Do Abortion-Related Complications Differ Based on Facility Where Done?

Bottom Line: Performing an abortion in an ambulatory surgery center instead of in an office-based setting was not associated with a significant difference in abortion-related complications such as infection and hemorrhage.

Why The Research Is Interesting: Multiple states have laws requiring abortion facilities to meet ambulatory surgery center (ASC) standards. More than 95 percent of abortions are provided in non-hospital-based settings in abortion clinics, other clinics or physician offices. Limited evidence exists about abortion-related complications after an abortion at performed at an ASC compared with an office-based setting.

Who and When: 49,287 women with private health insurance who had 50,311 abortions in an ASC or in an office-based setting from 2011 to 2014

What (Study Measures and Outcomes): Facility type where the abortion was performed (ASC vs office-based setting, which included abortion clinics, other clinics and physician offices) (exposures); any abortion-related complication (such as perforation of the uterus, infection, hemorrhage, tissue that remains in the uterus) within six weeks after an abortion (outcomes).

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Sarah M. Roberts, Dr.P.H., University of California, San Francisco, and coauthors

Results:

Study Limitations: Only included abortions paid for by private insurance so the findings may not be generalizable to all abortions in the United States

Study Conclusions:

Related material: The editorial, “Abortion-Related Adverse Events by Facility Type,” by Carolyn L. Westhoff, M.D., M.S., and Anne R. Davis, M.D., M.P.H., Columbia University Medical Center, New York, is also available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.7675)