Is it safe to do a medical abortion by yourself?
WHO recommends that individuals in the first trimester (up to 13 weeks pregnant) can self-administer mifepristone and misoprostol medication for an abortion without direct supervision of a health-care provider.
Abortions are safe if they are done with a WHO-recommended method that is appropriate to the pregnancy duration, and if the person providing or supporting the abortion is trained.[1]
The risks of medical abortion
The risk of an abortion with medicines are similar to the risks of commonly prescribed medicines and over the counter medication such as antibiotics and some painkillers. [2][3] An abortion with pills is much safer than childbirth and safer than plastic surgery [4]
Using Mifepristone and Misoprostol is no more complicated than using other medications.
A medical abortion does not need to take place in a hospital or urgent care center.[5] The risks of a medical abortion are the same as those of a miscarriage. About 15% of all pregnancies end in a miscarriage. These miscarriages do not happen in a hospital but usually at home. Most women know how to deal with it themselves and only go to a hospital in case of problems like heavy bleeding or fever. A medical abortion provokes a miscarriage. You can take the medicines yourself at home as long as you are not longer than 10 weeks pregnant and live within one hour of medical help.
World Health Organization medical abortion recommendations
Scientific research in the British Medical Journal of 1000 women in the Republic of Ireland and Northern Ireland who secured an abortion with pills online from 2010-2012 showed that it is safe and acceptable to do a medical abortion at home, with support services.[6] Additionally, a World Health Organization study, which analyzed the outcome of thousands of women’s abortions at home versus in a clinic in Tunisia, Vietnam, Albania, France, India, Nepal, Turkey, between 1997-2008 showed that there was no evidence to say home-based abortion is any less effective or safe than medical abortions in a clinic setting. The rate of complete abortion for women who took the pills at home was 90% which was comparable to those who took the pills under the supervision of a medical authority.[7]
In a 2015 study, abortions through Mifepristone and Misoprostol were shown to be nearly 98% effective, with very few complications.[8] Mifepristone and Misoprostol have been on the list of essential medicines of the World Health Organization since 2005.[9]
Citations
[1] https://apps.who.int/iris/bitstream/handle/10665/278968/9789241550406-eng.pdf
[2] WHO, Safe abortion: technical and policy guidance for health systems, 2nd Ed., 2012. Available in: http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf. Last access on 9/14/2017.
[3] https://www.nap.edu/read/24950/chapter/4#69, Page 69
[4] https://www.nap.edu/read/24950/chapter/1
[5] How much supervision is necessary for women taking mifepristone and misoprostol for early medical abortion? Caitlin Shannon1 & Beverly Winikoff, Women's Health, March 2008, Vol. 4, No. 2, Pages 107-111, http://www.ncbi.nlm.nih.gov/pubmed/19072508
[6] Abigail Aiken, Irena Digol, James Trussel, Rebecca Gomperts. “Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland.” BMJ2017; 357 :j2011, http://www.bmj.com/content/357/bmj.j2011
[7] “Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic: a systematic review.” November 2010. Thoai D Ngo a, Min Hae Park b, Haleema Shakur a & Caroline Free. http://www.who.int/bulletin/volumes/89/5/10-084046/en/
[8] “Efficacy and safety of medical abortion using mifepristone and buccal misoprostol through 63 days.” Gatter M, Cleland K, Nucatola DL. Contraception. 2015;91:269-273. https://www.ncbi.nlm.nih.gov/pubmed/25592080
[9] “Medication Abortion.” The Henry Kaiser Family Foundation. October 2017. https://www.kff.org/womens-health-policy/fact-sheet/medication-abortion/#footnote-239028-4