Legal abortion: a critical assessment of its risks.

A review of the methods used and the results obtained in 1182 legal abortions in one teaching hospital confirms that termination of pregnancy, even in the early weeks, is neither simple nor safe. Nearly 17% of patients lost more than 500 ml. of blood and 9.5% required transfusion. Cervical lacerations occurred in 4.2% and the uterus was perforated in 1.2%. All the perforations were associated with the technique of vacuum aspiration. Emergency laparotomy was required for 6 patients and hysterectomy was twice necessary to save life. Pyrexia of 38 degrees C or more persisting for longer than 24 hours occurred in 27%. Peritonitis developed in 14 patients, with paralytic ileus in 7, and 6 others had septicaemia. No patient died. The need is stressed for a wider appreciation of the risks involved in allowing certain pregnancies to continue and those associated with their termination, irrespective of the method used. Methods of reducing certain of these risks are indicated.