Advocacy for Misoprostol, Advocacy for Saving Lives

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By: Katie Millar, Technical Writer, Women and Health Initiative, Harvard T.H. Chan School of Public Health

Hundreds of thousands of women die every year giving birth. The leading causes of these deaths—hemorrhage, infection, and eclampsia—are mostly preventable and treatable. Yet, proven treatments for these conditions are not reaching the women who need them most. In the poorest parts of the world, one in six women will die giving birth, compared to one in 30,000 in Northern Europe. To die giving birth must not be an expectation; we must make it the rarest exception.

Post-partum hemorrhage (PPH), the leading cause of maternal mortality, is mostly preventable. The onset of PPH is usually sudden, and if a woman is not giving birth in a well-equipped facility, she will face many delays getting care—delays that could cost her life. Since PPH needs immediate and effective treatment, prevention is a better option, especially for women who live far from a facility.

A prevention strategy has been discovered. The drug Misoprostol is a tablet that, when given immediately after the baby is born, can prevent life-threatening PPH. Misoprostol works by causing strong uterine contractions, putting pressure on potentially leaky blood vessels. Although this strategy is simple and inexpensive, there are many controversies surrounding its implementation.

Despite the WHO adding misoprostol to its essential medicines list for all countries, some contest its scale-up. One reason is that misoprostol can be used to cause abortion if taken before the clinically indicated period, or the time immediately following birth. To advocate for this life-saving commodity, Family Care International has created an advocacy tool to facilitate the uptake and scale-up of misoprostol to save lives.

This publication, available in English and soon in French, provides national advocates and civil society organizations guidance in conducting effective advocacy for the successful uptake of misoprostol for prevention and treatment of PPH. Through case studies and an Advocacy for Access Framework, the publication provides concrete examples to support misoprostol’s availability and use at the national level.

If you are working to prevent maternal mortality, please take a moment to explore this resource. Advocating for the scale-up of misoprostol can have a profound effect on decreasing the number of women who die giving birth each year.

Are you currently working in preventing PPH and/or the scale-up of misoprostol? Please contact Katie Millar if you are interested in being a guest blogger for the MHTF. We, and many others in the field, would benefit greatly to hear about your experiences.