Article

Misoprostol: life-saving.

Centre for Research in Reproductive Health of Campinas (CEMICAMP), Campinas, Brazil.
The European Journal of Contraception and Reproductive Health Care (Impact Factor: 1.81). 04/2011; 16(2):57-60. DOI: 10.3109/13625187.2011.561940
Source: PubMed
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    ABSTRACT: Background Abortion rates in Latin America and the Caribbean (LAC) are nearly triple those in Western Europe, due to less use of contraception and highly restrictive abortion laws. Women resort to clandestine and often unsafe methods to end unwanted pregnancies, exposing themselves to the risk of complications and mortality. Medical abortion (MA) presents a safer alternative. Objectives To present evidence of MA's contributions to reduced complications, describe strategies to enhance safe MA, and highlight existing barriers to access in LAC, while examining MA's role in newly legal abortion services. Results Substantial declines in abortion-related morbidity and mortality and lower costs of treating complications are observed in LAC with MA than with other self-induction methods. Telephone hotlines, telemedicine and harm reduction models enhance access to safer abortion and help reduce complication rates by facilitating information on MA's proper use. Misoprostol is registered in most LAC countries, but access is increasingly limited by regulations and cost. Conclusion Despite highly restrictive abortion laws in LAC, MA increases access to safer abortion. Yet, significant barriers remain and much more must be done to enhance use of modern contraceptive and safer abortion methods among women in the region.
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    ABSTRACT: To explore the feasibility of educating communities about gynecologic uses for misoprostol at the community level through community-based organizations in countries with restrictive abortion laws. In 2012, the Public Health Institute and Ipas conducted an operations research study, providing small grants to 28 community-based organizations in Kenya and Tanzania to disseminate information on the correct use of misoprostol for both abortion and postpartum hemorrhage. These groups were connected to pharmacies selling misoprostol. The primary outcomes of the intervention were reports from the community-based organizations regarding the health education strategies that they had developed and implemented to educate their communities. The groups developed numerous creative strategies to reach diverse audiences and ensure access to misoprostol pills. Given the restrictive environment, the groups attributed their success to having addressed the use of misoprostol for both indications (abortion and postpartum hemorrhage) and to using a harm reduction approach to frame the advocacy. This initiative proves that, even where abortion is legally restricted and socially stigmatized, community-based organizations can publicly and openly share information about misoprostol and refer it to women by using innovative and effective strategies, without political backlash. Furthermore, it shows that communities are eager for this information.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 01/2014; · 1.41 Impact Factor