Women’s reliance on the black market for access to medication abortions means they may not follow best medical practice. C., a Recife-based teacher, purchased misoprostol in 2013 from a drug dealer. She then searched Google for how to use it. “Because it was illegal, there was no information about how to take it or what to take,” she said.
Her search led her to recommendations to insert the tablets into her vagina as a doctor would do if she was in a clinic. However, she was warned that any traces could be left behind and give her away in case she ended up in hospital. Instead, she disintegrated them under her tongue, which works, but takes longer.
C., who requested to be identified only by her middle initial due to fear of prosecution, bled for several weeks and wanted to consult her mother, a female gynecologist. However, her mother is an anti abortion activist. Finally, C. said she thought she had miscarried, and her mother took her to see a colleague who performed a dilation-and-curettage under anesthetic.
“When I was having the curettage, I had to keep saying over and over to myself, ‘Don’t say anything, you can’t say anything’ — it was torture,” she said. “Even though I was totally sure that I wanted an abortion, I had no doubts, you still feel like you’ve done something wrong because you can’t talk about it.”
Dr. Derraik said that misoprostol restrictions have made it difficult to provide regular obstetric care. This includes the use of the drug to induce labor. The doctor must fill in a triplicate of the request at Rio public maternity, where she is medical chief. Next, the supervisor must sign the prescription before the drug is released from a locked cabinet. The physician must then administer the drug with a witness to ensure it isn’t diverted for black market sales.
“Not all of these steps are officially required,” Dr. Derraik said. “But hospitals do them because of the intense paranoia around the drug.”
Source: NY Times
