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 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.