Safety and Effectiveness of Home-Based Medical Abortion up to 12 Weeks Confirmed by Recent Study

A comprehensive five-year review conducted in Scotland confirms that early medical abortion administered at home up to 12 weeks of pregnancy is both safe and effective, with outcomes comparable to traditional hospital procedures. The study, published in the BMJ Sexual & Reproductive Health, analyzed cases of women seeking abortions between 10 and 12 weeks gestation. It highlights that, despite current legislation limiting at-home medical abortions to 10 weeks in England and Wales, Scotland's legislation permits up to 12 weeks, providing a valuable model for broader policy updates.

During the pandemic, authorities in Scotland, England, and Wales adapted laws to allow women to take abortion pills—mifepristone and misoprostol—at home, with the WHO supporting the safety of early at-home medical abortions during the first 12 weeks. The review examined 14,458 referrals in NHS Lothian, selecting 485 women who were between 10 and 12 weeks pregnant. Of these, 371 chose early medical abortion, with 70% opting for at-home treatment.

Results showed a 97% rate of complete abortions, with three women still pregnant post-treatment; one continued with pregnancy, while two proceeded with hospital abortions. Serious complications, such as heavy bleeding or infection, were rare, occurring in four cases—all among women who chose medical abortion at home, yet none required critical care. Women who underwent at-home abortions were more likely to contact healthcare providers for advice or return for follow-up, which reflects the increased contact time with healthcare professionals during hospital procedures.

The study underscores that complications post-abortion are rare among women under 20 weeks, and the findings align with prior research on early medical abortion in controlled settings. The authors advocate for extending legal access to at-home early medical abortion up to 12 weeks across the UK and Europe, aligning legislation with WHO recommendations, thereby offering women safer and more accessible options.

This evidence supports policy changes to broaden access, ensuring women can safely choose at-home medical abortions up to 12 weeks gestation.