Research News

Online abortion service is safe and effective way to end pregnancy, finds study

BMJ 2017; 357 doi: (Published 17 May 2017) Cite this as: BMJ 2017;357:j2351
  1. Zosia Kmietowicz
  1. BMJ

Online telemedicine provides a safe and effective method to end pregnancy, a study published in The BMJ has found.1

Rates of adverse events among 1000 women in Ireland who used such a service were low, and women were able to identify potentially serious complications and seek medical attention when advised.

The results provide the best safety evidence to date for self sourced medical abortion through telemedicine and have important implications for millions of women worldwide, said the researchers.

About a quarter of the world’s population lives in countries with highly restrictive abortion laws, and every year an estimated 43 000 women die from unsafe abortions. Millions more have complications.

To find out more about the safety and effectiveness of medical abortion provided through online clinics, a team of international researchers analysed self reported outcome data submitted to the online Women on Web clinic by 1000 women from the Republic of Ireland and Northern Ireland four weeks after receiving and using the drugs mifepristone and misoprostol to end an early pregnancy.

Women on Web ( is a non-profit organisation that provides access to abortion medicines through online telemedicine in countries where safe abortion is not universally available.2

The study found that almost 95% of women reported successfully ending their pregnancy. Seven women (0.7%) reported receiving a blood transfusion, and 26 (2.6%) reported receiving antibiotics. No deaths were reported.

Ninety two women (9.3%) reported experiencing any symptom for which they were advised to seek medical attention, such as heavy bleeding, fever, abnormal discharge, or pain several days after abortion. Of these women, 87 (95%) sought attention. None of the five women who did not seek medical attention reported an adverse outcome.

Limitations of the study included the fact that data from a third of women were missing, meaning that rare complications could not be detected. In addition, the results may not be generalisable to all settings, said the researchers.

In an editorial,3 researchers in Canada said that, while findings from self reported data must always be treated with some caution, these “reassuring study data support growing calls for reform [of abortion laws].”

They emphasised that repeal of legal restrictions “would support the safest and most equitable abortion care for women in Irish jurisdictions” and concluded, “Until then, for the first time in history, women of all social classes in a legally restricted yet high resource setting have equitable access to a reasonable alternative: medical abortion guided by physicians through telemedicine.”


View Abstract

Log in

Log in through your institution


* For online subscription