Trends in induced legal abortion morbidity and mortality

Abortion mortality in the USA experienced an eight-fold decline between 1972 and 1981, with the greatest decline occurring after 1975. The risk for all groups of women declined, but the decline was greater for some groups than for others. When both changing risk for a given characteristic and changing prevalence of that characteristic were examined, it appears that the declining mortality rates are largely due to a downward shift in the gestational ages at which abortions are obtained and the increased use of D&E for abortions at 12 gestational weeks or later. Although morbidity data analogous to the mortality data are not available, analysis of morbidity trends from three large multicentre prospective studies between 1970 and 1978 suggests that morbidity may not have declined quite as rapidly as mortality. The morbidity data, as well as giving information on cause-specific abortion mortality in the USA, showing dramatic declines for such causes as infection and pulmonary embolus, suggest that improved medical management of complications has contributed to declining abortion mortality in the USA.