Outcomes after unsupervised self-administration of abortion pills presenting at a tertiary care hospital in Eastern India

Background: Medical abortion is safe and effective when used according to standard guidelines. However, unsupervised self-administration may result in resource wastage and maternal morbidity. This study assessed outcomes and complications associated with unsupervised abortion pill intake in a tertiary care hospital in Eastern India. Methods: A retrospective cross-sectional study was conducted at Calcutta National Medical College and Hospital from January to December 2025 after institutional ethical approval. Women presenting after abortion pill intake without supervision of a registered medical practitioner were included. Women with spontaneous abortion or medically supervised termination were excluded. Detailed data regarding Sociodemographic characteristics, clinical presentation, complications etc were collected from hospital records and analysed using standard statistical methods and recorded. Results: Among 152 women, 38.8% were aged 26–30 years and 57.2% were from rural areas. Unintended pregnancy was the commonest reason for abortion (63.9%), while influence of friends or relatives (30.9%) was the leading reason for avoiding medical consultation. Vaginal bleeding was the commonest presenting complaint (64.5%). Incorrect dosage occurred in 59.8% and 38.2% took pills beyond 9 weeks of gestation. Surgical intervention was required in 54.6%, including laparotomy for ectopic pregnancy in two cases. ICU admission was required in 17.7%. No maternal death occurred. Incorrect dosage (aOR 2.57, 95% CI 1.25–5.27), gestational age >9 weeks (aOR 3.84, 95% CI 1.79–8.26) and increasing age were significantly associated with complications. Conclusions: Unsupervised self-administration of abortion pills were associated with substantial maternal morbidity. Appropriate counselling, adherence to recommended regimens and access to supervised abortion services are essential to reduce preventable complications.