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Reproductive Health Services: Assessing the Safety and Quality of Abortion Care in the U.S.

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Health care quality is a multidimensional concept. With support from six private foundations, the National Academies of Sciences, Engineering, and Medicine convened a committee to examine the available evidence on the safety and quality of different abortion methods, health facilities, and types of clinicians as well as the potential physical and mental health impacts on women. This resulting report provides a comprehensive review of the state of the science.

About Past Events

Description

In 1975, the Institute of Medicine (IOM) issued the report, Legalized Abortion and the Public Health: Report of a Study. The report contained a comprehensive analysis of the then available scientific evidence on the impact of abortion on the health of the public. Since 1975, there have been substantial changes in the U.S. healthcare delivery system and in medical science. In addition, practices for abortion care have changed, including the introduction of new techniques and technologies. An updated systematic and independent analysis of today’s available evidence has not been conducted. An ad hoc consensus committee of the Health and Medicine Division (HMD), which as of March 2016 continues the consensus studies and convening activities previously carried out by the IOM, will produce a comprehensive report on the current state of the science related to the provision of safe, high quality abortion services in the United States.

The committee will consider the following questions and offer findings and recommendations:
1) What types of legal abortion services are available in the United States? What is the evidence regarding which services are appropriate under different clinical circumstances (e.g., based on patient medical conditions such as previous cesarean section, obesity, gestational age)?
2) What is the evidence on the physical and mental health risks of these different abortion interventions?
3) What is the evidence on the safety and quality of medical and surgical abortion care?
4) What is the evidence on the minimum characteristics of clinical facilities necessary to effectively and safely provide the different types of abortion interventions?
5) What is the evidence on what clinical skills are necessary for health care providers to safely perform the various components of abortion care, including pregnancy determination, counseling, and gestational age assessment, medication dispensing, procedure performance, patient monitoring, and follow-up assessment and care?
6) What safeguards are necessary to manage medical emergencies arising from abortion interventions?
7) What is the evidence on the safe provision of pain management for abortion care?
8) What are the research gaps associated with the provision of safe, high quality care from pre-to post-abortion?

Collaborators

Committee

Co-Chair

Co-Chair

Member

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Committee Membership Roster Comments

Note: There was a change in the Committee Membership with the resignation of Michael L. Raggio effective 04/19/2017 (April 19, 2017).

Sponsors

JPB Foundation

Private: Non Profit

The David & Lucile Packard Foundation

William and Flora Hewlett Foundation

Staff

Rose Marie Martinez

Lead

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