Safety and effectiveness of one-day later abortion procedures: A retrospective chart review

Abstract

Introduction The abortion process at later gestational ages—from placement of dilators, to completion of procedure—can have a duration of up to three days. Coupled with mandatory waiting periods in many states, later-abortion procedures often place undue burdens on patients (increased travel, accommodation, and administrative costs). We present evidence on the safety of later-abortion protocols that are carried out in one day, which can result in reducing client burden. Method We conducted a retrospective review of 379 patient medical charts from two different clinics (in four states) that provide abortions for gestational ages 18–24 weeks, in one day. Data was collected using an online data collection platform. We used Stata 15 to clean and perform preliminary descriptive analyses. Results We found that, on an average, complications occurred in 0.79% (n = 3) of the total procedures. Literature suggests that for D&E procedures occurring between 14 and 24 weeks, complications occur in 4% of cases (Autry et. al, 2002). In our study, cervical tear was the only incident. All the incidents were resolved in the procedure room on the day of the procedure. Conclusions One-day procedures result in a low occurrence of complications—lower than what has been reported for longer procedures and have not needed hospital admission. By adopting shorter procedures, financial burden on patients, especially those traveling long distances, can be reduced, and access to later abortion care can be expanded.