Misoprostol use in developing countries: results from a multicountry study

Objective: To identify information and service delivery needs for obstetric/gynecologic uses of misoprostol in developing countries. Methods: The study included a survey of reproductive health providers in 23 countries and a qualitative study of misoprostol use in four developing countries. Researchers used purposive sampling methods for the survey and qualitative study and conducted a descriptive statistical analysis of survey data and computer-assisted text-based content analysis of qualitative data. Results: In some developing countries, women frequently access misoprostol through pharmacies and self-medicate to induce early abortion. Some clinicians expressed concern about this use of misoprostol, but many stated that its availability had reduced serious complications resulting from unsafe abortions. Conclusion: Although misoprostol is routinely used for a range of off-label obstetric/gynecologic indications, evidence-based, up-to-date information about safety, effectiveness, and appropriate regimens is not widely available. This information is requested by providers, including pharmacists. Women need information and guidance about its use.