 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Tara Lehman, MD, MPH1, Suellen Miller, CNM, MHA, PhD1, Martha Campbell, PhD2, Sonia Brito-Anderson, MD3, Hector Rodriguez4, and Wilme Vargas Gonzales5. (1) School of Public Health, University of California, Berkeley, 312 Warren Hall, Berkeley, CA 94720, 415-457-6118, hadeido@yahoo.com, (2) CEIHD, University of California, Berkeley, 717 University Hall, Berkeley, CA 94720, (3) Prime II, Federico Henriquez y Carvajal #11, Segundo Piso-Gazcue, Santo Domingo, Dominican Republic, (4) Oficina Nacional de Estadistica, Av. México esq. Leopoldo Navarro, Edificio Juan Pablo Duarte, Santo Domingo, Dominican Republic, (5) ADOPLAFAM, C/Juan Sánchez Ramírez #46, Zona Universitaria, Santo Domingo, Dominican Republic
Background: Though abortion remains illegal in the Dominican Republic, anecdotal evidence suggests that life-threatening complications and maternal deaths due to illicit abortion are declining. This decline has been attributed to increased local use of misoprostol to induce abortion. However, no study has documented the impact of misoprostol use on Dominican women’s health.
Objectives: To evaluate the prevalence of abortion-related misoprostol use and its effect on abortion prevalence and abortion complications in the Dominican Republic.
Methods: Key informant interviews were conducted with fifty local women’s health experts. One hundred-fifty Dominican women were surveyed for their knowledge of the drug. Attempts to purchase misoprostol were made at eighty pharmacies. The admission logs, death registries, and annual reports of two major maternity hospitals, and national data on abortion trends, were analyzed.
Findings: Health professionals agreed that abortion-related misoprostol use began in the mid-1990s and is now widespread. Surveyed women endorsed popular use of the drug, but few were aware of possible side-effects or the need for subsequent medical care. Pharmacies commonly sold misoprostol without prescription, but rarely provided instructions or counseling. Local abortion prevalence appeared unaffected by the introduction of misoprostol. Abortion-related maternal mortality declined 50% between 1997 and 2001, and the rate of life-threatening abortion complications decreased 75% from 1986 to 2001.
Conclusions: Misoprostol use in the Dominican Republic has replaced riskier abortion methods and improved women’s health. However, incomplete community knowledge of the drug’s proper use suggests that education efforts may further improve outcomes.
Learning Objectives:
Keywords: Abortion, Maternal Morbidity
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.