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Objective: To determine the proportion of women presenting for an induced abortion in Ghana who could use a gestational wheel to determine if they had reached at least 13 weeks or fewer than 13 weeks of pregnancy accurately. Methods:The present cross-sectional study was conducted at four facilities in Ghana between February 1, and July 31, 2014. Women aged at least 18 years seeking induced abortions who had not previously been informed of the length of their pregnancy by a clinician were enrolled. Women self-assessed pregnancy duration using a gestational wheel before a clinician assessed the length via clinical assessment and bimanual exam for use as a respective reference point. The proportion of participants who used the wheel successfully was calculated. Results:The study enrolled 780 participants, 770 of whom used the gestational wheel.Of these, 221 (28.7%) could use the wheel without verbal instructions, and 465 (60.4%) described it as easy to use. Agreement in pregnancy-length assessments was recorded for 728 (94.5%) patients. There were 10 (1.3%) and 28 (3.6%) participants who made evaluations with "low-risk disagreement" and "high-risk disagreement" with the clinician assessment, respectively. Conclusion:Almost all participants could use the gestational wheel to date their pregnancies correctly. This tool could help women perform medical abortions safely in the community, reducing morbidity and mortality from unsafe abortions. K E Y W O R D SAbortion; Gestational dating; Ghana; Medical abortion; Misoprostol; Reproductive health | INTRODUCTIONDespite Ghana having relatively liberal laws surrounding induced abortion, evidence has demonstrated that the self-administration of misoprostol by women outside clinical settings is common practice. [1][2][3] Misoprostol alone, when administered according to the regimen recommended by WHO, is an effective medical abortion technique with a success rate of 85% for patients at up to 9 weeks of pregnancy. 4 Although there is limited evidence of the effectiveness of misoprostol for induced abortion of pregnancies at 9-13 weeks, WHO has endorsed using the evidence-based regimen for earlier than 9 weeks of pregnancy for pregnancies between 9 and 13 weeks. 5 Given the safety and simple administration of the regimen, arguments have been made against the need for clinical oversight in the use of misoprostol,This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.