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The Comparative Safety of Legal Induced Abortion and Childbirth in the United States

Raymond, Elizabeth G. MD, MPH; Grimes, David A. MD

doi: 10.1097/AOG.0b013e31823fe923
Original Research

OBJECTIVE: To assess the safety of abortion compared with childbirth.

METHODS: We estimated mortality rates associated with live births and legal induced abortions in the United States in 1998–2005. We used data from the Centers for Disease Control and Prevention's Pregnancy Mortality Surveillance System, birth certificates, and Guttmacher Institute surveys. In addition, we searched for population-based data comparing the morbidity of abortion and childbirth.

RESULTS: The pregnancy-associated mortality rate among women who delivered live neonates was 8.8 deaths per 100,000 live births. The mortality rate related to induced abortion was 0.6 deaths per 100,000 abortions. In the one recent comparative study of pregnancy morbidity in the United States, pregnancy-related complications were more common with childbirth than with abortion.

CONCLUSION: Legal induced abortion is markedly safer than childbirth. The risk of death associated with childbirth is approximately 14 times higher than that with abortion. Similarly, the overall morbidity associated with childbirth exceeds that with abortion.


In the United States, legal induced abortion is markedly safer than childbirth.

From Gynuity Health Projects, New York, New York; and the Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

See related editorial on page 212.

The authors thank Rachel K. Jones, PhD and Lawrence B. Finer, PhD of the Guttmacher Institute and Suzanne Zane, DVM, of the Division of Reproductive Health, Centers for Disease Control and Prevention, for providing essential input to develop the manuscript.

Corresponding author: Elizabeth G. Raymond, MD, MPH, Gynuity Health Projects, 15 East 26th Street, Suite 801, New York, NY 10010; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2012 by The American College of Obstetricians and Gynecologists.