Unregulated usage of labour-inducing medication in a region of Pakistan with poor drug regulatory control: characteristics and risk patterns

Results: Of the 6379 women included in the study, 607 (9.5%) received labour-inducing medication prior to reaching the hospital; of these, 528 (87.0%) received unregulated medication. Out of 528 labour-inducing medication administrators, traditional birth attendants (also known as dai) 197 (37.3%) and lady health workers 157 (29.7%) provided unregulated treatmentmostfrequently. Women givenunregulated medication whowere diagnosed with obstructed/prolonged labour were at risk for uterine rupture (RR 4.1, 95% CI 1.7–9.9) and severe birth asphyxia (RR 3.9, 95%CI2.5–6.1), and thosewithantepartum haemorrhagewereatrisk for stillbirth (RR 1.8,95% CI 1.0–3.1). Conclusions: In a conflict-affected region of Pakistan, exposure to unregulated treatment with labour-inducing medication is common, and carries great risk for mother and child. Tighter regulatory control of labour-inducing drugs is needed, and enhanced training of the mid-level cadres of healthcare workers is required.