How to do a Medical abortion in Morocco

In Morrocco, women can get 30 tablets artotec in the pharmacy for 100 dirhams. To do a safe abortion (till 12 weeks of pregnancy) a woman needs 12 tablets artotec. The following information is based on research by the World Health Organisation.
To cause an abortion (or miscarriage) should put 4 pills Artotec under the tongue. She should not swallow the pills but let them dissolve under the tongue for at least until 30 minutes. She should spit out the inner hard tablet.
After 3 hours she should put another 4 pills under the tongue. She should again spit out the remains of the tablets after half an hours.
After 3 hours she should put another 4 pills under the tongue again for a third time. She should again spit out the remains of the tablets after half an hours.
Within a few hours most women will get cramps and start bleeding. Bleeding can be more than a normal menstruation and can last for 3 weeks. After 3 weeks a woman has to do a pregnancy test to make sure the abortion was successful.
The woman has to go to a hospital as soon as possible to make sure she has no complication when:
1- she has a fever for more than 24 hours,
2- she has very heavy bleeding filling more than 2 maximum pads per hour for 2 hours.
3- in case of long lasting pain
In case you want more information please email info@womenonweb.org.

Fact sheet medical abortion based on scientific information:

 The following information is from the “Safe abortion, Technical and policy guidance for health systems, second edition, World Health organization, 2012” [1]

 “An estimated 22 million abortions continue to be performed unsafely each year, resulting in the death of an estimated 47 000 women and disabilities for an additional 5 million women (1). Almost every one of these deaths and disabilities could have been prevented through sexuality education, family planning, and the provision of safe, legal induced abortion and care for complications of abortion.”

 “In countries where induced abortion is legally highly restricted and/or unavailable, safe abortion has frequently become the privilege of the rich, while poor women have little choice but to resort to unsafe providers, causing deaths and morbidities that become the social and financial responsibility of the public health system.”

“Laws and policies on abortion should protect women’s health and their human rights. Regulatory, policy and programmatic barriers that hinder access to and timely provision of safe abortion care should be removed.”

“Recommended methods for medical abortion. Where mifepristone is not available. For pregnancies of gestational age up to 12 weeks (84 days):

The recommended method of medical abortion is 800 μg of misoprostol administered by vaginal or sublingual routes. Up to three repeat doses of 800 μg can be administered at intervals of at least 3 hours, but for no longer than 12 hours.”

Misoprostol is on the List essential medication WHO[2] and available in Morocco in the medicine “Artotec”. Artotec contains 50 mg of diclofenac in an inner core and 200 micrograms of misoprostol in an outer mantle.” [3]  Artrotec in the pharmacy costs 100 dirham for 30 tablets.

Diclofenac does not diminish effectiveness but significantly reduced the pain in medical abortion.[4] [5]

 

 



[1] http://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241548434/en/

[2] http://whqlibdoc.who.int/hq/2011/a95053_eng.pdf

[3] Scand J Rheumatol Suppl. 1992;96:37-48. Biopharmaceutical profile of diclofenac-misoprostol combination tablet, Arthrotec. Karim A, Smith M. http://www.ncbi.nlm.nih.gov/pubmed/1439623)

[4] (“Fiala C, Swahn ML, Stephansson O, Gemzell-Danielsson K, The effect of non-steroidal anti-inflammatory drugs on medical abortion with mifepristone and misoprostol at 13-22 weeks gestation” Hum Reprod. 2005 Nov;20(11):3072-7. Epub 2005 Jul 29. (http://humrep.oxfordjournals.org/content/20/11/3072.long)

[5] “Pre-emptive effect of ibuprofen versus placebo on pain relief and success rates of medical abortion: a double-blind, randomized, controlled study.”Avraham S, Gat I, Duvdevani NR, Haas J, Frenkel Y, Seidman DS. Source, Fertil Steril. 2012 Mar;97(3):612-5. Epub 2012 Jan 20. (http://www.ncbi.nlm.nih.gov/pubmed/22265034)

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