By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Editor’s note. NRL News Today ran a preliminary story on Wednesday that addressed some of the issues raised in far more detailed analysis by Dr. O’Bannon. The nub of the earlier post was that media outlets treated the USCF study (as usual) as gospel, recycling the claim that abortion has fewer complications associated with it than having your wisdom teeth removed!
What if you walked into the waiting room of any of the country’s abortion clinics and told the young mothers waiting there in the lobby that there’s a new study indicating that the “procedure” they’re about to undergo will, in the coming year, send thousands of women to the emergency room or back to the clinic to deal with a complication or a “failed abortion”?
How many of them would say that makes them feel more comfortable with their decision? None, you would suspect.
Yet if one actually reads a new study (as opposed to the press release) out of the University of California – San Francisco (UCSF), that’s what is being acknowledged but cloaked. Instead of a true picture, you get a UCSF release trumpeting the results as showing that the “Major Complication Rate After Abortion Is Extremely Low” (UCSF Release, 12/8/14).
But a closer look at the data shows there is some real stretching and spinning going on here, belying the “extremely low” complication rate assertion. As you read our analysis, be sure to focus in on what the authors consider to be “minor” complications.
The UCSF study, “Incidence of Emergency Department Visits and Complications After Abortion,” is based on a recent study of California Medicaid recipients. It appeared in the December 8, 2014, edition of the journal Obstetrics & Gynecology.
California is one of the states that pays for the abortions of women enrolled in Medicaid. The study looked at the billing data from 50,273 Medi-Cal patients who had 54,911 abortions in 2009-2010.
The authors do not give comparable state data from those years, but note that of the 181,730 abortions performed in California in 2011, about 51% were covered by the state’s Medi-Cal program. This study looked at just those records of patients were treated under the fee-for-service (vs. managed care) part of the program. 
Nearly 8% (or between one in 12 and one in 13) of women showed up at the clinic or a local Emergency Room (ER) seeking some service within six weeks of their abortions. Some of those were eliminated from further study because billing records appeared to show that they came in for some service unrelated to the abortion. (These were not specified, but this could be something like smashing a finger in the car door, coming down with the flu, etc.)
But even pulling these out and other “complications not validated,” one is left with a substantial number of women dealing with medical problems resulting from their “safe” abortions.
On the billing records of those women returning to the clinic or going to the ER, they found women hemorrhaging, dealing with infections, uterine perforations – the sort of problems we’re supposed to think were relics of the early days following the Roe v. Wade decision when abortionists were just learning their craft.
A surprising number of these were related to the new chemical or “medication” abortion method that was supposed to offer women a safer alternative to surgical abortion.
There were nearly four times as many surgical abortions (34,755 first trimester, 8,837 2nd trimester or later) tracked by the study as there were chemical abortions. (11,319). Yet there were more identified complications associated with the chemical method (588) than they were for the surgical ones (438 for first trimester, 130 for 2nd or later) combined.
The complication rate for chemical abortions was 5.2%, versus complication rates of 1.3% for first trimester suction aspiration abortions and 1.5% for second trimester or later methods. This would make chemical abortions four times riskier than early surgical ones and more than three times less safe than a second or third trimester procedure.
This is hardly the “advance” or “improvement” that women were promised when the government was asked to approve RU-486 more than a decade ago.
A number of these complications involved “incomplete” or “failed” abortions . Most of these were identified as “minor” complications by researchers (there were also “minor” hemorrhages, uterine perforations, and infections).
UCSF originally found 535 repeat abortions within six weeks –165 “subsequent medication [chemical] abortions,” and 370 “subsequent aspirations.
Theoretically, some of these could be new abortions, but much more likely is that these are chemical or surgical procedures that were performed to complete the earlier incomplete or failed abortions.
These may not all have been counted as complications, or they may have fallen into the category of 658 “Other” or “Undetermined” complications. The latter seems likely, given that the “treatment” for 400 of these (about 61%) was “uterine aspiration.”
The point which their own data makes abundantly clear is that these abortions far from being as safe or successful as advertised.
Remarkably, the researchers attribute the high rate of complications (the majority of which they term “minor” and “expected”) among women having chemical abortions to “aspirations performed presumptively or to alleviate bleeding or cramping symptoms.”
In other words, bleeding or cramping was so bad that women came back to the clinic or went to the ER, where doctors (noticeably including those from the clinic who would have seen ordinary abortion bleeding before) decided emergency surgery was needed. Yet in most cases, UCSF wants us to believe, this was just a “minor” or “expected” complication.
All told, the study found that 2.1%, or about one out of every 48 abortions, were connected to a complication that was diagnosed or treated at some medical facility. Though perhaps lower than the complication rates one might expect for essential life-saving major surgery, this is hardly the risk- free “procedure” the abortion industry and lobby wants people to think it is. It is also higher than people might expect for a “procedure” that abortionists have been working to perfect for over 40 years.
Remember this study was of a selected population in California. What if one applied these results nationwide, based on the estimate there are now roughly 1.05 million abortions annual?
It would translate into more than 22,000 women visiting their local ER or returning to the clinic for medical care each year. How many women in clinic waiting rooms today would be surprised to hear that number? How many would be reassured of abortion’s safety?
An important consideration to keep in mind: This focuses on just the first six weeks, makes no effort to track complications or injuries that might occur later on, such as infertility, subsequent premature birth, or breast cancer, which can be heartbreaking, expensive, or even deadly. And we have not even begun to consider the long-term psycho-social effects of abortion and the health consequences that flow from subsequent depression, drug abuse, eating disorders, and documented higher rates of suicide.
The UCSF researchers admit that there may be critical data missing from their study. Some complications might never have been recorded and there was no data at all on abortion’s maternal mortality, possibly the most critical piece of information.
Also, by relying on Medi-Cal codes, we could not assess whether any of the complications lead to deaths or detect complications not documented by the billing codes. For instance it is possible that complications seen or treated at the original abortion facility did not result in any Medi-Cal reimbursements, thereby undermining the complication rate.
This last sentence tell us that if a woman returned, distraught and bleeding, to the abortion clinic where she first went for her abortion, and the clinic decided not to make waves and charge the state to complete the abortion or repair the damage done by the first procedure, there would be no record of the complication.
In the light of recent operations like those of abortionist Kermit Gosnell’s, such a scenario does not seem far-fetched. If true, it would point to an even higher complication rate.
On the whole, by tracking and matching the billing records of clinics and hospitals, the study does represent an improvement over surveys which simply relied on abortionists self-reporting. This is probably one reason why the numbers were as high as they were, even with some still potentially serious holes in the data.
One thing is clear. No matter the spin, no matter the “medical progress,” no matter the experience, the special training, the new methods, abortion has not become “safe” or even appreciably safer. Women are still being injured by abortion, and women are still dying.
Of course, the biggest “complication” is that someone – the innocent unborn child – dies in every “successful” abortion. This alone is evidence that abortion is an inherently unsafe and unsound “medical procedure.” Abortion violates the most basic principle of medical ethics: “first do no harm.”
Abortion harms women and children. What further research do we need?
 The data from this study was supposed to be better because patients who did not return to the clinic but went instead to the ER were included by cross referencing the abortion billing and treatment coding. Researchers looked at any billing for any medical service occurring anywhere within six weeks of their original abortion billing and sought from codes to determine whether or not that treatment was abortion related.
 “Incomplete” abortions, of which there were 231, would be those abortions in which some part of the baby, placenta, gestational sac remained in the woman’s body. “Failed” abortions, of which there were 30, would be when the baby remained and the abortion failed to occur.