A team of researchers presents an analysis of reports from women living in Ireland and Northern Ireland, where abortions are highly restricted. The scientists reviewed data from a group of 1,000 women from the two nations who self-sourced medical abortions through Women on Web, a nonprofit organization that provides access to medications used to induce abortions.
The results – published Tuesday in the journal The BMJ – show that 95 percent of the group’s abortions were successful, and less than three percent of women required antibiotics afterward. No deaths were reported.
Furthermore, the women were able to identify the symptoms of possibly serious complications, nearly all of whom reported seeking in-person medical attention when advised.
“Irish and Northern Irish people who access or help others to access this pathway are choosing an option that has similar effectiveness rates to medication abortion performed in a clinic and has lower rates of complications than continuing a pregnancy to delivery,” said lead author Abigail Aiken, assistant professor at the University of Texas at Austin.
The research provides some of the clearest practical evidence so far about the outcomes of self-sourced medical abortions for a population of women who do not have reliable access to abortions.
About a quarter of the world’s population lives in nations with significant abortion restrictions. Each year an estimated 43,000 women die because they lack access to safe legal abortions services through their nations’ health care systems. Millions more experience complications.
“For the millions of women worldwide living in areas where access to abortion is restricted, the findings show the vital role played by self-sourced medical abortion in providing an option with high effectiveness rates and few reported adverse outcomes,” the team writes.
Self-reporting data presents certain study limitations – and the results might not be applicable to all settings, according to the authors. However, they also note strengths of the research, such as the high follow-up rate and large sample size.
“It is also likely that most complications were captured as this online telemedicine service was probably the only safe outlet for women needing to discuss symptoms of suspected complication,” two Canadian researchers write in a linked editorial.
Aiken added, “Following waves of restrictive legislation in the United States, the parallels between women seeking abortion in certain parts of the U.S. and Ireland and Northern Ireland are striking.
“In the case of the United States, we already know women are self-sourcing, so there is a public health duty to help make it as safe and supported as possible.”