That women rely on the black market to access medical abortion means they may not follow best medical practices. When S, a 24-year-old teacher from Recife, bought misoprostol from a drug dealer last year, she Googled how to take it. “Because it was illegal, there was no information on how to take it or what to take,” she said.
During her search, recommendations were found to insert pills into her vagina, as a doctor would do if she was in a clinic, but warned that traces could remain and give her away if she was in the hospital; instead, she dissolved them under her tongue, a method that also works, but less quickly.
K., who for fear of prosecution asked to be identified only by her patronymic initial, bled for weeks afterwards and wanted to seek advice from her mother, a gynecologist. But her mother is an anti-abortion activist. In the end, S. said that she thought she had a miscarriage, and her mother took her to a colleague who performed dilatation and curettage under anesthesia.
“When I was undergoing curettage, I had to repeat to myself over and over: “Don’t say anything, you can’t say anything” – it was torture,” she said. “Although I was completely sure that I wanted to have an abortion, I had no doubts, you still feel like you did something wrong because you can’t talk about it.”
The misoprostol restriction has complicated routine obstetric care, in which the drug is used to induce labor, said Dr. Derrike. At the public maternity hospital in Rio, where she is medical director, the doctor must fill out a drug application form in triplicate, which must be signed by the doctor. Derrike, take it to the pharmacy, where the warden must also sign before removing it from the locked cabinet, and then the doctor must inject the medicine in the presence of a witness to ensure that it is not sold on the black market.
“Not all of these steps are officially required,” the doctor says. Derrick said. “But hospitals are doing this because of the intense paranoia surrounding the drug.”