Dr Stacie Geller
Doctors are working to deliver misoprostol— known as the “abortion drug”– to women in developing countries to prevent thousands of deaths due to postpartum hemorrhaging.
“We have the answers. This is not a complex question… We know how to get women, in most cases, to have a healthy delivery,” said Stacie Geller, professor in the Department of Obstetrics and Gynecology at University of Illinois-Chicago.“We need governments and we need governments engaged in spending money to do this.”
She shared her experiences delivering misoprostol to women in India and Ghana Tuesday at a forum at Prentice Women’s Hospital.
Postpartum hemorrhage– or excessive post-birth bleeding– is one of the leading causes of death for women across the world. Ninety-nine percent of those deaths occur in developing countries, according to Geller. Poorly trained (or non-existant) birth attendants, rudimentary health facilities and lack of prenatal care contribute to the disparity between high-resource and low-resource settings.
“That’s something we don’t think about a lot in the U.S., but it’s a huge global problem” said Sharon Green, executive director of the Women’s Health Research Institute at Northwestern University.
It can be prevented by taking oxytocin– the U.S.-preferred hormone– but it is expensive, requires refrigeration (which is not available in places with limited electricity) and can be difficult to administer. misoprostol is an alternative that many doctors prefer in low-resource settings due to its affordability, long shelf-life, ease of delivery and non-invasiveness.
But use of the drug has been fought by government officials who contend women will misuse the drug for abortions or sell it on the black market.
“This is about fear that women will control their reproduction and have abortions,” Geller said.
In Ghana, where she conducted her most recent research, Geller’s team distributed misoprostol to women in their 7th month of pregnancy to use in case of excessive bleeding during labor.
“I was convinced that women would not misuse it. Women don’t want to die,” Geller said. “They’re not going to give it away, they’re not going to lose it and they’re not going to sell it.”
She proved the naysayers wrong. Her team tracked 98 percent of doses given to women. All doses were either properly used or returned, convincing the government to distribute the drug to women on a limited basis.
“Women just want information. They want to take care of their families and they want to take care of themselves,” said Katie Doyle, a clinical nurse manager who attended Tuesday’s forum. “It’s always going to be their first goal–no matter where you live and how much money you have in the bank.”
Geller urged health practitioners Tuesday to translate their medicine into real-world outcomes.
“Do you do your science, do you publish a paper in the Lancet…and do you go home happy?” Geller asked the crowd of 65 health practitioners. “Well we could have. But it’s important that the work then be heard elsewhere and translated into policy changes.”
Her message hit home.
“It allows us to…have an awareness of the luxury we have in providing healthcare and resources we have,” said Doyle, whose clinic regularly uses misoprostol. “I really appreciated the fact that there’s so much work being done globally to ensure something that is at a low cost and high value can be used elsewhere.”
