The Safety and Quality of Abortion Care in the United States

201 Pages·2017·3.01 MB·English

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The Safety and Quality of Abortion Care in the United States
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240 pages | 6 x 9 | PAPERBACK
ISBN 978-0-309-46818-3 | DOI 10.17226/24950
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GET THIS BOOK Committee on Reproductive Health Services: Assessing the Safety and Quality of
Abortion Care in the U.S.; Board on Population Health and Public Health
Practice; Board on Health Care Services; Health and Medicine Division; National
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The Safety and Quality of Abortion Care in the United States

THE SAFETY AND QUALITY OF
ABORTION CARE IN THE
UNITED STATES

Committee on Reproductive Health Services:
Assessing the Safety and Quality of Abortion Care in the U.S.

Board on Population Health and Public Health Practice

Board on Health Care Services

Health and Medicine Division

A Consensus Study Report of

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Copyright National Academy of Sciences. All rights reserved.
The Safety and Quality of Abortion Care in the United States
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by contracts between the National Academy of Sciences and the
David and Lucile Packard Foundation, Grove Foundation, 7KH JPB Foundation, Susan
Thompson Buffett Foundation, Tara Health Foundation, and William and Flora Hewlett
Foundation. Any opinions, findings, conclusions, or recommendations expressed in this
publication do not necessarily reflect the views of any organization or agency that provided
support for the project.
International Standard Book Number-13: 978-0-309-XXXXX-X
International Standard Book Number-10: 0-309-XXXXX-X
Digital Object Identifier: https://doi.org/10.17226/24950
Library of Congress Control Number:
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Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. The safety
and quality of abortion care in the United States. Washington, DC: The National Academies Press.
doi: https://doi.org/10.17226/24950.

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Copyright National Academy of Sciences. All rights reserved.
The Safety and Quality of Abortion Care in the United States

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by
President Lincoln, as a private, nongovernmental institution to advise the nation on issues
related to science and technology. Members are elected by their peers for outstanding
contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the
National Academy of Sciences to bring the practices of engineering to advising the nation.
Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D.
Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970
under the charter of the National Academy of Sciences to advise the nation on medical and
health issues. Members are elected by their peers for distinguished contributions to medicine
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Learn more about the National Academies of Sciences, Engineering, and Medicine at
www.nationalacademies.org.

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The Safety and Quality of Abortion Care in the United States

Consensus Study Reports published by the National Academies of Sciences, Engineering, and
Medicine document the evidence-based consensus on the study’s statement of task by an
authoring committee of experts. Reports typically include findings, conclusions, and
recommendations based on information gathered by the committee and the committee’s
deliberations. Each report has been subjected to a rigorous and independent peer-review
process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and
Medicine chronicle the presentations and discussions at a workshop, symposium, or
other event convened by the National Academies. The statements and opinions contained in
proceedings are those of the participants and are not endorsed by other participants, the
planning committee, or the National Academies.

For information about other products and activities of the National Academies, please
visit www.nationalacademies.org/about/whatwedo.

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The Safety and Quality of Abortion Care in the United States

COMMITTEE ON REPRODUCTIVE HEALTH SERVICES: ASSESSING THE SAFETY
AND QUALITY OF ABORTION CARE IN THE U.S.

B. NED CALONGE (Co-Chair), University of Colorado
HELENE D. GAYLE (Co-Chair), Chicago Community Trust
WENDY R. BREWSTER, University of North Carolina at Chapel Hill School of Medicine
LEE A. FLEISHER, University of Pennsylvania Perelman School of Medicine
CAROL J. ROWLAND HOGUE, Emory University Rollins School of Public Health
JODY RAE LORI, University of Michigan School of Nursing
JEANNE MIRANDA, University of California, Los Angeles
RUTH MURPHEY PARKER, Emory University School of Medicine
DEBORAH E. POWELL, University of Minnesota Medical School
EVA K. PRESSMAN, University of Rochester Medical Center
ALINA SALGANICOFF, Kaiser Family Foundation
PAUL G. SHEKELLE, The RAND Corporation
SUSAN M. WOLF, University of Minnesota

Study Staff
JILL EDEN, Study Director
KATYE MAGEE, Research Associate
MATTHEW MASIELLO, Research Assistant
ANNA MARTIN, Senior Program Assistant
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and
Public Health Practice
SHARYL NASS, Board Director, Board on Health Care Services
HOPE HARE, Administrative Assistant
PATRICK BURKE, Senior Financial Officer
MISRAK DABI, Financial Associate (from June 2017)

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The Safety and Quality of Abortion Care in the United States

