Managing abortion at home using pills is safe and may ease hospital burden: The Lancet

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Managing abortion at home using pills is safe and may ease hospital burden, claimed a study published in The Lancet journal on Friday.

The randomised controlled trial of 435 women by Swedish researchers analysed women who took the first dose of misoprostol (a pill given as part of the procedure for medical abortions) at home or in the hospital.

Those who took the pill at home had a 71 per cent chance of completing their care in hospital within 9 hours with no overnight stay, compared to 46 per cent of women who took the first dose of misoprostol at the hospital.

Women in hospital settings are more likely to find abortion "stressful and isolating", compared to those at home.

In a medical abortion (also known as abortion with pills) women are typically prescribed two types of pills.

Mifepristone, which blocks the hormone progesterone therefore causing the lining of the uterus to break down, is usually prescribed in a clinic.

Misoprostol, which makes the womb contract, can be taken two days later. The medicine has to be taken every few hours until the abortion is complete

"Offering the choice to take the first dose of misoprostol at home provides a safe and effective alternative to taking all misoprostol doses at the hospital and enables women to self-manage some of the process," said Johanna Rydelius, Sahlgrenska Academy, University of Gothenburg, Sweden.

This can also help women with "feelings of autonomy during a time where they can feel extremely vulnerable", Rydelius said.

Previous studies indicate that most medical abortions after 12 weeks of pregnancy are completed within eight to 12 hours after the first misoprostol dose and require an average of two to three misoprostol doses, with some patients needing to stay overnight in the hospital.

Rydelius said that in the study, "1 per cent of the women who took misoprostol at home completed the abortion before attending hospital for the next dose."

The study, however, found no difference in the average pain score, types and number of side effects, or rates of admittance to hospital earlier than planned between the two groups.

The patients in the home treatment group (1 per cent ) had the abortion on the way to the hospital, between one to two hours after taking the first dose of misoprostol.

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