The National Academies of Sciences, Engineering, and Medicine says in a report issued Friday that restrictions on abortion can get in the way of providing services at the earliest, safest time in a pregnancy, a conclusion that is in line with the position of groups that have lobbied for more access to abortion.
“Abortion-specific regulations in many states create barriers to safe and effective care,” wrote authors of a medical and health policy committee.
The report details how restrictions on the procedure can impede abortions from being performed earlier in a pregnancy, arguing that creates safety issues.
“Serious complications from abortion are rare regardless of the method, and safety and quality are enhanced when the abortion is performed as early in pregnancy as possible,” the report said, noting that 90 percent of abortions happen during the first 12 weeks of a pregnancy.
The information comes as anti-abortion advocates have pushed for more hurdles for abortion, including waiting periods, ultrasounds, clinical requirements for facilities, and limiting which types of medical professionals can be involved in an abortion. They often argue that such restrictions are necessary to protect a pregnant woman’s health.
The committee involved in writing the report reviewed the four types of abortion methods that are available, including the abortion bill, aspiration, dilation and evacuation, and inducing labor, and looked at state data where restrictions on abortion vary widely. They concluded that abortion was a safe procedure, especially when it happens earlier in a pregnancy.
It said some of the state regulations can provide incorrect information about the risks involved or cause delays that make abortion later in a pregnancy less safe. It argued there is a “lack of scientific evidence” that women who have abortions have a higher risk of developing a mental illness or getting breast cancer.
Having an abortion doesn’t increase a woman’s risk of later becoming infertile, or pregnancy-related hypertensive disorder, it said. But it did note that having a higher risk of later preterm births appears to be associated with having two or more previous aspiration abortions.
The National Academies said most abortions can be provided in an office setting and medical staff shouldn’t need hospital admitting privileges to make sure women are safe after an abortion, as some states have required. For medication abortion, the committee concluded that no special arrangements are needed, but for other methods, it concluded that it was contingent on whether a woman was sedated during the procedure.
“If moderate sedation is used, the facility should have equipment to monitor oxygen saturation, heart rate, and blood pressure as well as have emergency resuscitation equipment and an emergency transfer plan,” the committee wrote. “Deeper sedation requires equipment to monitor ventilation.”
It concluded that trained doctors, such as OB-GYNs and doctors of family medicine, as well as advanced practice clinicians, such as certified nurse-midwives, nurse practitioners, and physician assistants, can oversee medication abortions or aspiration abortions, which involve using a vacuum-like device. For dilation and evacuation, which adds a cutting device to the procedure, a doctor should have “appropriate training and sufficient experience to maintain requisite surgical skills.”
Clinicians with training in managing labor and delivery can safely and effectively provide induction abortions, the committee concluded.
The study was sponsored by the Grove Foundation, the JPB Foundation, Packard Foundation, Susan Thompson Buffet Foundation, Tara Health Foundation, and the William and Flora Hewlett Foundation.
