WHO Approves Misoprostol to Prevent Hemorrhage

By: Shafia Rashid, Senior Program Officer, Global Advocacy, Family Care International

The following was originally published on the FCI blog. It is reposted here with permission

Last week, the WHO Expert Committee on the Selection and Use of Essential Medicines approved the inclusion of misoprostol for the prevention of postpartum hemorrhage (PPH) on the WHO List of Essential Medicines. PPH,or severe bleeding following childbirth, is one of the major causes of maternal death and disability in developing countries. The Expert Committee noted that “600 micrograms [misoprostol] given orally is effective and safe for the prevention of PPH” in settings where oxytocin, currently the standard of care to prevent PPH, is not available or feasible. Moreover, the committee moved misoprostol from the complementary to the core list of essential medicines, validating the drug’s important role in women’s health.

Structure of the misoprostol molecule
Structure of the misoprostol molecule

Misoprostol, a prostaglandin, offers several potential advantages over oxytocin for managing PPH in resource-constrained settings. It is widely available in developing countries, is relatively inexpensive, can be transported and stored without refrigeration, and can be administered without an injection.

The addition of misoprostol to the WHO List of Essential Medicines is an important step forward in making the drug more widely available for PPH, and provides a critical opportunity for disseminating clear, evidence-based information to ministries of health, regulatory authorities, health system managers, health workers, and other audiences.

Strong, effective, and consistent advocacy at the global, regional, and country levels is critical for improving women’s access to misoprostol for both prevention and treatment of PPH. FCI is working with Gynuity Health Projects and other partners to develop an evidence-based advocacy agenda and communications plan to harmonize and disseminate messages on the use of misoprostol for preventing and managing PPH.