/IPS DEVELOPMENT BULLETIN/ CUBA: New Abortion Methods in Use in Cuba

By Dalia Acosta Reprint | | Print |

Dalia Acosta

HAVANA, May 24 1997 (IPS) - Cuban doctors are proscribing Misoprotol – a drug originally intended to treat duodenal ulcers – for use in terminating unwanted pregnancies.

The use of Misoprostol to induce abortion is based on the collaborative efforts of Cuban and Spanish physicians and has proved succesful on more than 1,800 women since it was introduced more than one year ago, according to hospital authorities. Collaboration was by Havana’s Eusebio Hernandez Women’s Hospital, and the Mediterranean Clinic located in Valencia, Spain.

At the Tenth National Congress of Gynecology and Obstetrics, earlier this month, Abelardo Velazco, director of the Cuban Women’s Hospital, announced that his staff has used Misoprostol to induce 40 abortions, and that the drug had been employed successfully in 93 per cent of all cases.

The Cuban legalization of abortion dates back to 1965 when legislators wrote a law which guarantees women the right to determine how many children they will have. The same legislation made it legal to interrupt pregnancy to prevent maternal death or other serious pathologies.

Simultaneously, it became illegal to abort without maternal permission, or to have abortions outside the Cuban health system where abortion services is provided free of charge. The number of abortions in Cuba, however, has declined since the 1980s when 8 out of every 10 pregnancies were ended by deliberate intervention.

Latest available figures from the Cuban Public Health Ministry Sources show that nearly 84,000 abortions were performed throughout Cuba – which meant of 100 pregnancies nearly 34 were terminated by abortion.

Cuban health experts say that the decline has been brought about by the introduction of menstrual extraction as a service offered by the Cuban Health Care System. Menstrual extraction makes it impossible to determine how many abortions are actually taking place.

The use of Misoprostol in women 9 to 12 weeks pregnant is likely to reduce the abortion rate even further, doctors said. In addition to cost cutting advantages over other abortion methods, treatment with Misoprostol is less threatening to the woman since anesthesia is not required. Similarly, it is not necessary to dilate the cervix, and there is no possibility of sepsis or perforation. Thus, it is possible to avoid the chief causes of morbidity and mortality associated with mechanical abortion methods.

According to Cuban health reports, eight women died in 1995 as a result of induced abortion, a rate of 5.4 per 100 thousand live births. Overall, maternal deaths have risen slightly from 31.6 per 100 thousand live births in 1990 to 32.6 per 100 thousand in 1995.

The foremost causes of death among 48 maternal death reported in 1995 were toxemia, hemorrhage and abortion.

A report on The State of the World’s Population issued by the United Nations, states that 500 thousand maternal deaths took place in 1995, and that 67 thousand of these were caused by abortion.

A recent study entitled “Cuban Fertility Transition” conducted by a team of Cuban scientists and UN conultants, said that “abortion can not be viewed exclusively through a medical lens”.

The problem of abortion is not rooted in legalization of the procedure but in the fact that many women resort to abortion as a contraceptive method without taking into account that it is a high- risk procedure which should be reserved as an intervention of last resort, it said.

It was reported during the Congress of Gynecology and Obstetrics that Misoprostol is available in 72 countries. According to a representative of the Pan-American Health Organization, clinical studies conducted in Africa reveal the drug’s ability to treat post-partum hemorrhage.