At-home abortions should be allowed for up to 12 weeks of pregnancy across the UK, according to academics, after a study found they were just as safe and effective as hospital care.
A medical abortion involves taking two medications, mifepristone and misoprostol, to end a pregnancy. In 2022, at-home medical abortions were made permanent in England and Wales, after temporary legislation allowed them to take place at home during the pandemic. In Northern Ireland, at-home abortion care is not permitted at any gestation.
Despite the World Health Organization (WHO) recommending that early medical abortions can occur safely at home in the first 12 weeks of pregnancy, legislation across England and Wales limits this to 10 weeks.
The study, published in BMJ Sexual & Reproductive Health, looked at the outcomes of abortions carried out between 10 and 12 weeks of pregnancy in hospital and at home across NHS Lothian in Scotland, between 2020 and 2025. At-home medical abortions are legal in Scotland up to 12 weeks.
During this period, 14,458 referrals were made to the abortion service, and of these 485 women (3.5%) were assessed as being between 10 and 12 weeks of pregnancy either by the date of their last period or by an ultrasound scan.
The researchers found that 97% of abortions were successful for both groups of women.
They also found cases of serious complications, such as heavy bleeding or infection, one month after the procedure among those who had opted for a medical abortion at home. But despite this, the researchers concluded it was a rare complication among women who are less than 20 weeks pregnant.
“Our study contained a small number of patients, with only one case of haemorrhage that presented one month following abortion with chronic bleeding, and so admission to hospital for [early medical abortion] is unlikely to have altered this,” they said.
The researchers concluded that the study showed that at-home medical abortions between 10 and 12 weeks were “highly effective and safe”.
“In line with WHO guidance, action is needed to extend [early medical abortion] at home up to [12] weeks to women across the rest of the UK and beyond,” they concluded.
Heidi Stewart, the chief executive of the British Pregnancy Advisory Service, said: “This important study from Scotland adds to the already extensive body of evidence that at-home medical abortion between 10 and [12] weeks’ gestation is safe and effective.
“Thousands of women each year in the UK are being compelled to attend hospital appointments and undergo surgical procedures when, as this research makes clear, they could be treated at home.”
She added: “When the abortion law was first passed in 1967, it was designed to protect and improve women’s health. Nearly 60 years later, this legislation is restricting our ability to innovate and develop services in line with clinical practice.
“It is time for parliament to modernise our out-of-date legal framework, and finally allow healthcare professionals to give all women in the UK the best possible care, including the choice of an at-home medical abortion care throughout the first trimester.”
The Department of Health and Social Care has been approached for comment.
