Medical abortion at home: a lesson from Sardinia for all of Italy.

In Sardinia, medical abortion will also be available in family planning clinics and—for now, on a trial basis—even at home . This marks the start of a process the Region has undertaken to implement the national guidelines on abortion approved in 2020. The proposal comes from Health Councilor Armando Bartolazzi. The center-left government, chaired by Alessandra Todde, has tasked the General Directorate of Health with developing regional guidelines to ensure access to this type of abortion outside of hospitals, namely in family planning clinics and equipped public clinics—provided they are connected to a hospital and authorized by the region.

Ru486 pill: available in day hospitals in Lombardy starting in 2019

Medical abortion (also called medical or chemical abortion) is a termination of pregnancy performed using specific medications. It is considered the first-choice method for terminating a pregnancy within the first weeks of gestation. This procedure involves the administration of an abortive drug ( mifepristone, the abortion pill RU486 ) followed by a prostaglandin (misoprostol) , 48 hours apart.

Until now, medical abortion in Italy was administered only in hospitals and authorized clinics, and the medications used were for hospital use only. Now, in Sardinia, it can be performed in clinics and at home, and for those who go to the hospital, it will be administered as a day hospital procedure, without the need to spend the night in the hospital.

Bartolazzi emphasized in a statement that the decision marks a turning point for the Region "after ten years of silence." "Sardinia is finally aligning itself with the most advanced European standards , also introducing a trial for home administration of the drug , previously only available in Emilia-Romagna . This is a concrete sign of concern for women's health and self-determination," the councilor stated.

The resolution aims to reduce the invasiveness of procedures, improve the quality and safety of procedures, optimize hospital resources, and increase local accessibility , even in areas where hospitals are more distant or less well-equipped.

According to data from the Ministry of Health's national surveillance system, Sardinia still records higher numbers than the national average for more invasive practices , such as curettage (21% versus 7.2%), while only 38.1% of abortions are performed using medical methods (versus 51.3% nationwide).

Medical abortion in Italy and Europe

In France, the cost of contraceptives for women is covered by the state.

In Italy, the provision of voluntary medical abortion dates back to 2009 , when the Italian Medicines Agency (AIA) approved the use of mifepristone (RU-486) in hospitals, in combination with misoprostol, up to the seventh week of pregnancy. In 2020, the limit was extended to nine weeks. Although ministerial guidelines issued five years ago opened the possibility of extending access to medical abortion outside of hospitals, their implementation has remained uneven across the country. Some regions have shown resistance to adapting to the new guidelines, maintaining the provision of abortive drugs exclusively in hospitals or limiting their availability. The only region, besides Sardinia, to have introduced the possibility of administering abortive drugs at home is Emilia-Romagna , which introduced this option in October 2024.

In many other European Union countries, however, medical abortion is now an established practice, accessible even outside of hospitals. France has allowed medical abortion in family planning clinics since 2013, and with the COVID-19 emergency, it expanded the option of home medication up to the seventh week of pregnancy and then up to the ninth. Patients receive a prescription after a medical consultation and can take the medication at home, with remote monitoring and access to 24-hour emergency numbers. During the pandemic, the British government introduced " telemedicine abortion ," which allows for remote medical consultations and the delivery of medications by mail. This measure was later established in 2022, making home medical abortion a permanent practice up to 10 weeks of gestation. In Sweden and the Netherlands , medical abortion is also available up to the ninth week and can be performed at home, following an initial medical consultation in an outpatient clinic.

These models demonstrate how home delivery can be effective , safe , and less invasive , provided it is integrated into a well-organized and accessible healthcare system. The trial launched in Sardinia could therefore represent a step toward aligning with these standards, improving access to abortion and strengthening women's decision-making autonomy in Italy as well.