Ulcer Drug Misoprostol Misused for Abortions in Nigeria

International   |   Marie Smith   |   Aug 23, 2011   |   6:09PM   |   Abuja, Nigeria

The drug misoprostol has been approved in Nigeria for use in preventing and treating post partum hemorrhage (PPH) but is increasingly being used to induce abortion.

Nigeria, the first country in the world to develop guidelines for community level distribution and use of misoprostol for prevention of PPH, is now facing the challenge of illegal use of the drug for abortion. Concern is growing that use of the drug for abortion will result in injury and death. The government is being advised to re-evaluate its January, 2011 guidelines which allowed wide access to the drug.

A recent Nigerian Tribune news article highlights the dangers of misoprostol for so-called medical abortion warning that use of the drug can “turn out to be a complete nightmare–stomach ache, excessive bleeding and even death– when misused”.  It is reported that the drug is provided by clinics or purchased by women in pharmacies.

Dr Chris Aimakhu, a Nigerian obstetrician and gynecologist at the University College Hospital (UCH) in Oyo State warns: “We now know that Misoprostol is now readily available for people to buy off the counter without a prescription.  Misoprostol is an agent used now by ladies who have unwanted pregnancies to induce abortion… But the drug has its drawbacks and it might invariably lead to many deaths.”

“Although, Misoprostol might trigger an abortion, they may also end up having an incomplete abortion. An incomplete abortion could result in severe infection, bleeding and in rare cases, even infertility, thus making conception impossible in future…” states Dr. Aimakhu. He continues, “…irrespective of the dose of Misoprostol that is used by the lady, it can cause the rupture of her womb, thus leading to severe bleeding and, of course, death. I have seen quite a few of cases like this in the course of my medical practice.”

The need to regulate misoprostol to prevent use for abortion was emphasized, “Nigeria needs to ensure that the use of Misoprostol is regulated considering that causes of death in women are five –bleeding, obstructed labour, high blood pressure in pregnancy, abortion and infection. And of course, if we continue to have increase in cases of abortion, then we have a problem in the country because we would still have many women dying,” according to Dr Aimakhu.

He relays the tragic case of one woman: “I have seen a situation where a woman that used Misoprostol was brought to the hospital. She had been bleeding for three days and when her blood level (packed cell volume) was checked, it was nine per cent, whereas the blood level in a normal woman is about 30 per cent. So, she had bled substantial volume of her blood. This had damaged her kidney and so she had stopped passing out urine.”

He continued his warning, “A lot of abortions are still going on in Nigeria and they are unreported. For example, if a lady is impregnated by her boyfriend, she could easily procure these tablets at the pharmacy since she does not need to tender any prescription. But, she could die as a result, and as such, there is the need to have checks and balances on the sale of this medicine.”

The article also states that misoprostol is especially dangerous when used by women with existing medical conditions including asthma, heart disease, anemia, diabetes, hypertension, and bleeding problems.  Women who have previously given birth or had a D and C are especially advised that the powerful contractions of the drug can not only expel their child in the womb but can also cause rupture of their uterus and uncontrollable bleeding.

PNCI notes that the push for the registration of misoprostol in Africa and Asia is the led by Venture Strategies, a company founded by radical abortionist Dr. Malcolm Potts and his wife Martha Campbell. The company, and its affiliated organization Venture Strategies International (VSI), work with health ministries and policy makers to advance broad access to misoprostol. One of VSI’s most recent projects is with the health ministry in Ethiopia to provide misoprostol for what is described as comprehensive abortion care (CAC). Ethiopia legalized abortion in 2005 and has an extremely high maternal mortality ratio of 720 deaths per 100,000 live births.

LifeNews.com Note:  Marie Smith is the director of the Parliamentary Network for Critical Issues.