Abortion Is Less Risky For Women Than Childbirth, But Is Anyone Surprised?

The new analysis compares women who received an abortion to those who were denied one and finds that the former do as well, or better, on all physical metrics.

This week, we are not going to put to rest the abortion debate in the US. But we will put to rest one thread of argument that has never been well-supported by data. The argument is that abortion poses significant health risks to the mother.

According to the most rigorous study yet of the long-term physical effects of abortion vs. childbirth, appearing in the Annals of Internal Medicine, that particular line of argument should be discarded from the broader national dialogue.

Let’s take a look.

There’s something special about the design of the “Turnaway” study. Rather than comparing women who receive an abortion to all other women, as many observational studies do, it compares women who seek an abortion to women who are denied an abortion, typically on the basis of later gestational age.

For example, if a clinic had a gestational age limit of 22 weeks, the study would compare women in the clinic who received an abortion just under that limit (20-22 weeks) to women who were just over that limit (21-23 weeks) and were thus denied an abortion. This is not a perfect control group, but it’s about the best we could hope for, and the baseline characteristics of the women in these two groups were quite similar.

The “Turnaway” study uses a clever design to compare women who received to those who were denied an abortion.

The “Turnaway” study uses a clever design to compare women who received to those who were denied an abortion.

Lauren Ralph, PhD MpH

Lauren Ralph, PhD MpH

The women were followed for 5 years to allow the researchers, led by Dr. Lauren Ralph of UCSF to evaluate their long-term physical health outcomes. Why the focus on physical health? Here’s Dr. Ralph:

“So there’s certainly a narrative, a public narrative that abortion harms women. And one of those threads is that it harms women’s health in the long-term and I don’t think that’s evidence-based at all”.

Physical Health Outcomes at 5-Years

So her team set out to examine the evidence. By every metric, the women who received an abortion had similar physical health outcomes to those who were refused one. For a few relevant outcomes, like self-rated health, women who received an abortion fared better.

Prior studies in the same cohort examining short-term physical outcomes, and short- and long-term mental health showed a similar pattern. Women who received an abortion fared the same or better as women who were denied one.

In other words, abortion is a medical procedure which, like all procedures has risks, but childbirth seems to have greater risks.

In fact, a startling piece of data in this study is that two of the 163 women who were denied an abortion died due to complications of pregnancy or childbirth.

Will this study move the needle on the national debate?  Here’s Dr. Ralph again:

“As a researcher, my hope is always that it can inform the debate that is going on. I think it does very clearly quantify what the consequences are of denying women access to a wanted abortion and that is certainly something that is on the table right now”.

As I said up front, we never had good data to support the argument that abortion causes long-term physical harm to women. And though this has never been the primary argument against abortion, we now have good-quality data to suggest that no such harm exists.

This commentary originally appeared on medscape.com.