Misoprostol

Addresses unassisted birth

Skilled assistance during childbirth remains low in many countries, which restricts access to emergency care when it is needed – including postpartum hemorrhage prevention tools.

Self-administration

This heat-stable, oral tablet can be distributed to pregnant women to self-administer when they go into labor, helping prevent life-threatening bleeding when giving birth at home.

WHO recommended

The World Health Organization (WHO) indicates that self-administration of misoprostol could have potential – but additional evidence to support delivery is needed.

Slow uptake

Access is also limited due to policy barriers related to misoprostol’s alternative use for medical abortion – which is restricted in some high burden settings.

What is postpartum hemorrhage?

Defined as excessive bleeding after birth, postpartum hemorrhage is the leading cause of maternal death worldwide. However, most cases of postpartum hemorrhage are avoidable with access to appropriate detection, prevention and treatment tools. Nearly all deaths of mothers from severe bleeding after birth occur in low- and middle-income countries, where access to those tools is limited.

How can childbirth without the support of a skilled birth attendant put a woman at risk?

Skilled birth attendants are critical in ensuring detection and management of complications during childbirth. Giving birth unassisted can put women at increased risk of death from complications such as postpartum hemorrhage. Many women in low- and middle-income countries do not have assistance when giving birth, which contributes to the disproportionate burden of maternal deaths shouldered by those countries.

How can misoprostol help reduce this risk?

Misoprostol is an oral medicine used for preventing postpartum hemorrhage. Because it is heat-stable and comes in tablet form, the World Health Organization recommends it for women delivering outside a health facility. Though the goal is to ensure all women have quality care during childbirth, misoprostol has potential to prevent life-threatening bleeding in women delivering without assistance.

What challenges restrict access to this medicine?

Supplies of misoprostol in many low- and middle-income countries are of varying quality and health care services do not have the tools necessary to quality-screen the pills. Meanwhile, effective implementation models for self-administration are required to help increase uptake of the recommendation. Because misoprostol is also used in medical abortion, women at high risk of postpartum hamorrhage also face policy barriers when accessing misoprostol for self-administration.

How is Unitaid helping to accelerate access?

We are funding a large-scale demonstration project to inform optimal deployment and scale-up of misoprostol, as part of a package of new and newly recommended postpartum hemorrhage drugs in low- and middle-income countries.