ABORTION MORTALITY, UNITED-STATES, 1972 THROUGH 1987

OBJECTIVE: The aim of our study was to describe risk factors for legal abortion mortality and the characteristics of women who died of legal abortion complications for the period 1972 through 1987. STUDY DESIGN : We reviewed abortion mortality surveillance data collected by the Di vision of Reproductive Health, Centers for Disease Control and Prevent ion, and calculated rates by various demographic and reproductive heal th variables using the Center for Disease Control and Prevention's abo rtion surveillance data as denominators. Rates are reported as legal a bortion deaths per 100,000 abortions. RESULTS: Between 1972 and 1987, 240 women died as a result of legal induced abortions. The case-fatali ty rate decreased 90% over time, from 4.1 deaths per 100,000 abortions in 1972 to 0.4 in 1987. Women greater than or equal to 40 years old h ad three times the risk of death as teenagers (relative risk 3.0, 95% confidence interval 1.5 to 6.0), and black women and those of other mi nority laces had 2.5 times the risk of white women (relative risk 2.5, 95% confidence interval 1.9 to 3.2). Abortions at greater than or equ al to 16 weeks were associated with a risk of death almost 15 times th e risk of death from procedures at less than or equal to 12 weeks' ges tation. Women undergoing currettage procedures for abortion had a sign ificantly lower risk of death than women undergoing other procedures. Whereas before 1977 infection and hemorrhage were the leading causes o f death, during 1977 through 1982 anesthesia complications emerged as one of the leading causes of death and since 1983 have become the most frequent cause. CONCLUSIONS: Although legal induced abortion-related deaths are rare events, our findings suggest that more rigorous effort s are needed to increase the safety of anesthetic methods and anesthet ic agents used for abortions and that efforts are still necessary to m onitor serious complications of abortion aimed at further reducing ris ks of death associated with the procedure.