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Review
. 2004 Apr 20;140(8):620-6.
doi: 10.7326/0003-4819-140-8-200404200-00009.

Induced abortion: an overview for internists

David A Grimes  1 , Mitchell D Creinin
Affiliations
Free article
Review

Induced abortion: an overview for internists

David A Grimes et al. Ann Intern Med. .
Free article

Abstract

Internists care for many women who have had abortions and many who will seek abortions in the future. Each year, about 2% of all women of reproductive age have an abortion. Women having abortions tend to be young, white, unmarried, and early in pregnancy. Most abortions are done by suction curettage under local anesthesia in a freestanding clinic. However, medical abortion is growing in popularity as a nonsurgical alternative. The regimen approved by the U.S. Food and Drug Administration specifies mifepristone, 600 mg orally, followed 2 days later by misoprostol, 400 microg orally (within 49 days from last menses). Recent studies have recommended alternative approaches, such as mifepristone, 200 mg orally, followed in 1 to 3 days by misoprostol, 800 microg vaginally (up to 63 days). Medical abortion can be provided by a broader variety of physicians than can surgical abortion. The overall case-fatality rate for abortion is less than 1 death per 100,000 procedures. Infection, hemorrhage, acute hematometra, and retained tissue are among the more common complications. Referral back to the original abortion provider for management is advisable. Overall, induced abortion does not lead to late sequelae, either medical or psychiatric. Of importance, no link exists between induced abortion and later breast cancer. For physicians who are asked to help with a referral, the National Abortion Federation and Planned Parenthood Federation of America have helpful Web sites and networks of high-quality clinics. The cost of abortion (currently about 372 dollars at 10 weeks) has decreased in recent decades. Provision of ongoing contraception and encouragement of emergency contraception can reduce unintended pregnancies and the need for abortion.

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Comment in

  • Late sequelae of induced abortion.
    Stone WJ. Stone WJ. Ann Intern Med. 2004 Jul 20;141(2):161; author reply 161-2. doi: 10.7326/0003-4819-141-2-200407200-00019. Ann Intern Med. 2004. PMID: 15262675 No abstract available.
  • Late sequelae of induced abortion.
    Hoeldtke N. Hoeldtke N. Ann Intern Med. 2004 Jul 20;141(2):161; author reply 161-2. doi: 10.7326/0003-4819-141-2-200407200-00018. Ann Intern Med. 2004. PMID: 15262676 No abstract available.

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