A groundbreaking report from the National Academies of Sciences, Engineering, and Medicine concludes – with no margin for rational disagreement – that the abortion procedures used in the United States are safe and effective.
The 186-page review, available online in its entirety or as a tidy summary, is based on a review of the available clinical and real-world data regarding the medical outcomes and quality of the four current methods – medication, aspiration, dilation and evacuation (D&E), and induction.
Moreover, the diverse team of expert authors found no evidence to supporting the benefit of regulations, varying state-by-state, that require abortion-providing clinics to meet stringent facilities criteria, offer pre-procedure counseling, observe waiting periods, and limit which providers can perform the procedures. Their analysis proves that these laws, passed under the thinly veiled claim that they protect women’s wellbeing, accomplish the opposite instead.
“Abortion is safer when it’s performed earlier in gestation,” Dr Hal Lawrence, CEO of the American College of Obstetricians and Gynecologists, told NPR. “And so delaying and making people wait and go through hoops of unnecessary, extra procedures does not improve the safety. And actually by having them delay, can actually worsen the safety.”
Although all four methods are safe, undergoing an abortion before 10 weeks is the least invasive, as women can simply take one oral dose of the medication mifepristone combined with a vaginal suppository of misoprostol. Thus, any delay to accessing an abortion runs down the clock to a point at which she would need a more intensive procedure that carries a greater risk of complications (and is offered at fewer locations).
According to the report, about 17 percent of women had to travel more than 50 miles to obtain an abortion due to the scarcity of operating clinics. And 27 states mandate that women receive counseling and then wait a prespecified time (usually 24 hours) before they can return and undergo the procedure. When these logistical situations are combined, as is common in the middle American states, women in need of abortions who lack adequate time away from work/family obligations or reliable transportation (i.e. low-income individuals) may face unjust difficulty.
When examining what resources an abortion clinic truly needs, the authors determined that the equipment, personnel, and hospital availability necessary for patient safety are no different than what other outpatient medical centers that perform procedures of similar complexity offer. As the majority of abortions are simple, they estimate that 95 percent can be performed in an office setting.
Finally, the paper calls out the misleading nature of many states’ informed consent requirements.
“Some states require abortion providers to provide women with written or verbal information suggesting that abortion increases a woman’s risk of breast cancer or mental illness, despite the lack of valid scientific evidence of increased risk,” the authors wrote.