A study conducted by Swedish researchers and published in The Lancet journal has highlighted the safety and efficacy of managing abortion at home using pills. The study, led by Johanna Rydelius from the Sahlgrenska Academy, University of Gothenburg, Sweden, analyzed the experiences of 435 women who took the first dose of misoprostol, a pill used in medical abortions, either at home or in the hospital.
The results were striking. Women who took the pill at home had a 71% chance of completing their care in the hospital within 9 hours with no overnight stay, compared to 46% of women who took the first dose of misoprostol at the hospital. This suggests that at-home administration of the pill can be more effective in avoiding overnight hospital stays.
Moreover, the study found that women in hospital settings are more likely to find abortion stressful and isolating, compared to those at home. Offering the choice to take the first dose of misoprostol at home provides a safe and effective alternative to taking all misoprostol doses at the hospital and enables women to self-manage some of the process, said Rydelius.
These findings are particularly relevant in light of the current World Health Organisation (WHO) guidelines, which recommend self-managed medical abortions only for patients under 12 weeks of gestation. In England, at-home medical abortions are permitted only until ten weeks gestation. However, this study, along with other recent research, suggests that at-home medical abortions can be safe and effective even after 12 weeks of pregnancy.
This has led to calls for a change in the law. Doctors and abortion providers have expressed concern that the current legislation is out of step with the latest scientific evidence and have called for an urgent change to legislation. The study's findings could potentially influence future policy decisions and lead to a revision of the current guidelines.
The study also has implications for the ongoing debate over the use of mifepristone, another drug used in medical abortions. Mifepristone, which blocks the hormone progesterone and causes the lining of the uterus to break down, is usually prescribed in a clinic. However, recent legal challenges in th have led to concerns about the future availability of mifepristone.
In this context, the study's findings about the safety and effectiveness of misoprostol, which makes the womb contract and can be taken at home, are particularly significant. If mifepristone were to become unavailable, misoprostol could potentially be used as a safe and effective alternative.
However, it's important to note that the use of misoprostol alone is associated with more side effects, such as nausea and diarrhea, compared to the combination of mifepristone and misoprostol. Therefore, while the study's findings are promising, further research is needed to fully understand the implications of using misoprostol alone for medical abortions.
