“While legal abortions in the U.S. are safe, the likelihood that women will receive the type of abortion services that best meet their needs varies considerably depending on where they live, says a new report from the National Academies of Sciences, Engineering, and Medicine.  In addition, the report notes, the vast majority of abortions can be provided safely in office-based settings. The committee that wrote the report examined the scientific evidence on the safety and quality of the four abortion methods used in the U.S. — medication, aspiration, dilation and evacuation (D&E), and induction. It assessed quality of care based on whether it is safe, effective, patient-centered, timely, efficient, and equitable according to well-established standards.  Most abortions in the U.S. are performed early in pregnancy; in 2014, 90 percent occurred by 12 weeks of gestation.  Medication and aspiration abortions are the most common methods and, together, account for about 90 percent of all abort ions. Serious complications from abortion are rare regardless of the method, and safety and quality are enhanced when the abortion is performed as early in pregnancy as possible.  Abortion-specific regulations in many states create barriers to safe and effective care. These regulations may prohibit qualified providers from performing abortions, misinform women of the risks of the procedures they are considering, or require medically unnecessary services and delay care, the report says. Examples of these policies include mandatory waiting periods, pre-abortion ultrasound, and a separate in-person counseling visit.  Some states require abortion providers to provide women with written or verbal information suggesting that abortion increases a woman’s risk of breast cancer or mental illness, despite the lack of valid scientific evidence of increased risk. In 2014, there were 17 percent fewer abortion clinics than in 2011, and 39 percent of women of reproductive age resided in a county without an abortion provider.  In 2017, 25 states had five or fewer abortion clinics, and five states had only one abortion clinic.  In addition, approximately 17 percent of women travel more than 50 miles to obtain an abortion.The vast majority of abortions can be provided safely in office-based settings, the report says. In 2014, 95 percent of abortions were provided in clinics and other office-based settings. For any outpatient procedure, including abortion, the important safeguards are whether the facility has the appropriate equipment, personnel, and an emergency transfer plan to address complications that might occur. The committee found no evidence indicating that clinicians who perform abortions require hospital privileges to ensure a safe outcome for the patient…”