When there is nowhere left to turn: a qualitative study on people who could not access safe abortion care after 20 weeks’ gestation
Published in: Reproductive Health, 2026
June 2017
The World Health Organization recommends abortion after 12 weeks of pregnancy to take place under clinical supervision. This is, however, unavailable in most settings. This study examines the care seeking experiences and outcomes of individuals who sought information on abortion at 20 or more weeks’ gestation through WoW between January 2020 and December 2023. During this period, information on the use of abortion pills was provided only for pregnancies under 20 weeks due to the limited knowledge and acceptance of self-managed abortion (SMA) at the time.
Key findings:
👆 Almost half of care-seekers came from four countries with restrictive settings: Brazil, Indonesia, Morocco, and the Philippines.
🌍 Care seekers described serious mental health problems related to the inability to safely terminate an unwanted pregnancy – including suicide attempts – and circumstances surrounding their requests for help, such as the detection of fetal malformations, rape, violent relationships or family situations, fear of criminalization, and the inability to travel for care
💊 Many had already tried to end their pregnancy before contacting Women on Web. However, as they did not have access to information, they did so either with inadequate doses or application routes of misoprostol, or with unsafe methods.
These results support a recent (2024) change in WoW´s policy on providing information on abortion pill use at or after 20 weeks pregnancy as they reaffirm the importance of information provision on SMA at any gestational length as a harm-reduction strategy, allowing people to make informed decisions over their own bodies.
Why these findings matter:
Little is known about the experiences of individuals who seek abortion care after 20 weeks’ pregnancy, especially in settings where neither formal care nor accurate information and support are available. This study highlights the need and urgency for abortion care at and beyond 20 weeks.
