Medication Abortion and Preterm Birth
Considerable controversy exists about the effects of medication abortion on the incidence of preterm birth (PTB). Medication abortion of various types continues to be touted as a safe alternative to surgical abortion, and without increased risk for PTB. There is a paucity of evidence regarding medication abortion and PTB, but available papers are reviewed here. There is moderate-quality evidence that medication abortions which require surgical completion increase PTB rates more than surgical abortion alone.
Practice Guideline 11: A Detailed Examination of the Data on Surgical Abortion and Preterm Birth
Overwhelming evidence from 168 studies over fifty years points to a clear dose-response relationship between surgical abortion and subsequent preterm birth. The 2018 National Academy of Sciences report considered only five of these 168 studies and represents a biased sample that underreports a significant association between surgical abortion and subsequent preterm birth.
Practice Guideline 5: The Association between Surgical Abortion and Preterm Birth: An Overview
Evidence in peer-reviewed literature from 168 studies over fifty years points to a causal, dose-response relationship between surgical abortion and subsequent preterm birth. This document provides an overview of this literature, discusses mechanisms for this effect, demonstrates the strength of evidence for causality, and offers guidance for informed consent prior to surgical abortion.