Abortion surveillance at CDC - Creating public health light out of political heat

In the late 1960s, states began to liberalize their abortion laws, and a ne w era in women's health began. Under the leadership of Jack Smith, the Cent ers for Disease Control and Prevention (CDC) established a voluntary aborti on surveillance system that provided the first nationwide information on th e numbers and characteristics of women having abortions. Studies of abortio n morbidity done by the CDC revealed that suction curettage was safer than sharp curettage, local anesthesia was safer than general anesthesia, free-s tanding clinics were safer than hospitals, and dilation and evacuation (D&E ) was safer than the alternative of labor induction for early second-trimes ter abortions. This evidence, which contradicted traditional medical tenets , rapidly changed the practice of abortion in the United States. CDC also e stablished a surveillance system for abortion deaths. This demonstrated a r apid improvement in die safety of abortion in the early 1970s. Lessons lear ned from mortality investigations helped to change practice as well. Today, more is known about the epidemiology of abortion than any other operation in the history of medicine. In the midst of strident debate over the aborti on issue, CDC abortion surveillance data have helped to guide judicial ruli ngs, legislative actions, and Surgeon General's reports, which have support ed safer choices for women of reproductive age. When medical historians of the future look back on this century, the increasing availability of safe, legal abortion will stand out as a public health triumph.