Résumé : Women in Brazil induce abortion despite legislation in the country forbidding such practice except to save the mother's life and in cases of rape. Misoprostol, a synthetic analogue of prostaglandin E1, was introduced in Brazil in 1986, under license for treatment of gastric and duodenal ulcers. Misoprostol, however, stimulates uterine activity and when used either alone or together with mifepristone (RU-486) or methotrexate, the drug has shown a variable effectiveness in inducing complete abortion. Bought over the counter in pharmacies, misoprostol has become a popular abortifacient agent among Brazilian women. By 1990, about 70% of women hospitalized with abortion-related diagnoses reported use of the drug. In 1991, the Ministry of Health restricted the sale of misoprostol, even banning its use in some states. The proportion of abortions induced with misoprostol has since decreased, but the drug is still sold on the black market at an inflated price. Research suggests that women have gained experience using the drug over time, and are using lower doses administered more effectively. Several studies show that the rate and severity of complications are significantly less among women who used misoprostol compared with women who underwent invasive abortion methods. Research also suggests that although about half of the women have complete abortion with misoprostol, they seek medical care as soon as they experience vaginal bleeding.
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