Misoprostol: The abortion or life saving pill?

The drug used to treat ulcers and induce emergency labour in women is now being abused by teenage girls to carry out abortion, writes Kevin Oguoko

When Marilyn found out she was pregnant, she could not fathom the thought of her tummy bulging with pregnancy barely two years into her university degree.

Her parents would not accept this. Further more, the father of her unborn child was also a student, and far from a stable income. Getting rid of the pregnancy was the only way out of this predicament.

“The thought of performing an abortion in one of those backstreet clinics scared me to death. I sought counsel from a fellow friend on the safest to do the procedure,” says Marilyn.

One of her close friends informed her about a particular drug that is easily available in the pharmacies. She was told she could take them without a specialist prescription. But this was to happen if and only if the pregnancy was below nine weeks old.

The two tablet drugs were misoprostol. 

What she was never told are the horrific side effects, and that what she was about to do was an illegality that could send her to jail.

Abuse

“Some pharmacies are dispensing these drugs over the counter making a kill. Some fail to properly instruct the customers how to use misoprostol, so they end up injuring themselves, sometimes they die,” said Emmanuel Simiyu, a pharmacist working in Bungoma.

Simiyu says the drug is only Sh80 shillings per tablet, and that people use three to four tablets, inserted instead ingesting. The end result is postpartum haemorrhage, a leading cause of maternal mortality, and any midwife and doctor’s nightmare in the maternity wards.

“The drug was sneaked into the country around 2007, when it was still illegal for use in Kenya. We did a situational analysis and discovered that misoprostol was in fact being sneaked into the country and used widely in Kenya,” says Dr Ong’ech.

At the time, the Government refused its marketing following media reports and analysis claiming that misoprostol will be used to do abortion, which was illegal under the constitution.

But information from World Health Organisation and pharmaceutical firms, and other medical research showed that the government was ‘burying its head in the sand’ as it was already in use. For the sake of mothers who die in hospitals because of postpartum haemorrhage, Kenya was forced to cave in to the pressure and legalise the use of misoprostol.

 Effects

Misoprostol has also been known to cause uterine rupture, and has on several occasions led to the death of both mother and baby. To curb this there has been specialised training on the dosage.

“Lack of proper dosage may cause uterus rapture, unstoppable bleeding and even death,”  Simiyu explains.

To expel a pregnancy, different dosage depending on the age of the pregnancy, can be used. When one uses more or less, the results are different. Either nothing will happen as intended action will not take place or it will happen and end up causing unimaginable damage to the uterus.

Besides being made available as an over the counter, misoprostol is being given in wrong dosages across pharmacies. This is especially dangerous especially when committing an abortion or without proper training in home deliveries. In both cases the pregnant woman runs the risk of rapturing the uterus even and death.

Marilyn, after using the drug, was shocked that nothing really happened. Except for some few drop of blood. She had to seek a professional’s help, who administered more of the misoprostol to her and the pregnancy finally came out.

But the second administered dosage made her bleed for long and imaginable pain. She had to seek the assistance of a more trained doctor, who aided and informed her that the dosage given the second time was more than was required.