Reaching women in Latin America with instructions for misoprostol use


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

4278.0: Tuesday, December 13, 2005 - Board 1

Abstract #115136

Jessica Cohen, MHS¹, Lorelei Goodyear, MPH², Deborah L. Billings, PhD³, Olivia Ortiz⁴, Silvia Llaguno⁴, Imelda Martinez, Obstetric Nurse⁵, and Soraya Vasquez⁶. (1) Technology Solutions, Program for Appropriate Technology in Health (PATH), 1455 NW Leary Way, Seattle, WA 98107, (206) 285-3500, jcohen@path.org, (2) Reproductive Health Strategic Program, Program for Appropriate Technology in Health (PATH), 1455 NW Leary Way, Seattle, WA 98107, (3) Research and Evaluation, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516, (4) Genes, S.C., Callejón Hidalgo #5, San Pablo Oztotepec, Milpa Alta, 12400, Mexico, (5) Centro de Investigaciones en Salud de Comitán A.C., 10a Sur Ote #13, barrio San Sebastián, Comitán de Domínguez, Chiapas, 30029, Mexico, (6) Binational Program, Planned Parenthood of San Diego, 1075 Camino del Rio South, San Diego, CA 92108

Introduction: The World Health Organization recommends medical abortion (mifepristone with misoprostol) as a safe, highly effective, and acceptable method for pregnancy termination in the first trimester. Mifepristone, however, is not widely available, is expensive, and is not registered in countries where legal abortion is only narrowly allowed by law. Because misoprostol is inexpensive, accessible, and effective, health care providers use misoprostol to safely induce births and abortions. In many countries in Latin America where abortion is highly restricted, women also use the drug to induce abortions without guidance from health care providers; these women lack effective and evidence-based use instructions, including information on dosing, side effects, and follow-up care. The goal of this research is to identify channels through which misoprostol use instructions can be disseminated.

Methodology: Data were collected in one Latin American country through in-depth interviews and focus groups. A total of 33 in-depth interviews were conducted with: (1) pharmacists and pharmacy employees, (2) physicians and midwives, (3) women who received safe abortion care, and (4) women from the community. Three focus groups were also conducted with civil society organization members and health providers.

Results: Results discuss the benefits and limitations of providing misoprostol use instructions to women through pharmacies, health providers, and community networks.

Conclusion: With correct, evidence-based instructions on misoprostol use, women and health care providers can make fully informed decisions about use of this drug and the need for follow-up care. These results will inform appropriate strategies for reaching women with misoprostol use instructions.

Learning Objectives:

At the conclusion of the session, the participant (learner) in this session will be able to

(1)Discuss the evidenced based regimen for use of misoprostol to terminate early pregnancy; and (2)Describe the types of communication strategies that are suitable for sharing information on abortion options in legally restricted settings.

Keywords: Abortion, Reproductive Health Research

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Abortion: U.S. and International Perspectives

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA