Abortion pills   Aims: To investigate misoprostol use as a self-administered medical abortifacient and to explore the knowledge and availability of misoprostol and attitudes towards it among Saudi women.

Methods: A questionnaire-based cross-sectional study was conducted in obstetric and gynecological outpatient clinics at private and teaching institutions between January 1 and June 29, 2012.

Results: Of the 678 respondents, 40% (271/678) were aware of misoprostol use as an abortifacient and 7.4% (50/678) reported personal use of it as an abortifacient. Misoprostol users were more likely to have had previous abortions (96%, 48/50; p < 0.01), had a relative/friend working in the medical field (70%, 35/50; p < 0.01) and known someone else who had used the drug (82%, 41/50; p < 0.01). The majority responded incorrectly that higher misoprostol doses are required with more advanced gestational age (96%, 48/50) and that misoprostol use confers no fetal risks (100%, 50/50).

Conclusion: The proportion that reported personal use of misoprostol in the current study (7.4%) exceeded that in similar samples in Brazil (2.2%) and the USA (5%). One concerning finding was the users’ poor knowledge about misoprostol. Increased awareness about the inherent risks associated with unsupervised misoprostol use as an abortifacient is needed.