In Brazil, abortion is illegal except in cases of rape and incest
or to save the life of the woman. In 1986, misoprostol was introduced
in Brazil for the prevention of NSAID-induced gastric ulcers. By the
early 1990s, the abortifacient properties of misoprostol were well
known in Brazil and physicians, pharmacists, and women themselves
spread information about misoprostol. Through the use of misoprostol,
women were able to self-induce abortions. Women were also able to
provoke miscarriages and subsequently gain admittance to public health
facilities and access to legal post-abortion care.
The misoprostol experience in Brazil has sparked renewed debate about the legal status
of abortion. Although the misoprostol-only regimen is not as effective as
when misoprostol is used in
conjunction with either mifepristone or misoprostol, the single abortifacient regimen is much safer than
many of the methods of self-induction used in legally restricted settings (such as vaginal douching with caustic
agents or the use of sharp sticks or hard massage). Misoprostol alone is also more effective at terminating an
early pregnancy than many of the non-efficacious "traditional" methods
of abortion that women in legally restrictive
settings often employ. Evidence from Brazil has demonstrated that misoprostol offers women a safer option
for inducing abortion in legally restrictive settings and that non-clinic use of misoprostol use can reduce
both maternal morbidity and maternal mortality at the population level.
