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Medical abortion at home after twelve weeks is safe and effective
Last reviewed: 02.07.2025
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A new study published in The Lancet by researchers at the University of Gothenburg and the Karolinska Institutet shows that starting a medical abortion after 12 weeks of pregnancy at home is as safe as starting it in hospital. When treatment is started at home, day hospital care is usually sufficient and women are satisfied with the treatment.
For medical abortion up to the 10th week of pregnancy, the so-called home abortion is used. From 10 to 12 weeks, a day hospital is most often used, while a medical abortion after 12 weeks of pregnancy may require a longer course of treatment with an overnight stay in the hospital.
The study involved 457 women in Sweden planning a medical abortion after 12 weeks of pregnancy. The aim of the study was to find out how necessary hospitalisation is when treatment is started at home.
About half of the participants were randomly assigned to a group that took the first dose of the abortion drug misoprostol at home in the morning, two hours before arriving at the hospital's gynecology department. The remaining participants were assigned to a group that followed usual medical practice and took the first dose after arriving at the hospital.
Benefits of a Home Treatment Group
The researchers assessed how many people experienced complications or required surgery due to the abortion. Participants' morbidity was assessed several times during treatment, and specific satisfaction surveys were conducted.
The results showed that 71% of women who initiated abortion at home could be treated as day patients, compared with 46% of those who initiated treatment in hospital, a statistically significant result.
The rate of severe complications during and after abortion was low, and the proportion of participants requiring surgery was 6.4% in the home group and 8.5% in the hospital group, confirming previous studies in this area.
Most study participants were very satisfied with their treatment: 86% in the home group and 81% in the hospital group. However, significantly more people in the home group (78%) would prefer the treatment to which they were randomised, compared with 49% in the hospital group.
Economic aspects and autonomy
The researchers believe that if patients were offered the first dose of misoprostol at home, a greater proportion could be treated as day patients for medical abortion after 12 weeks of pregnancy. This change could have several benefits.
Johanna Rüdelius, PhD student in the Department of Obstetrics and Gynecology at Sahlgrenska Academy, University of Gothenburg, gynecologist at Sahlgrenska University Hospital and one of the researchers:
"Providing day hospital care for this group of patients may allow countries with limited access to hospital care to expand abortion care. Day hospital care may also be less costly for both the health system and the patients themselves. The ability to initiate treatment at home also helps increase patient autonomy."