Midwives could be allowed to prescribe abortion pills in Sweden under new abortion legislation. Home abortions without prior clinic pill visit could also be permitted. These and other recommendations were made by a Swedish government-commissioned investigation. But these are all decisions that remain to be taken.

“Many midwives already support and care for women seeking abortions, while a doctor does the work of prescribing the medication…”

Changes to the Swedish abortion law could be made as soon as it is agreed formally that medical abortion at home is considered a safe procedure. A physical visit to a clinic to take the first abortion pills should not be required by law anymore, according to a new report.

The Swedish abortion law came into force in 1975 but has remained largely unchanged since then.

Now, a government-commissioned investigation is proposing a number of legislative changes that are considered to be of great importance for women and transgender men who might become pregnant. “The changes we are proposing are the biggest in 50 years and will allow the abortion applicant to have more self-determination and independence during the abortion process,” Inga-Maj Andersson, PhD, the government’s investigator and a midwife, told Euractiv.

Medical abortions in Sweden

Around 35,000 abortions take place in Sweden every year, according to Andersson’s recent report.

The vast majority (96 per cent) are medical abortions taking place in abortion clinics or at home. The abortion applicant is free to choose, but the first pills must be taken in the clinic to comply with the current law.

In the case of a home abortion, the procedure needs to occur before the tenth week of pregnancy. The second medication to complete the abortion may be taken at home.

Medical abortions started in the 1990s in Sweden. Since then, the number of surgical abortions has fallen sharply from 31,000-37,000 per year during the same period (1990s) to only 1,250 in 2023.

Therefore, there was a need to review the abortion law to adapt it to medical development, according to Acko Ankarberg Johansson, the Swedish Health Minister.

Changes to the law

The investigator’s report states that the new law should clarify or strengthen the right to abortion; apply to the person seeking an abortion, either a woman or a transgender man; other health personnel than doctors could receive authorisation to prescribe abortion pills; and it would no longer be compulsory to visit an abortion clinic to take the first pills during early pregnancy.

But abortion seekers would still need to contact an abortion clinic, and abortions must still be offered by clinics that have the needed competencies and resources, according to Inga-Maj Andersson. She also emphasised that clinical trials have demonstrated that medical abortions in early pregnancy at home are safe.

Welcomed changes, all still requiring approval

Midwife Åsa Mörner, a board member of the Swedish Association of Health Professionals – whose members are mostly nurses and midwives – told Euractiv that the union welcomes the legislative changes. “We find the proposals to be positive. Especially the removal of the requirement to visit an abortion clinic since there could be women who have difficulties with visiting a clinic, for example, if they have to travel far,” she said. She is also happy that midwives could be allowed to prescribe abortion drugs, as this would mean an expanded and more independent role for them.

Currently, only doctors have such authorisation in Sweden.

“Many midwives already support and care for women seeking abortions, while a doctor does the work of prescribing the medication,” Mörner said, explaining that midwives often work in teams with various health professionals.

For women in later stages of pregnancy (after week 12), medical abortions need to be carried out at a hospital as more medication and more painkillers are usually needed, according to Inga-Maj Andersson.

Decision transparency needed

Abortion is permitted up to 18 weeks of pregnancy in Sweden. After that week, a council at the National Board of Health and Welfare (Rättsliga Rådet) can give the green light for up to 21 weeks (plus six days) but only in special circumstances.

Around 500 women apply for late abortions (after 18 weeks) each year, mostly because of late-diagnosed congenital anomalies. However, the council’s decisions, which are not transparent, have been heavily criticised in recent years.

“The abortion seeker only gets a yes or a no, with no explanation and with no possibility to appeal to a higher authority,” Åsa Mörner explained.

Also, the investigation deems that there is a need for a review of the council regarding, for example, the non-transparency in its decision-making and the abortion seeker’s rights to understand its praxis.

SOURCES: Euractiv.com, by Monica Kleja, 3 March 2025. Translated from Swedish by Kristina Castell; Jurist, by Mariam Bahaa Eldein Thabet, Mansoura University Faculty of Law, EG. 3 March 2025.