Abortion is SafeAccording to a groundbreaking report from a new report from the National Academies of Sciences, Engineering and Medicine

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A new report from the National Academies of Sciences, Engineering and Medicine (NASEM) concludes that abortion is safe and effective.

The Report

The report is an evidence-based, nonpartisan, scientific research overview developed by an independent panel of 13 leaders in the medical field. It is also the firs t comprehens ive look at abortion safety, access and care conducted in the las t 40 years .

This presentation summarizes the report findings and describes the implications of the research.

All forms of abortion are safe and effective.

Abortion can be safely performed in an office setting with a trained provider.

Medically unnecessary regulations hinder a woman’s ability to access quality care.

Key Findings

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1 - Medication abortion

● Complications occur in less than one percent of cases .

● Effective in 96.7 percent of cases .

● Doesn’t require the phys ical presence of a clinician, or special equipment or emergency arrangements .

Types of Abortion

2 - Aspiration abortion

● Most common form of abortion, making up 68 percent of procedures .

● Minimally invas ive and takes less than 10 minutes .

● Rarely results in complications and can be safely performed in an office-based setting by a phys ician ass is tant, certified nurse-midwife, nurse practitioner or phys ician.

● Highly effective – in 99.8 percent of cases .

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3 - Dilation & Evacuation (D&E)

● Most common for abortions after 14 weeks .

● Studies have found few complications associated with D&E.

● Reported as the superior method for abortion when aspiration is no longer appropriate .

● Despite scientific evidence, at leas t eight s tates have passed laws banning the procedure outright and at leas t 17 s tates have banned abortion after 20 weeks .

Types of Abortion

4 - Induction

● Nonsurgical, time- and resource-intens ive procedure.

● Rarely leads to complications according to available evidence.

● Can be provided in a medical office or clinic by a trained clinician with the same skills needed for managing labor and delivery.

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Skilled Clinicians

Many types of clinicians have the skills necessary to provide abortion care safely and effectively.

These providers are capable of performing the core components of abortion care, including preparation for and completion of the procedure, as well as managing any pain, complications and pos t-procedure care.

Abortion can be performed safely in an office setting without special equipment or emergency arrangements .

Mos t procedures are performed in an outpatient, community-based clinic or another medical clinic – not a hospital setting.

The committee found no evidence indicating that clinicians that perform abortions require hospital privileges to ensure a safe outcome for patients .

Facility Requirements

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Availability of TrainingThere are not enough professionals trained to provide abortion in the U.S., because abortion training is not universally available and overregulation.

30% of OBGYN Programs Offer Integrated Abortion Training

• 90 OBGYN Programs offer fully-integrated trainings with the option to opt -out

• 193 OBGYN Programs do not offer fully-integrated abortion training

7% of Family Residency Programs Offer Integrated Abortion Training

• 26 Family Medicine Programs offer fully-integrated abortion training

• 443 Family Medicine Programs do not offer fully-integrated abortion training

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Three factors that impact the availability of abortion training

Abortion training is only required for

OB/GYNS.

Hospitals owned by religious organizations and hospitals in states hostile to abortion often prohibit providing and teaching

abortion.

Abortion-specific state regulations across the U.S.

create barriers for providers seeking training.

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The report explains that abortion has no impact on a woman’s future fertility, breas t cancer risk or likelihood to experience mental health disorders .

Informed ConsentLegally requiring providers to inform women about risks that are invalidated by scientific research violates long-es tablished s tandards of informed consent.

The report is an indictment on the regulations in 16 states that require abortion providers to offer or provide inaccurate or mis leading information, such as abortion can increase risk of breas t cancer or impact women’s future fertility.

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Quality CareThe Ins titute of Medicine (IOM) identified 6 dimensions of quality care in the report Crossing the Quality Chasm: A New Health System for the 21st Century.

These s ix attributes are widely cons idered to be a guide for how to measure quality across all aspects of health care.

The report conducted a rigorous review of decades of abortion research to answer the ques tion:

Does abortion care in the United States meet the six attributes of quality health care?

Safe

Effective

Patient Centeredness

Efficiency

Timeliness

Equity

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Attribute 1 – Safety

IOM DEFINITION:

Avoiding injuries to patients from the care that is intended to help them.

CONCLUSION

All four types of abortion –medication, aspiration, dilation & evacuation (D&E) and induction – are safe and rarely result in serious complications .

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Attribute 2 – Effectiveness

IOM DEFINITION:

Providing care based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit.

CONCLUSION

All four types of abortion are effective. But, whether women receive the care that bes t meets their needs often depends on where they live and s tate regulations .

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Factors Limiting Effective Care● Imposing hospital-like structural standards on facilities

● Prohibiting certain types of abortion that are most effective in some circumstances

● Delaying care by imposing mandatory waiting periods

● Prohibiting capable clinicians from performing abortion

● Requiring clinicians to provide inaccurate informationto patients

● Mandating unnecessary services, such as in-person counseling or ultrasound that obstruct or delay care

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Attribute 3 – Patient Centeredness

IOM DEFINITION:

Providing care that is respectful of and respons ive to individual patient preferences , needs and values and ensuring that patient values guide all clinical decis ions .

CONCLUSION

A patient’s personal circumstances and preferences may be dis regarded depending on where they live, due to s tate regulations .

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State Regulations Limiting Patient Centeredness● Requiring patients receive

information that is inaccurate or misleading about potential harms

● Mandating clinically unnecessary services and delays (e.g. pre-abortion ultrasound, in-person counseling, waiting periods)

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Attribute 4 – Timeliness

IOM DEFINITION:

Reducing waits and sometimes harmful delays for those who receive and those who give care.

CONCLUSION

Timeliness depends on availability of care, dis tanceto providers , waiting periods and follow-up care requirements .

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Regulations Limiting Timeliness● Mandating waiting periods

(from 18-72 hours)

● Requiring in-person counseling

● Laws that limit the availability of providers and facilities

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Attribute 5 – Efficiency

IOM DEFINITION:

Avoiding was te, including was te of equipment, supplies , ideas and energy.

CONCLUSION

Efficiency of care is diminished by regulations that require needless equipment and services that decrease the efficiency of care.

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Regulations Limiting Efficiency● Imposing hospital-like structural

standards on facilities

● Requiring unnecessary services

● Mandating multiple patient visits, increasing the cost for the patient

● Requiring scripted counselling that may include inaccurate information

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Attribute 6 – Equity

IOM DEFINITION:

Providing care that does not vary in quality because of personal characteris tics such as gender, ethnicity, geographic location, and socioeconomic s tatus .

CONCLUSION

A patient’s ability to access care depends on their geographic location and/or socioeconomic s tatus .

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Regulations Limiting Equity● Mandating waiting periods

● Limiting qualified providers

● Requiring multiple appointments

● Limits on insurance coverage

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Regulations Impact Quality Care

• Requiring abortion to be performed by a licensed physician (34 states)

• Mandatory waiting periods (from 18 to 72 hours) (26 states)

• Requiring clinicians providing medication abortions to be in the physical presence of the patient taking the medication (19 states)

The report debunks many regulations that states have implemented to limit access to abortion.

• Requiring all abortions to be performed in a facility that meets the structural standards of an ambulatory surgical center (17 states)

• Requiring abortion providers to offer or provide inaccurate or misleading information (16 states)

• Specifying procedure room size, corridor width or maximum distance to a hospital (16 states)

• Requiring clinicians to have hospital admitting privileges or an agreement with a local hospital to transfer patients (10 states)

• Mandating abortion facilities have an agreement with a local hospital to transfer patients (8 states)

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