ICMA STATEMENT ON MISOPROSTOL INTERNET SALE 27 May 2009
While it would be far preferable for all women who seek an abortion to have access to a trained provider through their national health system, this is not always possible, especially where laws are restrictive.
Internet and pharmacy sales of the pills for medical abortion have become increasingly sophisticated. Sometimes these internet services employ appropriate counseling, patient screening and other safeguards for safe and correct use. Where abortion is severely restricted and safe abortion services are not legal or easily available the alternative of safe internet sales may be the safest forms of access available to women.
However, caution is advised while purchasing medical drugs on the internet from an unknown site, since they may sell counterfeit or ineffective drugs and charge higher rates than necessary.
For women in many countries where abortion is not legal, a reliable site is Women on Web: http://www.womenonweb.org.
Women on Web is an online abortion help service for women living in countries where access to safe abortion services is restricted. The goal of the Women on Web service is to help women around the world to obtain a safe medical abortion and reduce the mortality and morbidity due to unsafe abortions. Additionally the website raises funds to give donations to women without financial means to obtain a safe medical abortion. Women on Web answers all the emails that are received through the website within few hours in Spanish, Portuguese, Polish, English, French and Arabic.
Medical abortion can make abortion earlier, more accessible, safer, less traumatic, less medicalised and less expensive. It has increased access to safe abortion and reduced maternal mortality, including in legally restricted settings.
Medical abortion has been shown to be safe and effective in both the first and second trimesters of pregnancy, with efficacy rates as high as 95 - 98%. Acceptability among women is high, because medical abortion does not involve surgery or anaesthesia, and is a simple procedure that happens entirely in the woman's body.
Acceptability among providers is high too, because they feel that it is safe and offers women an alternative to surgical abortion, and is a choice that many women prefer.
"Medical abortion" is the use of drugs to terminate a pregnancy. It is sometimes also called non-surgical abortion. The regimen for first trimester medical abortion, registered in more than 30 countries, consists of two drugs, recently included in the WHO Model List of Essential Medicines: mifepristone (an anti-progestogen that blocks progesterone, the hormone necessary to sustain a pregnancy) followed 36 - 48 hours later by misoprostol (a prostaglandin that makes the uterus contract). These drugs can be taken to cause a miscarriage to occur, starting from the time a woman misses her period. Where mifepristone is not available, misoprostol can be used alone to cause a miscarriage to occur.
Unsafe abortions are a major public health problem. As many as 150 million women worldwide who want to limit or space their pregnancies lack access to effective contraception. Even women who use contraception may experience unintended pregnancies, as no contraceptive is 100% effective.
Of 210 million pregnancies yearly, an estimated 46 million end in induced abortion
Of the estimated 19 million unsafe abortions in the world each year, 18.5 million occur in developing countries.
About 68 000 women die each year from unsafe abortion.
Young and unmarried women are often afraid to tell anyone they are pregnant and are more likely to seek terminations from unqualified practitioners. They account for a disproportionate share of death and illness from the complications of dangerous abortions.
“I liked the tablets. See, I did not need to stay in the hospital. With curetting I would have spent two days there. I told my mother-in-law I was going to the market. I did not abort at the hospital although I waited for 3 hours. I was scared, would mother-in-law come to know? How many days I bled.... I was going to the toilet every hour to check. See, we don’t have our own toilet. I felt embarrassed. But it happened when she was out. A little pain was there but that much is to be tolerated. Whatever you would have done, pain is always there. Everything has turned out well. I am very happy now. I will definitely use this method again.”
(From Bela Ganatra’ presentation at ICMA conference, 2004)
Your Opinion Counts Is Mifepristone available through the internet?
