Adverse events following self-administered abortion pills: A retrospective observational study

Background and objectives In India, limited awareness regarding the potential adverse effects of medical termination of pregnancy (MTP) pills, coupled with their non-prescribed over-the-counter availability, has led to their widespread unsupervised use. Such practices may result in serious maternal complications. This study aimed to describe the clinical profile and outcomes among women presenting to a tertiary care hospital following unsupervised self-administration of MTP pills. Methods A record-based retrospective study was carried out at a tertiary academic medical centre. Case files of women who attended between January and June 2025 with a documented history of self-administered MTP pills were retrieved and evaluated for clinical outcomes and complications. Results Seventy-six women fulfilling the inclusion criteria were enrolled. Women aged 25-30 y constituted the largest group (30/76; 39.5%). The predominant diagnosis was incomplete abortion (54/76; 71.1%), with shock complicating 10/76 (13.2%) and sepsis complicating 8/76 (10.5%) cases. Dilatation and evacuation was performed in 42/76 (55.3%) patients. Serious adverse outcomes comprised 2 maternal deaths, 5 intensive care unit admissions, and 18 women with prolonged hospitalisation beyond three days. Interpretation and conclusions Among women presenting to a tertiary care hospital after unsupervised use of MTP pills, incomplete abortion was the most frequent complication, often accompanied by shock and sepsis. These findings underscore the need for strengthening public awareness, enforcing existing regulations, and promoting supervised medical abortion services to reduce preventable maternal morbidity.