Into women’s hands? A transnational cartography of misoprostol in Burkina Faso and Senegal

In global reproductive health discourses, misoprostol is represented as a pharmaceutical panacea for maternal mortality reduction in sub-Saharan Africa. We locate misoprostol in transnational and postcolonial politics of pharmaceutical governance, whereby reproductive commodities are deployed to discipline African women's fertility, and Africa represents a global epicentre of pharmaceutical trafficking. Drawing on ethnographic research in Burkina Faso and Senegal, we show how misoprostol is manufactured and travels across continents and through pharmaceutical regulatory systems to distributors, health workers, vendors, and consumers. Misoprostol's availability, quality, authenticity, and price in official and unofficial circuits are deeply embedded in these transnational processes and are marked by inequities in access to medications. We disrupt the essentialisation of misoprostol as a life-saving medication for African women, or as a safe tool for reproductive self-care, and show instead how it falls short of delivering these promises.