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The following is a summary of “Weight and Procedural Abortion Complications: A Systematic Review,” published in the January 2025 issue of Obstetrics and Gynecology by McMahon et al.
Several studies have raised questions about whether people with higher body mass index (BMI) 30 or greater experience increased risks of complications during procedural abortions.
Researchers conducted a retrospective study to assess whether people with higher body weight experience an increased risk of complications during procedural abortions.
They screened 409 studies using Covidence, removed 133 duplicates, and reviewed 276 studies to identify 6 peer-reviewed studies conducted in the United States (2010 and 2022). Studies included people with a BMI of 30 or greater and examined procedural abortion safety outcomes stratified by body weight.
The results showed no significant association between higher body weight and complications during procedural abortions. Among 38,960 participants, 1 study reported a significant increase in complications for people with a BMI greater than 40 undergoing second-trimester abortions. All 6 studies, using retrospective cohort designs, met good quality criteria on the Newcastle–Ottawa Scale.
They concluded that higher body weight does not increase the risk of complications during procedural abortions, and referring people with higher body weight for hospital-based care lacks recent safety evidence, potentially delaying critical abortion access.
