The proper use of P2 and misoprostol amid misconceptions

Dar es Salaam. Many users of emergency contraceptive pills (commonly known as P2) or medications like misoprostol for abortion, may not know much about their proper use and effects.

Health experts have clarified that, contrary to common usage, these medications are designed to address specific reproductive health challenges for women and are intended for different uses.

Dr. Elias Kweyamba, an obstetrics specialist at Ifakara Mission Hospital in Morogoro Region, says that when used as intended, misoprostol can provide positive outcomes.

“There are people who use it differently from the instructions, hoping for different results. Misoprostol is meant to reduce bleeding after childbirth or help a woman who has experienced heavy bleeding or has given birth, as a treatment to prevent further bleeding,” he explains.

He also notes that it is used for pregnancies that have exceeded nine months without delivery, in order to strengthen labor for a woman being assisted in childbirth or in cases where the baby has died in the womb.

Additionally, Dr. Kweyamba says misoprostol is used to clear the uterus if a pregnancy has been terminated for any reason, either through expulsion or other means.

“While these are direct examples, usage varies depending on the patient’s condition and the doctor’s assessment. Therefore, it is crucial to use these medications under medical advice,” he adds.

Experts caution that misoprostol should not be used for abortion unless prescribed by a doctor. Dr. Ali Said, a specialist in obstetrics and gynecology, notes that:

“Those using misoprostol for abortion often face challenges in estimating the pregnancy’s age and the number of tablets to use, which can lead to incomplete abortions and excessive bleeding,” says Dr. Said, who is also a lecturer at Muhimbili University of Health and Allied Sciences (MUHAS).

Regarding P2, Dr. Kweyamba explains that it is used as a form of birth control and in emergencies to prevent pregnancy.

“For example, if a person has been raped, forgotten to take birth control pills, experienced a condom break, or had unplanned intercourse and miscalculated their cycle.”

“It is intended to prevent rather than terminate pregnancy. As an emergency method with high hormone content, using it contrary to expert advice may result in future pregnancy challenges due to the high hormone levels causing adverse effects,” he says.

Dr. Kweyamba emphasizes that P2 should be used within 72 hours of intercourse and not beyond that period.

Youth reproductive health expert and Program Manager at Youth Choice For Change (YCC), Godlove Isdory, advises that P2 should not be used more than three times within a 12-month period because its content is similar to birth control pills and excessive use can disrupt hormones.

He adds that taking two P2 pills is equivalent to consuming 60 regular contraceptive pills, according to Dr. Living Colman, an obstetrics and gynecology specialist.

Abortion

Dr. Said notes that a 2018 study estimated approximately 2.9 million pregnancies occur each year.

“Of these, the study revealed that 1.3 million were unplanned, 430,000 resulted in abortions, and unsafe abortion-related deaths account for 19 percent,” says Dr. Said.

Although 430,000 terminated pregnancies are officially recorded each year, experts believe the actual number is higher, as many seeking medical help are those who have suffered immediate harm from unsafe abortions.

Nondo Ejano, Regional Director of the International Network for Women’s Rights Africa (WGNRR AFRICA), states that unsafe abortions contribute up to 19 percent of maternal deaths in Tanzania, with the health system incurring costs of Sh10.4 billion annually to manage complications from unsafe abortions.

“These human and financial costs could be significantly reduced and resources redirected if legal reforms are made,” says Ejano.