Avia Collinder, Sunday Gleaner Writer

SENIOR MEMBERS of the medical profession are concerned that the 'abortion pill' Cytotec is again being abused and are demanding that the Ministry of Health implement tighter regulations for its use.

"Cytotec is sold on the streets of the Corporate Area. I have no idea of the price. They use it for termination of pregnancies. They have no idea of dosage, but women just buy it and take it," a worried Dr Douglas McDonald, senior medical officer of the Victoria Jubilee Hospital tells The Sunday Gleaner.

He says patients only come to Victoria Jubilee Hospital, the main state-run obstetrics institution in the country, when they begin to bleed heavily or haemorrhage.

"Patients say they got the pills themselves and insert them in the vagina," relates McDonald. "They just buy them off the street. The uterus contracts, they start bleeding and then come here when it gets really heavy. If not treated, torrential haemorrhage will result which can lead to death."

Although he has treated many cases, McDonald refutes claims that half of his gynaecology admissions are due to the abuse of the drug. "I would not say that," he states.

not an excuse for abortion

Consultant gynaecologist and obstetrician at Savanna-la-Mar Hospital in Westmoreland, Dr Evon Nepaul, says he has seen the effects of the widespread use and abuse of Cytotec. While confirming that the drug works (to terminate pregnancies), Nepaul emphasises that it should not be used as an excuse for legalising abortions. Tighter regulations, he argues, is the answer.

While McDonald denies knowledge of the involvement of members of the certified medical profession in its unregulated use, Nepaul suggests that some local pharmacies might be culpable. Staff engage in back-door sales without the knowledge of the pharmacist.

Local pharmacists, on the other hand, say that some medical doctors themselves might be performing abortions, using the drug as a means of expelling the foetus, a practice which is currently illegal. An employee of a Corporate Area pharmacy, who requests anonymity, tells The Sunday Gleaner that most private pharmacies have ceased stocking Cytotec because of the illegality of its use.

"When they (clients) come here with prescriptions, I send them to the hospital pharmacy. The doctors are saying that they prescribe the drug for miscarriages. Because we do not want to be participants in any abuse of the drug, we have ceased stocking Cytotec," the pharmacist states.

Another Kingston-based dispensary said it did not stock the drug, but was well aware that it was used for illegal abortions.

Cytotec facts

The likelihood of an abortion occurring when Cytotec is taken orally is only 25 per cent, but the likelihood increases to 40 per cent when the pill is inserted vaginally.

Manufactured by the American firm G.D. Searle for ulcers, Cytotec, among gynaecologists and obstetricians, is considered to be a wonder drug for ripening the cervix.

In small amounts, 20-50 micrograms, it is is used to induce labour where the natural process lags or where its use is otherwise indicated.

Manufacturer G.D. Searle released information (nrlc.org/ru486/randy.html) saying it received reports of "serious adverse events" with off-label uses of prostaglandin Cytotec and that the company was opposed to its use for abortion.

Searle promotes Cytotec to prevent gastric ulcers among people, such as those suffering from arthritis, who have to take a lot of nonsteroidal anti-inflammatory drugs. The company states that despite its widespread use in conjunction with RU486 (the 'abortion' pill), it opposes this.

Labels warn that it is not to be used by women who are pregnant because it can cause an abortion.

Manufacturers note that the drug Cytotec has an abortifacient property which can cause miscarriages, and is often associated with potentially dangerous bleeding, which may result in "infertility, congenital anomalies and even death in women".

The American College of Obstetrics and Gynaecology suggests that the pill, issued in small amounts of 50 mcg in the US, helps to induce labour.