Dear Editor,
Guyana has made huge progress in reducing maternal deaths. Between 1995 and 2023 maternal mortality fell by 63.8%. That is almost twice the world average over the same period, 32.9%.
(https://genderdata.worldbank.org/en/indicator/sh-sta-mmrt?view=trend&geos=WLD_GUY[1]) Yet we are still plagued by maternal deaths. The horrendous story of the deaths of Ms. Latoya Griffith and her baby at New Amsterdam Hospital (NAH) is a sad reminder of the awful pain behind cold statistics. Stabroek News, November 26, 2025).
I know nothing about medicine. I am a social scientist. I want to believe that the health staff at NAH acted in the best interest of their patients. Cytotec (Misoprostol) is such a safe drug that in its 2022 Abortion Care Guideline, the World Health Organization (WHO), urged that mid-level healthcare personnel should be allowed to administer it for early abortions, https://www.who.int/publications/i/item/9789240039483[2]. WHO went further. The safety of Cytotec is so well established that they advised that it should be provided by telemedicine and encouraged self-administration. They also provided a Pocket Guide of how to use the drug. (https://cdn.who.int/media/docs/default-source/reproductive-health/abortion/pocket-guide.pdf?sfvrsn=329a5654_9[3]) How is it that a drug that is so safe can be associated with so much harm?
Please allow me to share my own story with Cytotec. I met Dr. Annibal Faundes at a WHO meeting in Geneva. He is a Brazilian OB/GYN and a pioneer researcher on Cytotec. He explained that the more advanced a pregnancy was, the less Cytotec that was required. In 2002, in Tobago, Scarborough Hospital was admitting several young women with haemorrhage after attempting abortions with Cytotec. I visited a few pharmacists and learned that they were doing the exact opposite: The more advanced a pregnancy, the more Cytotec they were selling! How could I persuade them to adopt what seemed to be a counter-intuitive approach?
Midwives used to speak about pregnancies as ripening. So, I used the analogy of picking a fruit. The greener the fruit the harder one must pull to dislodge it from the tree. As it ripens, less effort is required, until it eventually falls all by itself. Then, with Dr. Faundes guidance, I prepared a protocol, laminated it and gave it to every pharmacy in Tobago. I also left a few in hairdressing parlours. Within a matter of weeks there were almost no further admissions for haemorrhage at Scarborough Hospital. The problem was never Cytotec, but the misuse of the drug. Knowledge matters.
Although, Guyana has had legal provision for mid-level healthcare professionals to offer non-surgical abortions in early pregnancy since 1995, decades before WHO recommended it, no mid-level professional is registered. That is not just shameful, it’s inexcusable. It reflects a health service that is doctor-centred rather than patient-centred.