

Abortion-related emergency department visits in the United States: An analysis of a national emergency department sample

Autores: Ushma D. Upadhyay, Nicole E. Johns, Rebecca Barron, Alice F. Cartwright, Chantal Tapé, Alyssa Mierjeski and Alyson J. McGregor

Abstract

Background: Media depictions and laws passed in state legislatures regulating abortion suggest abortion-related medical emergencies are common. An accurate understanding of abortion-related emergencies is important for informing policy and practice. We assessed the incidence of abortion-related emergency department (ED) visits in the United States (U.S.)

Results: Among all ED visits by women aged 15–49 (189,480,685), 0.01% (n = 27,941) were abortion-related. Of these visits, 51% (95% confidence interval, 95% CI 49.3–51.9%) of the women received observation care only. A total of 20% (95% CI 19.3–21.3%) of abortion-related ED visits were for major incidents. One-fifth (22%, 95% CI 20.9–23.0%) of abortionrelated visits resulted in admission to the same hospital for abortion-related reasons. Of the visits, 1.4% (n = 390, 95% CI 1. 1–1.7%) were potentially due to attempts at self-induced abortion. In multivariable models, women using Medicaid (adjusted odds ratio, AOR 1.28, 95% CI 1.08–1.52) and women with a comorbid condition (AORs 2.47–4.63) had higher odds of having a major incident than women using private insurance and those without comorbid conditions. During the study period, 0.11% of all abortions in the U.S. resulted in major incidents as seen in EDs.

Conclusions: Abortion-related ED visits comprise a small proportion of women’s ED visits. Many abortion-related ED visits may not be indicated or could have been managed at a less costly level of care. Given the low rate of major incidents, perceptions that abortion is unsafe are not based on evidence.