Background
Misoprostol is a life‐savingmedication in obstetric practice but the prevalence of misoprostol‐related self‐induced abortion is increasing in many communities.

Aims
To investigate the hospital incidence, clinical management, and legal framework of self‐induced abortions with misoprostol.

Materials and Methods
This was a prospective observational study conducted over 18 months. All patients <20 weeks pregnant who were admitted with a diagnosis of misoprostol‐induced abortion were included in the study. Results Of 186 women with abortion‐related admissions during the study period, 51 (27.4%) women reported using misoprostol to induce abortion. The majority were young (27.8 ± 5.5) married women (32/51: 62.7%), particularly educated (27/51: 52.9%) employed women (27/51: 52.9%), who were not on any contraception (46/51: 90.1%). Most abortions were induced in the first trimester (39/51: 76.5%) and patients were admitted because of prolonged bleeding (23/51: 45.1%). A significant proportion of participants who did not receive the correct dose of misoprostol developed sepsis compared to those who received a correct dose (6/18 (33.3%) vs 1/30 (3.3%); P = 0.008). Conclusion The use of misoprostol as an abortifacient is increasing in Papua New Guinea, particularly among educated and employed women. A review of the laws to meet the demand for abortion services and to limit complications of unsafe abortion practices is required.