'Sorry sister try elsewhere': The potential of medical abortion in pharmacies

Medical Abortion (MA) promises to expand women's access to safe abortion, making safe abortion possible for women in even the most remote communities, with the least access to health services. Safe and effective use of MA requires knowledgeable intermediaries to provide information and link women to services or, where services are unavailable, the drugs themselves. A literature review of pharmacy workers' role as providers of information and medicines for abortion and other reproductive and primary health services was conducted. Additionally, results from four studies conducted or supported by Ipas that examined the availability or provision of misoprostol in pharmacies where abortion is legally restricted were reviewed. Results were shared with experts in the field, and recommendations assembled. Pharmacies play a particularly important role in low resource settings where they often serve as the first point of reference, offering a convenient way to disseminate information about reproductive health, including abortion. However, studies show that pharmacy workers often provide inaccurate information. Awareness of misoprostol's uses and willingness to provide information to clients vary by country and the quality of information overall remains low, placing women at risk for method failure and complications. Despite this, pharmacies remain key reproductive health service delivery points. Providing accurate information to pharmacy workers on dosages, side effects, and referral mechanisms could make it safer for women wanting to end pregnancies with misoprostol. Understanding the roles that pharmacy workers play in delivering information and services is critical for designing interventions that increase access to safe reproductive health care.