Weight and Procedural Abortion Complications: A Systematic Review

( Obstet Gynecol . 2025;145(3):307–315. doi: 10.1097/AOG.0000000000005821) An overwhelming majority (95%) of abortions managed by medical professionals are managed in outpatient clinics, and nearly half of these are procedural abortions rather than medication abortions. As clinic locations are decreasing and access to care is limited, hospital-based procedural abortions are very difficult to obtain and often only occur in cases of medical emergency or severe fetal impairment. Many barriers exist in abortion care and family planning, and a disproportionate burden falls on individuals with a higher body weight; evidence has shown that these individuals are more likely to have unmet contraceptive needs and unintended pregnancies. In addition, there are barriers to care such as weight bias and stigma, as well as refusal of clinicians to provide procedural abortions due to a perceived increased risk of complications. Individuals with a higher body weight are often excluded from research, and thus common practices for abortion care in this population may not be evidence based. This article is a systematic review assessing existing evidence for a relationship between high body weight and procedural abortion complications, with the hypothesis that body weight would not be independently associated with an increased risk for complications from procedural abortion.