title: Incidence of emergency department visits and complications after abortion.
abstract: OBJECTIVE
  To conduct a retrospective observational cohort study to estimate the abortion complication rate, including those diagnosed or treated at emergency departments (EDs).
  
  
  METHODS
  Using 2009-2010 abortion data among women covered by the fee-for-service California Medicaid program and all subsequent health care for 6 weeks after having an abortion, we analyzed reasons for ED visits and estimated the abortion-related complication rate and the adjusted relative risk. Complications were defined as receiving an abortion-related diagnosis or treatment at any source of care within 6 weeks after an abortion. Major complications were defined as requiring hospital admission, surgery, or blood transfusion.
  
  
  RESULTS
  A total of 54,911 abortions among 50,273 fee-for-service Medi-Cal beneficiaries were identified. Among all abortions, 1 of 16 (6.4%, n=3,531) was followed by an ED visit within 6 weeks but only 1 of 115 (0.87%, n=478) resulted in an ED visit for an abortion-related complication. Approximately 1 of 5,491 (0.03%, n=15) involved ambulance transfers to EDs on the day of the abortion. The major complication rate was 0.23% (n=126, 1/436): 0.31% (n=35) for medication abortion, 0.16% (n=57) for first-trimester aspiration abortion, and 0.41% (n=34) for second-trimester or later procedures. The total abortion-related complication rate including all sources of care including EDs and the original abortion facility was 2.1% (n=1,156): 5.2% (n=588) for medication abortion, 1.3% (n=438) for first-trimester aspiration abortion, and 1.5% (n=130) for second-trimester or later procedures.
  
  
  CONCLUSIONS
  Abortion complication rates are comparable to previously published rates even when ED visits are included and there is no loss to follow-up.
  
  
  METHODS
  II.
authors.affiliation: Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California; John Snow, Inc, Arlington, Virginia; and Ibis Reproductive Health, Oakland, California. Ms. Zlidar is currently at the Public Health Institute, Washington, DC.
authors.forename: Ushma D
authors.initials: UD
authors.lastname: Upadhyay
authors.forename: Sheila
authors.initials: S
authors.lastname: Desai
authors.forename: Vera
authors.initials: V
authors.lastname: Zlidar
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Weitz
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.forename: Patricia
authors.initials: P
authors.lastname: Anderson
authors.forename: Diana
authors.initials: D
authors.lastname: Taylor
mesh_terms: D000019:Abortifacient Agents / Q000009:adverse effects; D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods; D000293:Adolescent; D000328:Adult; D000552:Ambulances / Q000706:statistics & numerical data; D000758:Anesthesia / Q000009:adverse effects; D001803:Blood Transfusion; D002140:California / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D008484:Medicaid / Q000706:statistics & numerical data*; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D019233:Retreatment; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014619:Vacuum Curettage; D055815:Young Adult
chemical_list: D000019:Abortifacient Agents