June 2022

Beyond safety: The 2022 WHO abortion guidelines and the future of abortion safety measurement

Gerdts C, O Bell S, Shankar M, Jayaweera RT, Owolabi O. BMJ Global Health. June 2022. DOI: 10.1136/bmjgh-2022-009557

In March 2022, the World Health Organization (WHO) released updated guidelines consolidating the current evidence and best practices for quality abortion care that span law, policy, clinical services, and mechanisms for service delivery. For the first time, WHO abortion service delivery recommendations include the self-management of medical abortion and fully recommend trained community health workers, pharmacy workers, and pharmacists as providers for the medical management of abortion up to 12-weeks gestation.

These shifts in WHO abortion care guidelines are the result of decades of work by grassroots activists and researchers. Their innovative efforts to ensure access to evidence-based abortion care—regardless of legal setting—laid the groundwork for widespread experiential knowledge and scientific evidence regarding the safety and effectiveness of self-managed medical abortion. Informed by this body of work, the recommendations for self-management of medical abortion in the new WHO guidelines have the potential to transform abortion access if international bodies, governments, and health systems expand the availability of abortion pills and access to trained support. The guidelines also have important implications for the way we conceptualize and measure abortion safety in the future.