This report is a call for action to expand medical abortion as one of the options for women who decide not to go through a full pregnancy. This urgently requires a coordinated effort to build the evidence needed to allow women to self-manage medical abortion. To enable women to do this, health systems must be supportive of women’s needs, providing information and support mechanisms, and ensuring the quality, availability and accessibility of medical abortion drugs, as well as post-abortion care. The report also recommends that the work to end unsafe abortion should take place across health systems and political structures. Legal frameworks must support access to safe abortion while health systems must be equipped to provide comprehensive abortion care.