SynthesisBulletin of the World Health Organization2011
Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic: a systematic review.
Synthesis in Bulletin of the World Health Organization, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02745093 (The Effectiveness, Safety, and Acceptability of Home-administered Medical Abortion at Gestational Age of 8 to ≤9 Weeks Versus >9 to ≤12 Weeks), which is not on this map. Cited by 53 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effectiveness, Safety, and Acceptability of Home-administered Medical Abortion at Gestational Age of 8 to ≤9 Weeks Versus >9 to ≤12 Weeks: A Prospective Cohort Study in Mexico City
Who cites it
53 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Home use of mifepristone for medical abortion: a systematic review.BMJ sexual & reproductive health · 2025Pooled it
- Telemedicine for the provision of medication abortion to pregnant people at up to twelve weeks of pregnancy: a systematic literature review and meta-analysis.Reproductive health · 2024Pooled it
- Pain management for medical abortion before 14 weeks' gestation.The Cochrane database of systematic reviews · 2022Pooled it
- Effectiveness, safety and acceptability of medical abortion at home versus in the clinic: a systematic review and meta-analysis in response to COVID-19.BMJ global health · 2020Pooled it
- Systematic review of early abortion services in low- and middle-income country primary care: potential for reverse innovation and application in the UK context.Globalization and health · 2020Pooled it
- Self-administered versus provider-administered medical abortion.The Cochrane database of systematic reviews · 2020Pooled it
- Telemedicine for medical abortion: a systematic review.BJOG : an international journal of obstetrics and gynaecology · 2019Pooled it
- Why do they take the risk? A systematic review of the qualitative literature on informal sector abortions in settings where abortion is legal.BMC women's health · 2019Pooled it
- Pooled it
- Facilitators and barriers to quality of care in maternal, newborn and child health: a global situational analysis through metareview.BMJ open · 2014Pooled it
- Women's Satisfaction With Quality of Abortion Care, Associated Factors, and Barriers in Public Health Facilities of South Gondar Zone, Ethiopia: A Mixed Study.Health science reports · 2026Article
- Transforming reproductive healthcare delivery through telemedicine services expansion: evidence from a mixed-methods pilot evaluation in rural Ghana.BMJ global health · 2026Article
- Feasibility of medication abortion self-care service delivery in Ghana.Reproductive health · 2025Article
- Effectiveness and acceptability of home use of misoprostol for medical abortion up to 10 weeks of pregnancy.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Medical abortion ratios and gender equality in Europe: an ecological correlation study.Sexual and reproductive health matters · 2021Article
- Real-Time Effects of Payer Restrictions on Reproductive Healthcare: A Qualitative Analysis of Cost-Related Barriers and Their Consequences among U.S. Abortion Seekers on Reddit.International journal of environmental research and public health · 2021Article
- Is the Right to Abortion at Risk in Times of COVID-19? The Italian State of Affairs within the European Context.Medicina (Kaunas, Lithuania) · 2021Review
- Safe Abortion in Women's Hands: Autonomy and a Human Rights Approach to COVID-19 and Beyond.Health and human rights · 2021Article
- Toward Human Rights and Evidence-Based Legal Frameworks for (Self-Managed) Abortion: A Review of the Last Decade of Legal Reform.Health and human rights · 2021Review
- Scoping review of research on self-managed medication abortion in low-income and middle-income countries.BMJ global health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare medical abortion practised at home and in clinics in terms of effectiveness, safety and acceptability.
methodsA systematic search for randomized controlled trials and prospective cohort studies comparing home-based and clinic-based medical abortion was conducted. The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE and Popline were searched. Failure to abort completely, side-effects and acceptability were the main outcomes of interest. Odds ratios and their 95% confidence intervals (CIs) were calculated. Estimates were pooled using a random-effects model.
findingsNine studies met the inclusion criteria (n = 4522 participants). All were prospective cohort studies that used mifepristone and misoprostol to induce abortion. Complete abortion was achieved by 86-97% of the women who underwent home-based abortion (n = 3478) and by 80-99% of those who underwent clinic-based abortion (n = 1044). Pooled analyses from all studies revealed no difference in complete abortion rates between groups (odds ratio = 0.8; 95% CI: 0.5-1.5). Serious complications from abortion were rare. Pain and vomiting lasted 0.3 days longer among women who took misoprostol at home rather than in clinic. Women who chose home-based medical abortion were more likely to be satisfied, to choose the method again and to recommend it to a friend than women who opted for medical abortion in a clinic.
conclusionHome-based abortion is safe under the conditions in place in the included studies. Prospective cohort studies have shown no differences in effectiveness or acceptability between home-based and clinic-based medical abortion across countries.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.