Cytotec (misoprostol) is an ulcer medication that is frequently used for inducing labor. It is not approved for this use.
This article discusses the dangers of Cytotec. In short, Cytotec is dangerous, the randomized controlled trials for use are weak, it is not approved for labor induction and it is often times administered without the patient even knowing.
Ina May reviewed 30 studies on using Cytotec (generic misoprostol) for labor induction and found that out of 3,415 births there were:
14 baby deaths
25 uterine ruptures
2 maternal deaths
2 life-threatening hemorrhages
The most significant finding in these studies is that most of these women were given the SMALLEST DOSE POSSIBLE (25 mcg). None of these women had scars from previous cesareans either.
Other side effects of Cytotec include:
hyperstimulation of the uterus
uteroplacental blood flow
uterine rupture (requiring surgical repair, hysterectomy, and/or salpingo-oophorectomy)
amniotic fluid embolism
severe genital bleeding
fetal and maternal death have been reported.
increased risk of uterine tachysystole, meconium staining of amniotic fluid, and Cesarean delivery due to uterine hyperstimulation
And here I was talking about how nasty Pitocin is!
Another thing worth noting is that because it is not recommended for use for labor induction and because the trials for the drug are weak, there is no standard on how to administer Cytotec. Some doctors put it on the cervix, some behind and some give it orally. This is experimentation on pregnant women without consent and knowledge of the risks. By the way, the package insert for Cytotec actually has a pregnant woman with an x through it.
Below are a list of quotes by doctors pulled right off the internet chat boards they participate in (I got this from Mardsen Wagner’s article on Cytotec):
“Cytotec is extremely effective at very low doses, is very cheap, and has been used on many, many women without their being aware that it really is still an experimental use.”
“I must say that I have heard some great things about Cytotec myself. I know some people who have used it and say that they have pretty good luck with it. It sounds like your ladies are pretty happy with its effects—two-hour labors and such. Just be careful. I would have to say that the biggest danger is leaving the woman alone. The stuff turns the cervix to complete MUSHIE (web message emphasis, not mine) and opens it with a couple of contractions. So whatever you do, remember that you must not stay gone too long.”
“At my suggestion our high risk OB referral hospital tried Cytotec—one-half tab per vagina—and after two cases of hyperstimulation stopped its use.”
“We’ve seen no cases of hyperstimulation after Cytotec that did not respond to a two-gram bolus of MgSo4. You can almost count on a delivery twelve hours after inserting the Cytotec tablet.” (Oh that’s nice, drug her and drug her some more)
“We are using it at Yale and although there is a format for how to give it, there is still controversy on to whom to give it. Pharmacy uses one of their nifty little pill cutters and sends us one-fourth of a 100 microgram tablet (remember this stuff was made for treatment of ulcers!)”
“I’ve personally used it twice and had excellent results in women wanting homebirths, but going postdates. I’m attaching my own protocol for anyone interested. Again I warn that I am no expert and I consider this protocol to be a “work in progress”—it will certainly change as I gather experience and information about this drug.”
“We are using misoprostol regularly for induction—my department loves it. We use one of the protocols published on OBGYN.Net web page.” (This one is my favorite, you mean to tell me they are going by something posted on a message board??)
“Our biggest fear is that the company will pull Cytotec from the market, since our internist/GI buddies tell us that it isn’t worth a darn for its labeled indication.”
To this, Marsden says:
“What is apparent from this Internet medical practice is the lack of appreciation of any borderline between experimenting on patients and practicing medicine on patients and the absence of concern for patient’s rights to informed consent.”
I say, who the hell do they think they are being so blase about guinea pigging pregnant women?!
If everyone knows that it’s not supposed to be used for labor induction and that it’s dangerous and long term affects haven’t been studied and so on, then why do doctors use it? Two reason, it works fast and it’s cheap.
We have got to start educating ourselves on what is happening to our bodies and our babies. We have got to start asking questions and refusing routine interventions and elective inductions. We cannot continue to allow these sort of things to happen. We can blame the doctors all day long and yes, they deserve a good bit of the blame but it’s also our fault too. We are letting this happen. We have to take control of our own situations and stand up for ourselves and break out of this obstetrical rut that we are in and if you don’t believe we are in a rut, think again sister. Too many women out there are way too naive and trusting about maternity care in America. We are the only ones that can do something about it.
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