A government review has indicated that the incidence of complications associated with abortion may be significantly higher than previously reported in the annual statistics on abortion.
The review, which was released earlier this past week, compared two different methods of analyzing complications that may arise following an abortion.
Over a five-year period from 2017 to 2021, the Office for Health Improvement and Disparities (OHID) conducted a comparative analysis of the complication rates derived from the annual abortion statistics, which utilize the Abortion Notification System (ANS) based on data provided by abortion providers, and the abortion complication rates from Hospital Episode Statistics (HES) over the same time period.
A five-year review of abortion complication rates found that the average rate was 1.52 per 1,000 abortions using data derived from the ANS, which is used in the annual abortion statistics. However, the review also found that the average abortion complication rate over the same time period using data from HES was 4.06, which is over 2.6 times higher.
When the analysis of Hospital Episode Statistics (HES) includes incomplete abortions, the complication rate during the same timeframe is 18.16 per 1,000 abortions. This figure is more than 11.9 times higher than the complication rate derived from the Abortion Notification System (ANS) used in the annual abortion statistics, as the ANS rate excludes incomplete abortions.
The review also revealed that the discrepancy in the reported complication rate is considerably higher for women under the age of 20 than for the general population. For women under the age of 20, the HES-derived complication rate is 4.43 times higher than the ANS-derived complication rate, in contrast to 2.67 times higher for the general population.
When incomplete abortions are included in the HES data analysis, the HES-derived complication rate for women under 20 is 17.43 times higher than the ANS-derived complication rate. This compares to a ratio of 11.95 times higher for the general population.
Abortion complication rate for medical abortion increases with gestational age
The complication rates for medical abortions, as determined by the ANS, demonstrate that the incidence of complications is 18.33 times higher for abortions occurring between 10 and 12 weeks compared to those occurring between 2 and 9 weeks. The complication rate increased to 110 times higher for abortions at 13 to 19 weeks and 160.33 times higher for abortions at 20 weeks and over when compared to medical abortions that occurred at 2 to 9 weeks.
It should be noted that the data from 10 weeks or more is for medical abortions that took place in a clinical setting, since medical abortion outside of this setting is not legal after 10 weeks. It is likely that the complication rate for women who perform their own medical abortion outside of a clinical setting at 10 weeks or beyond is considerably higher than the rates observed when women receive in-person medical supervision.
The review revealed that the most prevalent complications associated with abortion, as documented in the ANS data for 2021, were hemorrhage (65.8%), sepsis (11.4%) and cervical tear (11.1%). In contrast, the HES data indicated that delayed or excessive hemorrhage (81.4%), other and unspecified (10.6%), genital tract and pelvic infection (8.0%) and embolism were the most common complications.
Gaps in abortion complication data
The review also found that abortion providers were not documenting complications that occurred after discharge or after the completion of the form submitted to the Department of Health and Social Care (DHSC). Abortion providers are mandated to submit an HSA4 form, which records any complications arising from an abortion up to the point of discharge. However, during the 2022 review, the Office for Health Improvement and Disparities (OHID) observed “no evidence” indicating that abortion providers were informing the DHSC to update the data when a woman reported a complication that arose after the form had already been submitted.
‘DIY’ home abortions
The review also highlighted that complications might be less likely to be documented for terminations where either both or one of the abortion medications is administered at home. This is because the person completing the HSA4 form may not be aware if the woman experienced a complication following the abortion.
This underreporting likely explains the reduction in complication rates reported by the Abortion Notification System (ANS) in 2020, coinciding with the introduction of at-home abortion. Diana Johnson MP referenced this reduction in her speech to Parliament when MPs were deliberating on whether to permanently allow at-home abortion. However, she did not disclose to Parliament that this decrease was likely due to underreporting.
Contrary to the ANS data, Hospital Episode Statistics (HES)-derived data reveals the highest complication rate for the five-year period occurring in 2021, the year following the introduction of at-home abortions. The complication rate for 2021 is 4.4 per 1,000 abortions excluding incomplete abortions, and 19.3 per 1,000 including incomplete abortions.
Right To Life UK spokesperson Catherine Robinson said
“This Government’s review reveals that abortion complication rates are likely much higher than has been previously reported in the annual abortion statistics, which are based on reporting from abortion providers.
“We are calling on the Government to urgently introduce new measures to ensure that abortion complications data is accurately collected and reliably reported on”.
“ANS-derived complication rates by gestation show that the complication rate is 160 times higher for abortions at 20 weeks and over when compared to medical abortions that occurred at 2 to 9 weeks. The data from 10 weeks or more is for medical abortions that took place in a clinical setting, since medical abortion outside of this setting is not legal after 10 weeks. The complication rate for women who perform their own medical abortion outside of a clinical setting at 10 weeks or beyond is likely to be much higher than the rates when women are receiving in-person medical supervision.
“This reinforces the urgent need for the Government to heed calls to reinstate in-person appointments before all abortions take place to ensure that the gestation of babies can accurately be assessed, given that the abortion provider, the British Pregnancy Advisory Service sent out abortion pills to a woman whose baby, Lily, was at least 32 weeks gestation, and given the fact that this does not appear to be an isolated case.
“It is likely that these cases would not have happened had the gestation of the babies been accurately identified by ultrasound or a physical examination during an in-person appointment.”
Daniel Miller is responsible for nearly all of National Right to Life News' political writing.
With the election of Donald Trump to the U.S. presidency, Daniel Miller developed a deep obsession with U.S. politics that has never let go of the political scientist. Whether it's the election of Joe Biden, the midterm elections in Congress, the abortion rights debate in the Supreme Court or the mudslinging in the primaries - Daniel Miller is happy to stay up late for you.
Daniel was born and raised in New York. After living in China, working for a news agency and another stint at a major news network, he now lives in Arizona with his two daughters.
