title: Reaching women with instructions on misoprostol use in a Latin American country.
abstract: In Latin America, where restrictive laws limit women's access to safe abortion services, misoprostol is being used to induce abortions, often without correct information on dosage or regimens. This study in an unnamed Latin American country aimed to identify appropriate channels through which instructions on misoprostol use could be disseminated to women. In-depth interviews were carried out with physicians, pharmacy staff, women who had had safe abortions and women from the community, as well as focus group discussions with advocates of safe abortion. Participants considered physicians to be the most appropriate source of information and for ensuring confidentiality for both women and provider. Participants considered midwives, pharmacists and women's groups as appropriate referral points, but not providers of information. Legal restrictions and professional risk were the primary reasons why pharmacists rejected this role, though many are selling misoprostol. There was a general lack of information about misoprostol for medical abortion among both health professionals and women. Accurate information about misoprostol use for a wide range of gynaecologic and obstetric purposes, including induced abortion, could be incorporated into training and educational materials for physicians, midwives and other appropriate mid-level providers, as well as pharmacists. Without these alternative information channels, access to information would be severely restricted, especially in rural areas.
authors.affiliation: PATH, Seattle, WA, USA. jcohen@path.org
authors.forename: Jessica
authors.initials: J
authors.lastname: Cohen
authors.forename: Olivia
authors.initials: O
authors.lastname: Ortiz
authors.forename: Silvia Elena
authors.initials: SE
authors.lastname: Llaguno
authors.forename: Lorelei
authors.initials: L
authors.lastname: Goodyear
authors.forename: Deborah
authors.initials: D
authors.lastname: Billings
authors.forename: Imelda
authors.initials: I
authors.lastname: Martinez
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000494:pharmacology*; D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D007843:Latin America; D008875:Middle Aged; D016595:Misoprostol / Q000494:pharmacology*; D010353:Patient Education as Topic; D011247:Pregnancy
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol