For years, the question of where and how early medication abortions should take place has sparked debate across the United Kingdom. Now, a new study out of Scotland is adding fuel to the conversation, suggesting that at-home abortions up to 12 weeks’ gestation are just as safe and effective as those performed in hospitals. The findings, published in BMJ Sexual & Reproductive Health, are prompting academics and advocates to call for sweeping changes to abortion laws throughout the UK.
The research, led by Jacqueline Quinn of the University of Edinburgh Medical Research Council Centre for Reproductive Health and Chalmers Sexual Health Centre, took a close look at outcomes for women between 10 and 12 weeks pregnant who opted for medication abortions either at home or in hospital. The results? Both groups experienced a 97% complete abortion rate, with no significant differences in incomplete abortion or ongoing pregnancy rates. According to the data, 258 women had at-home abortions, while 113 underwent the procedure in hospital between April 2020 and March 2025. The regimen was identical for both: 200 mg of mifepristone taken orally, followed 24 to 28 hours later by 800 µg of misoprostol, with additional doses as needed. A self-performed low-sensitivity urinary pregnancy test two weeks later confirmed whether the abortion was complete.
“This study demonstrates that early medical abortion at home should be extended to allow women across the U.K. to access this up to 12 weeks if they wish to,” Quinn told MedPage Today. “Therefore, the law and regulations in other parts of the U.K. need to be changed to allow women access to this procedure between 10 and 12 weeks.”
Currently, the rules for at-home medication abortion in Britain are a patchwork. Since the COVID-19 pandemic, England and Wales permit at-home abortions up to 9 weeks and 6 days, while Scotland allows the practice up to 11 weeks and 6 days. Northern Ireland, however, doesn’t permit at-home abortion care at any gestation. These time limits stand in contrast to the World Health Organization’s guidance, which supports at-home medication abortions up to 12 weeks and encourages the use of telemedicine and hybrid models of care.
The study’s findings are especially timely given the recent legislative changes. In 2022, England and Wales made at-home medical abortions a permanent option after pandemic-era rules proved effective. Yet, despite mounting evidence and international recommendations, the legal cutoff remains below the 12-week threshold endorsed by the WHO.
Over the five-year study period, 14,458 referrals were made to the NHS Lothian abortion service in Scotland. Of these, 485 women—about 3.5%—were between 10 and 12 weeks pregnant, as determined by their last menstrual period or ultrasound. The researchers found that 97% of abortions were successful in both the at-home and hospital groups. There were, however, four cases of serious complications—all in the at-home group—including one hemorrhage requiring transfusion and three infections treated with intravenous antibiotics. Still, the authors emphasized that such complications were rare and unlikely to have been prevented by hospital admission. “Our study contained a small number of patients, with only one case of haemorrhage that presented one month following abortion with chronic bleeding, and so admission to hospital for [early medical abortion] is unlikely to have altered this,” the researchers wrote.
In terms of follow-up care, the at-home group was more likely to seek additional support. Rates of follow-up visits were higher for at-home patients (7% versus 2% for hospital patients), as was the use of telephone advice (11% versus 4%). Unscheduled contact with a hospital or abortion clinic due to abortion-related concerns within six weeks was also more common among those who had the procedure at home (23% versus 9%).
According to Ashley Brant, an ob/gyn and complex family planning subspecialist at the Cleveland Clinic who was not involved in the research, these findings highlight the importance of thorough counseling before the procedure. “Providing instructions on how and when to seek additional care or medical advice is an important part of pre-abortion counseling,” Brant told MedPage Today. She added that the study “supports the safety and efficacy of medication abortion via telemedicine at 10 to 11 weeks” and that “regulations, policies, and protocols that restrict access to medication abortion or require in-person evaluation do not improve the safety of abortion and are not grounded in medical evidence.”
Advocates are seizing on the study’s results to push for broader access and legal reform. Heidi Stewart, chief executive of the British Pregnancy Advisory Service, said: “This important study from Scotland adds to the already extensive body of evidence that at-home medical abortion between 10 and [12] weeks’ gestation is safe and effective. Thousands of women each year in the UK are being compelled to attend hospital appointments and undergo surgical procedures when, as this research makes clear, they could be treated at home.” Stewart called on lawmakers to modernize the country’s abortion laws, which she described as outdated. “When the abortion law was first passed in 1967, it was designed to protect and improve women’s health. Nearly 60 years later, this legislation is restricting our ability to innovate and develop services in line with clinical practice. It is time for parliament to modernise our out-of-date legal framework, and finally allow healthcare professionals to give all women in the UK the best possible care, including the choice of an at-home medical abortion care throughout the first trimester.”
Despite the strong evidence and growing calls for change, the issue remains contentious. Some policymakers and members of the public continue to express concerns about safety, oversight, and the potential for complications in the absence of direct medical supervision. However, the study’s authors and many in the medical community argue that these fears are not supported by the data. The low rates of serious complications, coupled with the high success rates for both at-home and hospital abortions, suggest that with proper guidance and support, at-home medication abortion can be a safe and effective option for women up to 12 weeks pregnant.
As the UK grapples with how best to align its laws with current evidence and international standards, the voices of women, healthcare providers, and researchers are growing louder. With the WHO and a mounting body of research backing at-home abortion up to 12 weeks, the pressure is on for lawmakers to reconsider the current restrictions. For now, the study from Scotland offers a clear message: when it comes to early medication abortion, home may be just as safe as hospital—and for many women, it may also be the better choice.
