Remember that Idaho pharmacist that refused to dispense an anti-uterine bleeding drug until she found out whether or not the woman had an abortion? The same battle is being waged daily around the world, only with access to misoprostol.
All Things Considered traveled to Mozambique to chronicle the controversy of misoprostol, which the World Health Organization recently added to a list of essential medicines. WHO officials say they still prefer oxytocin shots to prevent post-partum bleeding, in an ideal world, but the tablets are more practical in areas that don't have good access to medical care.
But misoprostol can also be used to induce abortion, and in countries like Mozambique where it's illegal, using it for terminations is widespread. That separate usage has complicated matters for its widespread distribution.
In Kenya, the government, aided by NGOs, has decided to widely distributed misoprostol, to massive controversy. Anti-abortion doctors see it as a stealth tactic to legalize abortion.
"I can't fathom a good reason why someone would want the drugs to be distributed so easily, unless these NGOs are pro-abortion," said Dr Caesar Mungatana, a Nakuru-based surgeon.
"I can't imagine a situation where vaginal bleeding is so life-threatening that one can't make it to the nearest health centre or hospital."
He can't? According to another medical professor, "8,000 women die in Kenya from complications arising from pregnancy and child birth every year with unsafe abortions accounting for a third of the deaths."
A 2007 study in the International Journal of Gynecology & Obstetrics found that "increased use of misoprostol, an option for pregnancy termination already available to many women in developing countries, could significantly reduce mortality due to abortion." Anti-abortion activists counter that legalizing abortion, including medication abortion before 12 weeks, didn't stop maternal mortality from worsening in South Africa, for example. But just because it's legal on the books doesn't mean women actually have access to safe abortions, as on-the-ground reporting has shown.