title: Community-based availability of misoprostol: is it safe?
abstract: This paper evaluates the safety and acceptability of long-term community-based use of misoprostol for management of postpartum hemorrhage (PPH) in home-births, by comparing deliveries with and without misoprostol use in communities of Kigoma, Tanzania. We administered a standardized survey instrument to women who delivered between August 2004 and May 2007. 940 women completed questionnaires, corresponding to 950 deliveries. Findings showed that the majority of TBAs administered misoprostol at the correct time (76%). Receipt of three or five tablets was most commonly reported (47% and 43% respectively). Misoprostol users were significantly more likely to experience shivering, high temperature, nausea, and vomiting after delivery; adjustment for gynecological history and delivery characteristics revealed no significant differences in experience of symptoms. Misoprostol was highly acceptable to all women surveyed. Misoprostol at the community level is a safe intervention.
authors.affiliation: School of Public Health, University of California, Berkeley, University Hall, Berkeley, CA 94720-7360, USA. ndola@berkeley.edu
authors.forename: Ndola
authors.initials: N
authors.lastname: Prata
authors.forename: Godfrey
authors.initials: G
authors.lastname: Mbaruku
authors.forename: Amy A
authors.initials: AA
authors.lastname: Grossman
authors.forename: Martine
authors.initials: M
authors.lastname: Holston
authors.forename: Kristina
authors.initials: K
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration; D008880:Midwifery; D016595:Misoprostol / Q000009:adverse effects* / Q000600:supply & distribution; D010120:Oxytocics / Q000009:adverse effects* / Q000600:supply & distribution; D010342:Patient Acceptance of Health Care; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011292:Premedication; D013636:Tanzania
chemical_list: D010120:Oxytocics; D016595:Misoprostol