WHO recommends that individuals up to 12 weeks pregnant can self-administer medical abortion without direct supervision of a health-care provider.
by Hazal Atay*
Abortion is one of the most common medical procedures performed worldwide. According to the World Health Organization (WHO) each year 56 million induced abortions occur. Abortion is essential healthcare and access to abortion is an important part of sexual and reproductive health services.
Worldwide, an estimated shortage of 18 million health workers is anticipated by 2030. Nonetheless, at least 400 million people worldwide lack access to the most essential health services. Access to essential and relevant healthcare is more challenging in humanitarian settings and pandemics, as healthcare institutions are disrupted and/or overloaded.
WHO consolidated guidelines on self-care interventions for «evidence-based, quality drugs, devices, diagnostics and/or digital products which can be provided fully or partially outside of formal health services and can be used with or without the direct supervision of health care personnel.» Recommending self-management of medical abortion, WHO puts forward that it is safe, feasible and acceptable.
The self-management of abortion is non-invasive and cost-effective, and it also improves autonomy as individuals might value the sense of control over their bodies and the abortion process, as well as the ability to maximize comfort being at their homes while taking pills.
Self-management can also be appealing for several practical reasons, WHO suggests, including lower costs, ease of scheduling, reduced transport needs, ability to manage stigma, and quicker termination of pregnancy.
In the same spirit, WHO in its interim guide for Maintaining essential health services: operational guidance for the COVID-19 context recommends expanding telemedicine mechanisms for safe abortion provision, to reduce barriers that could delay care, and to minimize facility visits and provider–client contact.
Research has shown that success rate and safety outcomes for abortion through telemedicine are similar to those for in-person abortion care. Operating as a telemedicine referral service since 2005, Women on Web aims to help women and pregnant people around the world to obtain and self-manage medical abortion. Our service also works towards reducing the mortality and morbidity related to complications of unsafe abortion.
*Hazal Atay is a researcher at Sciences Po Paris and coordinator at Women on Web, working on biopolitics and sexuality with a focus on safe abortion.
Last Updated: 22/02/2021
