What is Misoprostol and how its consumption grew in Latin America


It is an issue that often causes the deepest divisions in many countries, and remains prohibited in many of them: abortion.

An issue that also has a huge impact on the lives of millions of women.

And those who decide to carry out the termination of a pregnancy can undergo two main methods: a medical abortion or a surgical one.

Surgical abortion involves an operation to remove the pregnancy from the uterus, which can be by the aspiration method or by dilation and evacuation.

Medical abortion usually involves taking two different medicines to end the pregnancy: mifepristone and misoprostol.

But the World Health Organization (WHO) has noted that if mifepristone is not available, misoprostol can be used alone.

This drug, however, was not created to end a pregnancy. It was developed for the treatment of gastric ulcers and entered the world market under the name Cytotec in the mid-1980s.

And it was Latin American women who first became aware of the other therapeutic possibilities of misoprostol and who spread its use as an abortion drug.

“Word of mouth information”

“This arose in the 1980s with women, obviously with limited resources, who began to realize that the medication that was prescribed for gastric ulcers eventually caused the uterine detachment of the product,” Dr. Georgina Sánchez Ramírez tells BBC Mundo, author of “Realities and Challenges of Medication Abortion in Mexico”.

“In this way, and as they say vulgarly, word of mouth was commenting on the possibility that this medicine had. And in fact the cost is not high because it was designed precisely for gastric ulcers“, points out a specialist in Gender and Health from the Colegio de la Frontera Sur in Mexico.

Cytotec (misoprostol) was developed by Searle Pharmaceuticals in the mid-1980s. GETTY IMAGES

Misoprostol was developed in 1973 by Searle Pharmaceuticals and although it was originally marketed for gastrointestinal problems, it was quickly discovered that one of its side effects was to induce spontaneous abortion.

In the late 1980s, as a solution to Brazil’s criminalization of abortion, women began recommending the drug, then sold without a prescription, to end pregnancy.

In 1987, researchers in France developed mifepristone specifically for termination of pregnancyand this drug, combined with misoprostol, was shown to be a very effective way of inducing an abortion.

But by then, women in Latin America, where abortion was penalized in many countries, were making widespread use of misoprostol, as Dr. Sánchez Ramírez explains.

“Before mifepristone was designed in France, before that happened in a French laboratory, in Latin America many women’s groups already handled information including what dose and how to use the drug that was originally designed and continues being used for gastric ulcers,” says the expert.

How the drug works

Medical abortion does not require a surgical procedure and, in most cases, can be done at home.[iadeloscasossepuedehacerencasa

As usual a combination of mifepristone and misoprostol is used.

The first pill taken is mifepristone, which blocks the hormone progesterone that the body needs for the pregnancy to continue.

The second drug, misoprostol, is taken 24 to 48 hours later. A few hours after taking it, the lining of the womb breaks down, causing pain, bleeding, and emptying of the uterus.

In the 1980s it was discovered that mifespristone, combined with misoprostol, was a very effective way of inducing an abortion. GETTY IMAGES

The WHO says that if mifepristone is not available, misoprostol can be used alone.

As Dr. Georgina Sánchez Ramírez points out, in countries or places where abortion is illegal, the sale of mifepristone is prohibited. But even where it is legal, misoprostol is much more widely used.

“Since mifepristone is categorized as an exclusive medication to interrupt a pregnancy, it is not so easy to obtain it because, effectively, it is part of the prohibition (of abortion) that each one of the States or cities has,” says Sánchez Ramírez.

“And even in places where abortion has been decriminalized, such as Mexico City, we have references from users who indicate that mifepristone is not freely sold in pharmacies in these places and also has a fairly high cost.”

“That’s why misoprostol It is much more used, in addition to being cheaper“, he adds.

“Revolutionary”

Medical abortions now account for the majority of all abortions performed where the procedure is legal.

In the United States, for example, more than half of all abortions performed are medical abortions.

Furthermore, studies show that the rise of medical abortion has not only allowed many more women to have access to voluntary termination of pregnancy, but also drastically reduced mortality and complications clandestinely practiced abortion.

“The ideal world and where there are fewer deaths and complications from this cause is where (abortion) is decriminalized and where there is free and even free access to these medications to safely terminate pregnancy, even in the comfort of your home” , says the expert from the Colegio de la Frontera Sur de México.

Likewise, medical abortion has also eliminated the barriers that often delayed the process, allowing the termination of pregnancy to be carried out at increasingly earlier gestation times.

But as Dr. Georgina Sánchez Ramírez points out, perhaps the most important thing is that access to medication for abortion offers women a more private and less invasive procedure and allows them to acquire and self-administer the drug without the intervention of a health worker.

“I think that the most important part of this new era of the use of medical abortions is that it closes the access gate and also removes hospital offices, the hegemonic medical power and the power of the State, as long as these continue to exist. medicines, there is information for their use and there is access to them”.

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