From the Guidelines
The average woman in the U.S. seeks an elective abortion at around 8 weeks of gestation. Most abortions (about two-thirds) occur during the first 8 weeks of pregnancy, with approximately 88% of all abortions taking place within the first 12 weeks or first trimester. This timing is significant because earlier abortions are generally safer, less complicated, and more accessible. According to the study by the Centers for Disease Control and Prevention 1, maternal morbidity and mortality associated with induced abortion increase significantly with increasing gestational age. Key points to consider include:
- The risk for major abortion complications increases with advancing gestational age, with a major complication rate of 0.8% at 11-12 weeks' gestation compared to 2.2% at 17-20 weeks' gestation 1.
- The risk for maternal death also increases with gestation, with 1.1 deaths per 100,000 abortions performed at 11-12 weeks' gestation compared to 6.9 deaths per 100,000 abortions for procedures performed at 16-20 weeks' gestation 1.
- Earlier abortions are generally safer and less complicated, which is why the majority of women seek abortion care within the first trimester.
- Factors such as delayed pregnancy recognition, financial constraints, travel requirements, mandatory waiting periods, and difficulty accessing care can push the timing of abortion later in pregnancy.
- The gestational age at which women seek abortion has been trending earlier over recent decades, partly due to improved pregnancy testing and greater availability of medication abortion options.
From the Research
Gestational Age for Elective Abortion in the U.S.
- The average gestational age at which women in the U.S. seek an elective abortion is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies suggest that medical abortion is commonly performed up to 63 days of gestation, with high efficacy rates ranging from 93% to 97.7% 2, 3, 6.
- One study found that the efficacy of medical abortion was highest at 29 to 35 days (98.8%) and 36 to 42 days (98.8%) of gestation, and lowest at 57 to 63 days (95.5%) 2.
- Another study reported that the overall efficacy of mifepristone followed by buccal misoprostol was 96.7% up to 63 days of gestation, with a continuing pregnancy rate of 0.8% 3.
Factors Influencing Gestational Age
- The need for aspiration for any reason was found to be greatest at higher gestational ages 2.
- The odds of needing aspiration for any reason increased with gestational age, suggesting that earlier abortions may be safer and more effective 2.
- The quality of evidence for medical abortion up to 10+0 weeks' gestation was found to be very low to moderate, indicating a need for further research 4.
Regional Variations
- The provided studies do not specifically address regional variations in gestational age for elective abortion in the U.S. 2, 3, 4, 5, 6.
- However, one study found that mifepristone and misoprostol is highly effective, safe, and acceptable to women in low- and middle-income countries, making it a feasible option for reducing maternal morbidity and mortality worldwide 6.