Hemorrhage after abortion is rare, occurring in fewer than 1% of abortions, but associated morbidity may be significant. Although medication abortion is associated with more bleeding than procedural abortion, overall bleeding for the two methods is minimal and not clinically different. Hemorrhage can be caused by atony, coagulopathy, and abnormal placentation, as well as by ... Read more >

Standardization of abortion nomenclature and terms used to refer to different types of abortion will increase uniformity and accuracy in communication about abortion care. The Society of Family Planning’s recommendation is to use the terms medication abortion and procedural abortion for common use in clinical guidance, journal articles, print materials, websites, media, advocacy, policy briefs, ... Read more >

The highly politicized nature of abortion care in this country can make it difficult for institutions and obstetric providers to thoughtfully remark upon and plan for policy decisions that impact patient care. Individuals at high risk for pregnancy mortality and morbidity have unique needs for reproductive health services, including abortion care. Variations in state and ... Read more >

Historical evidence that fetal red blood cell (RBC) exposure during early spontaneous or induced abortion can cause maternal Rh sensitization is limited. A close reading of these studies indicates that forgoing Rh immunoglobulin administration before 12weeks gestation is highly unlikely to increase risk of Rh (D) antibody development, and recent studies indicate that fetal RBC ... Read more >

Cesarean scar ectopic pregnancy is a complication in which an early pregnancy implants in the scar from a previous cesarean delivery. This condition presents a substantial risk for severe maternal morbidity and mortality because of challenges in securing a prompt diagnosis. Ultrasound is the primary imaging modality for cesarean scar ectopic pregnancy diagnosis, although a ... Read more >

Substance use and substance use disorder remain significant public health crises. Substance use disorder or addiction, is a stigmatized and misunderstood disease. Accessing contraception and abortion care is particularly challenging, as people who use substances or are diagnosed with substance use disorder often experience internalized stigma and over discrimination within the healthcare system. There are ... Read more >

Pain is a complex phenomenon that involves more than a simple physical response to external stimuli. In maternal-fetal surgical procedures, fetal analgesia is used primarily to blunt fetal autonomic responses and minimize fetal movement. The purpose of this Consult is to review the literature on what is known about the potential for fetal awareness of ... Read more >

Analgesic options for surgical abortion (also called procedural abortion) beyond local anesthesia and minimal sedation include moderate sedation, deep sedation and general anesthesia. These clinical recommendations review the effectiveness of various moderate sedation, deep sedation, and general anesthesia regimens for pain control during abortion; medication regimens used to induce analgesia and anesthesia; patient factors affecting ... Read more >

Individuals who have bleeding disorders, thrombophilias, a history of venous thromboembolism (VTE), or who are taking anticoagulation medication for other reasons may present for abortion. Clinicians should be aware of risk factors and histories concerning for excessive bleeding and thrombotic disorders around the time of abortion. This document will focus on how to approach abortion ... Read more >

Women should be provided with evidence-based information when considering options for contraception and pregnancy management. When counseling about health conditions and available treatments, healthcare practitioners should employ strategies that encourage the incorporation of informed patient preferences into a shared decision-making process with the patient. To optimize the health of women at risk of experiencing adverse ... Read more >