Illicit abortion drug
causes birth defects
Aug. 29, 2001 - Failed
attempts to induce abortion using an ulcer drug called misoprostol may
be causing a minor epidemic of birth defects around the world. Misuse
of the drug is increasingly common where abortion is not freely
In Colombia, Brazil and the
Philippines, the drug is readily available on the black market. An
informal survey by New Scientist has also revealed that
clandestine abortions with the drug are taking place in the Dominican
Republic, Argentina, Spain, Nigeria, South Africa and Indonesia.
In Britain and the US,
doctors prescribing the abortion drug RU486 also give misoprostol to
induce contractions, although it's not licensed for this purpose
(New Scientist, 28 October 2000, p 13). The combination is highly
effective. But in countries where abortion is illegal, women are
taking misoprostol on its own to induce abortions.
"It's really the poor
person's method," says Susheela Singh of the Alan Guttmacher Institute
in New York, who has written extensively about clandestine abortion
practices in Latin America. The drug is very cheap-as little as 35 US
cents-and is often available over the counter.
But taking misoprostol on
its own only induces abortions about 40 per cent of the time, so many
babies are born after failed abortion attempts. Several studies in
Brazil, where up to 75 per cent of clandestine abortions involve
misoprostol, suggest the drug causes birth defects such as fused
joints, growth retardation and a condition known as Mšbius syndrome,
which is characterised by paralysis of the face.
One recent study found that
out of 93 children with defects associated with Mšbius syndrome, 34
per cent of those infants had been exposed to misoprostol, compared
with just 4.3 per cent of the 279 infants in a control group. Another
revealed that 49 per cent of infants born with Mšbius at seven
hospitals in Brazil had been exposed to misoprostol, whereas only 3
per cent of 96 infants born with neural tube defects had been exposed
to the drug.
While such findings clearly
suggest a link between misoprostol and certain congenital defects, the
real risk might never be known because it would be unethical to do the
necessary studies. "I think [these results] are real. Statistically
they are highly significant," says Fernando Vargas of the University
of Rio de Janeiro, who took part in both studies. Because the drug is
used secretly, it is hard to find out how many birth defects might be
caused by it, Vargas adds.
But even critics of the
drug's clandestine use recognise that, for women, attempting abortion
with misoprostol is less dangerous than other methods, such as
injecting saline. Misoprostol can cause bleeding, but this often
allows women to enter the health system legally. And it doesn't result
in the kind of complications caused by other methods.
In the US, misoprostol is
controversial not just because of its use in abortions but because it
is widely used to induce labour. The practice has come under scrutiny
recently because several cases of uterine ruptures and deaths of
babies and mothers have prompted lawsuits.