Bixby research informs landmark report on abortion safety

A groundbreaking report from the National Academies of Science, Engineering, and Medicine (NASEM) affirms that abortion care in the United States is safe and effective. This is the first comprehensive look at the science on abortion since 1975, just two years after the Roe v. Wade Supreme Court decision legalized abortion in the US. Research from the UCSF Bixby Center provided an important foundation for this landmark effort, with citations for 69 publications on clinical care, training, abortion facilities, the impact of abortion restrictions, and the mental health effects of abortion.

The report concludes that abortion is safe and most abortions can be performed in an office setting. It also confirms that nurse practitioners, certified nurse-midwives and physician assistants can perform medication and aspiration abortion safely. NASEM found that access to abortion training varies widely, with some residents and trainees seeking training outside of their program.

The evidence clearly shows no link between abortion and future health problems like breast cancer, infertility, preterm birth, depression, anxiety, or PTSD.

NASEM evaluated abortion based on six dimensions of healthcare quality and found that it varies widely based on where patients live and their resources:

• Safety. All methods of providing abortion are safe, and serious complications are rare. Safety is enhanced when abortion is performed early in pregnancy.
• Effectiveness. Abortions in the US are effective, but whether people receive abortion care that best meets their needs depends on where they live.
• Patient-centeredness. Patients’ circumstances and preferences might be ignored in some states. Laws requiring providers to give misleading information about abortion, perform unnecessary services, or delay care all interfere with decisions guided by a patient’s values and needs.
• Timeliness. Timeliness depends on factors like affordability and distance from a provider. Women in states mandating waiting periods tend to wait longer than the required time due to the logistical challenges of getting to a second appointment. These delays put the patient at greater risk of complications.
• Efficiency. Laws that require medically unnecessary equipment, services, or patient visits – like the TRAP laws struck down in Whole Woman’s Health v. Hellerstedt – decrease the efficiency of abortion care.
• Equity. Unevenly distributed providers, lack of insurance coverage, and regulations like waiting periods have a greater impact on women who live far from providers or have limited resources.

This extensive analysis of peer-reviewed research dismantles the justifications used to pass laws targeting abortion patients and providers. The research in this report should inform policies that put patients’ health and safety at the forefront and increase access to safe abortion.