Induced Abortion: An Overview for Internists

David A. Grimes, Mitchell D Creinin

Research output: Contribution to journalArticle

28 Citations (Scopus)

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 μg 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 pg 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 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.

Original languageEnglish (US)
Pages (from-to)620-626
Number of pages7
JournalAnnals of Internal Medicine
Volume140
Issue number8
StatePublished - Apr 20 2004
Externally publishedYes

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Induced Abortion
Misoprostol
Mifepristone
Hematometra
Referral and Consultation
Vacuum Curettage
Postcoital Contraception
Physicians
Pregnancy
Menstruation
Local Anesthesia
United States Food and Drug Administration
Contraception
Psychiatry
Breast Neoplasms
Hemorrhage
Costs and Cost Analysis
Mortality
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Induced Abortion : An Overview for Internists. / Grimes, David A.; Creinin, Mitchell D.

In: Annals of Internal Medicine, Vol. 140, No. 8, 20.04.2004, p. 620-626.

Research output: Contribution to journalArticle

Grimes, David A. ; Creinin, Mitchell D. / Induced Abortion : An Overview for Internists. In: Annals of Internal Medicine. 2004 ; Vol. 140, No. 8. pp. 620-626.
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