In the last few newsletters, we have urged members to urge governments to permit telemedicine for self-managed abortions at home up to 10 weeks LMP. Pills can either be sent by the post by a doctor, amid-level provider or a pharmacist, or collected from a local pharmacy. Ten weeks LMP is the upper limit “officially” recognised by the World Health Organization and the US FDA, based on extensive research data. Ongoing research is also showing that it is safe up to 11 weeks, but this is not yet “official”. Importantly, here is a quote from the 2018 WHO publication Medical Management of Abortion, which says:
“When using the combination mifepristone and misoprostol regimen, the medical abortion process can be self-managed for pregnancies up to 12 weeks of gestation, including the ability to take the medications at home, without direct supervision of a healthcare provider.It should be noted that there was limited evidence for pregnancies beyond 10 weeks. This is an option in circumstances where individuals have a source of accurate information and access to a healthcare provider should they need or want it at any stage during the process.”
On this basis, and with the advice also of their consulting physicians, Women Help Women also advise women that they can safely do self-managed abortion up to 12 weeks LMP, based on the experience of those using their telemedicine service, and support doing so in the current circumstances.
We think it is important to point out that at 10-12 weeks, coping with the size of the fetus may be problematic for women aborting alone. The help of a safe abortion information hotline and having someone you trust with you, to go through the abortion at your side, is very supportive whenever possible. Always seek advice and clinical care if you are not sure the abortion is complete or you think you may have complications.
Ongoing research is also showing that it is safe up to 11 weeks, and we hope the findings will soon be substantial enough to satisfy WHO and other national agencies. Women Help Women have told us they advise women that they can safely do self-managed abortion up to 12 weeks LMP, based on the experience of women using their telemedicine service.
We think it is important to point out that at 10-12 weeks, coping with the size of the fetus may be problematic for women aborting alone. The help of a safe abortion information hotline and having someone you trust with you, to go through the abortion at your side, is very supportive whenever possible. Always seek advice and clinical care if you are not sure the abortion is complete or you think you have complications.