While the number of abortions performed annually in the United States has increased steadily since 1969, the proportion of abortions performed in hospitals has been declining since 1975. Between 1974 and 1977, 1,229,000 abortions were performed at 12 or fewer weeks' gestation in U.S. hospitals, while 2,730,000 were performed in free-standing clinics and doctors' offices. Over the same period, there were 19 deaths which resulted from in-hospital procedures, and 17 from abortions performed in nonhospital facilities. The crude death-to-case rate are 1.5 deaths per 100,000 procedures for hospital abortions, and 0.6 deaths per 100,000 abortions performed in nonhospital facilities. When these rates are adjusted for the presence of preexisting medical conditions and for the concurrent performance of sterilizations, the death-to-case rates for first-trimester abortions performed in both kinds of facilities were about 0.7.