Copyright National Academy of Sciences. All rights reserved.
T h e S a f e t y a n d Q u a l i t y o f A b o r t i o n C a r e i n t h e U n i t e d S t a t e s

Reviewers

This Consensus Study Report was reviewed in draft form by individuals chosen for their
diverse perspectives and technical expertise. The purpose of this independent review is to provide
candid and critical comments that will assist the National Academies of Sciences, Engineering,
and Medicine in making each published report as sound as possible and to ensure that it meets the
institutional standards for quality, objectivity, evidence, and responsiveness to the study charge.
The review comments and draft manuscript remain confidential to protect the integrity of the
deliberative process.
We thank the following individuals for their review of this report:

REBECCA H. ALLEN, Brown University
DONALD M. BERWICK, Institute for Healthcare Improvement
CLAIRE BRINDIS, University of California, San Francisco
PONJOLA CONEY, Virginia Commonwealth University
VANESSA K. DALTON, University of Michigan
C. NEILL EPPERSON, University of Pennsylvania Perelman School of Medicine
DANIEL GROSSMAN, University of California, San Francisco
AMY LEVI, University of New Mexico College of Nursing
HEIDI D. NELSON, Oregon Health & Science University
WILLIE J. PARKER, Physicians for Reproductive Health
ROBERT L. PHILLIPS, JR., American Board of Family Medicine
SARA ROSENBAUM, The George Washington University Milken Institute School of
Public Health
MICHAEL W. VARNER, University of Utah School of Medicine
GAIL R. WILENSKY, Project HOPE
SUSAN F. WOOD, The George Washington University

Although the reviewers listed above provided many constructive comments and
suggestions, they were not asked to endorse the conclusions or recommendations of this report,
nor did they see the final draft before its release. The review of this report was overseen by
ALFRED O. BERG, University of Washington, and ENRIQUETA C. BOND, Burroughs
Wellcome Fund. They were responsible for making certain that an independent examination of
this report was carried out in accordance with the standards of the National Academies and that all
review comments were carefully considered. Responsibility for the final content rests entirely with
the authoring committee and the National Academies.

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C o p y r i g h t N a t i o n a l A c a d e m y o f S c i e n c e s . A l l r i g h t s r e s e r v e d .
The Safety and Quality of Abortion Care in the United States

Copyright National Academy of Sciences. All rights reserved.
The Safety and Quality of Abortion Care in the United States
Acknowledgments

The committee and staff are indebted to a number of individuals and organizations for
their contributions to this report. We extend special thanks to all the individuals who were
essential sources of information, generously giving their time and knowledge to further the
committee’s efforts. Thank you to Elizabeth Brown, Sidney Callahan, Olivia Cappello, Nancy
Chescheir, Mitch Creinin, Carrie Cwiak, Ann Davis, Diana Greene Foster, Marji Gold, Alisa
Goldberg, Kristy Goodman, Jane Henney, Susan Higginbotham, Elizabeth Janiak, Tara Jatlaoui,
Rachel Jones, Uta Landy, Amy Levi, Steve Lichtenberg, Abigail Long, Ana McKee, Michael
Raggio, Matthew Reeves, Debra Stulberg, Diana Taylor, Stephanie Teal, Ushma Upadhyay, Carl
Weiner, Kari White, Beverly Winikoff, and Susan Wood.
Thank you as well to the following individuals, who provided testimony to the
committee:
BONNIE SCOTT JONES, Senior Policy Advisor, Advancing New Standards in
Reproductive Health (ANSIRH), University of California, San Francisco;
SARAH ROBERTS, Associate Professor, Advancing New Standards in Reproductive
Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive
Sciences, University of California, San Francisco; and
JULIET ROGERS, Assistant Professor, Health Management and Policy, University of
Michigan.
Funding for this study was provided by the David and Lucile Packard Foundation, Grove
Foundation, 7KHJPB Foundation, Susan Thompson Buffett Foundation, Tara Health Foundation,
and William and Flora Hewlett Foundation. The committee appreciates the opportunity and
support extended by the sponsors for the development of this report.
Many within the Health and Medicine Division (HMD) of the National Academies of
Sciences, Engineering, and Medicine were helpful to the study staff. The committee would like
to thank Rebecca Morgan and the National Academies Research Center staff for their assistance
in the committee’s research efforts. We would also like to thank Patrick Burke and Misrak Dabi
(HMD Offices of Finance and Administration); Chelsea Frakes, Lauren Shern, and Taryn Young
(Health and Medicine Division Executive Office); and Greta Gorman, Nicole Joy, and Bettina
Ritter (HMD Office of Communications).
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