Commercial availability of misoprostol and induced abortion in Brazil. 1998

S H Costa
The Ford Foundation and Researcher of Department of Epidemiology and Quantitative Methods, National School of Public Health, Rio de Janeiro, Brazil.

In Brazil, abortion is only permitted to save the woman's life or in cases of rape. The principal effect of legal restrictions is not to make induced abortion practice less prevalent but to force poor women to resort to abortions performed under unhygienic conditions or attempt self-induced abortion. Within this context, misoprostol, a synthetic analogue of prostaglandin E1, was introduced in the country in 1986. Purchased over the counter in pharmacies, misoprostol has became a popular abortifacient method among Brazilian women. By 1990, about 70% of women hospitalized with abortion-related diagnoses reported use of the drug. In 1991, the Ministry of Health restricted the sale of misoprostol, and in some states its use was totally banned. While the proportion of abortions induced with misoprostol has decreased, the drug continues to be sold on the black market at an inflated value. Research indicates that women have acquired more experience with the drug over time, resulting in lower doses and more effective administration. Several studies show that the rate and severity of complications are significantly less among women who used misoprostol compared with women who used invasive methods. Research also suggests that about half of the women have complete abortion with misoprostol, but seek medical care as soon as they have vaginal bleeding. The experience of Brazilian women with misoprostol is an example of how women when faced with unwanted pregnancy will resort to illegal abortion whatever the costs are to their health.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D001938 Brazil A country located on the eastern coast of South America, located between Colombia and Peru, that borders the Atlantic Ocean. It is bordered on the north by Venezuela, Guyana, Suriname, and French Guiana, on the south by Uruguay, and on the west by Argentina. The capital is Brasilia.
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000020 Abortifacient Agents, Nonsteroidal Non-steroidal chemical compounds with abortifacient activity. Abortifacient Agents, Non-Steroidal,Abortifacient Agents, Non Steroidal,Agents, Non-Steroidal Abortifacient,Agents, Nonsteroidal Abortifacient,Non-Steroidal Abortifacient Agents,Nonsteroidal Abortifacient Agents
D000024 Abortion, Criminal Illegal termination of pregnancy. Abortion, Illegal,Illegal Abortion,Abortions, Criminal,Abortions, Illegal,Criminal Abortion,Criminal Abortions,Illegal Abortions
D000028 Abortion, Induced Intentional removal of a fetus from the uterus by any of a number of techniques. (POPLINE, 1978) Embryotomy,Abortion (Induced),Abortion Failure,Abortion History,Abortion Rate,Abortion Technics,Abortion Techniques,Abortion, Drug-Induced,Abortion, Rivanol,Abortion, Saline-Solution,Abortion, Soap-Solution,Anti-Abortion Groups,Fertility Control, Postconception,Induced Abortion,Previous Abortion,Abortion Failures,Abortion Histories,Abortion Rates,Abortion Technic,Abortion Technique,Abortion, Drug Induced,Abortion, Previous,Abortion, Saline Solution,Abortion, Soap Solution,Abortions (Induced),Abortions, Drug-Induced,Abortions, Induced,Abortions, Previous,Abortions, Rivanol,Abortions, Saline-Solution,Abortions, Soap-Solution,Anti Abortion Groups,Anti-Abortion Group,Drug-Induced Abortion,Drug-Induced Abortions,Embryotomies,Failure, Abortion,Failures, Abortion,Group, Anti-Abortion,Groups, Anti-Abortion,Histories, Abortion,History, Abortion,Induced Abortions,Postconception Fertility Control,Previous Abortions,Rate, Abortion,Rates, Abortion,Rivanol Abortion,Rivanol Abortions,Saline-Solution Abortion,Saline-Solution Abortions,Soap-Solution Abortion,Soap-Solution Abortions,Technic, Abortion,Technics, Abortion,Technique, Abortion,Techniques, Abortion
D016595 Misoprostol A synthetic analog of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties. Apo-Misoprostol,Cytotec,Glefos,Misoprostol, (11alpha,13E)-Isomer,Misoprostol, (11alpha,13E,16R)-Isomer,Misoprostol, (11alpha,13Z)-(+-)-Isomer,Misoprostol, (11alpha.13E,16S)-Isomer,Misoprostol, (11beta,13E)-(+-)-Isomer,Misoprostol, (11beta,13E,16R)-Isomer,Misoprostol, (11beta,13E,16S)-Isomer,Novo-Misoprostol,SC-29333,SC-30249,Apo Misoprostol,Novo Misoprostol,SC 29333,SC 30249,SC29333,SC30249
D017277 Drug Approval Process that is gone through in order for a drug to receive approval by a government regulatory agency. This includes any required pre-clinical or clinical testing, review, submission, and evaluation of the applications and test results, and post-marketing surveillance of the drug. Drug Approval Process,New Drug Approval,Food and Drug Administration Drug Approval,Food and Drug Administration Drug Approval Process,New Drug Approval Process,Approval Process, Drug,Approval Processes, Drug,Approval, Drug,Approval, New Drug,Approvals, Drug,Approvals, New Drug,Drug Approval Processes,Drug Approval, New,Drug Approvals,Drug Approvals, New,New Drug Approvals,Process, Drug Approval,Processes, Drug Approval

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