Emergency department visits and major complications after abortion: Analysis of a nationwide emergency department sample
Awarded 2016
Large Research Grants
Ushma Upadhyay, PhD, MPH
University of California, San Francisco

Objectives: We assessed the incidence of abortion-related emergency department (ED) visit use in the US. Methods: We conducted a retrospective observational study using 2009-2013 data from the Nationwide Emergency Department Sample (NEDS), a nationally representative sample of US ED visits. We estimated the proportion of ED visits among women of reproductive age that were for abortion-related care and described the characteristics of this population, the diagnoses and subsequent treatments, the characteristics associated with incidents and observation care only, the proportion of ED visits for potential self-induced abortions, and the overall rate of major incidents following abortion in the US. Results: Among all ED visits by women ages 15-49 (>189 million), 0.01% (n=27,941) were abortion-related. 51% of these visits received observation care only. Of abortion-related ED visits, 20% were for major incidents. 1.4% of visits were potentially attempts at self-induced abortion. In multivariable models, women using Medicaid (AOR 1.46) and women with a comorbid health condition (AOR 6.23) were significantly more likely to have a major incident than women using private insurance and those without comorbid health conditions. During the study time period, 0.11% of all abortions in the US resulted in a major incident seen in an ED. Conclusion: Abortion-related ED visits comprise an extremely small proportion of ED visits for women of reproductive age. Given the large proportion of visits that received observation care, many of these ED visits may not be indicated or could have been managed at a less costly level of care.