Update on Medical Abortion: Expanding Safe and Equitable, Patient-Centered Care

Abstract

Addressing disparities in abortion access and efforts to end the global problem of unsafe abortion are key public health and human rights priorities. Optimizing the role of various health workers in supporting safe medical abortion practices and working to remove unnecessary barriers to care are key strategies that address inequities in outcomes after abortion worldwide. Medical abortion using evidence-based protocols is effective through 70 days gestation and can safely be provided by non-physician providers in outpatient settings. Removing barriers of in-office administration of mifepristone and simplifying follow-up protocols are evidence-based approaches to expanding access to medical abortion, particularly in settings where access to surgical abortion is limited. Research supports expanding the role of women themselves, as well as task-shifting among health worker teams in providing safe abortion and postabortion care. Simplifying the process of medical abortion, including allowing prescription and home administration of mifepristone and utilizing telemedicine for follow-up protocols are safe and feasible, can optimize use of health resources and improve patient experience with medical abortion.