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Archive for the ‘Misoprostol’ Category

Not too long ago at a birthday party I talked to a mom of a brand-new little baby boy. Her fourth baby. She was telling me about her birth; that she was five days past her due date and the doctor decided she “had to” induce. So, this sweet lady went in and was given a magical little “miso pill,” as she called it. “It’s a tiny little white pill they stick next to your cervix to start labor. My baby was born at noon. They had to do that to get my third baby out too.”

I stood there talking to her, trying to act normal and fervently hoping my look of horror didn’t show. That little “miso” pill, as she called it, is none other than Misoprostol, the generic name for Cytotec, a drug used off-label that has caused the damage and death of myriads of laboring women and their babies. Of course, I wasn’t horrified at the mom. There is no way she could know that the doctor she trusted was essentially performing an experiment on her to start labor. I was shocked that the doctor (who also happened to be my childhood doctor, which made it even more disturbing) would knowingly put this mother at risk without giving her any information on the drug she administered.

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Miso was first used as an induction drug in the mid-1990s. FDA approved as an ulcer drug, this pill has never been tested or approved for use on pregnant women. In fact, in 2000, the manufacturing company sent out a letter to all obgyns and midwives, warning against the use of miso because it causes uterine rupture (the uterus detaches and breaks open) and can harm or kill both mother and baby. And yet, eleven years and many deaths and lawsuits later, doctors still use it.

Essentially, the pill is dangerous because it’s unstoppable. With other induction drugs, like Pitocin, Prepidil, or Cervidil, the source of the drugs can be removed or slowed if a woman’s uterus shows signs of hyperstimulation or the baby goes into distress. Those drugs aren’t foolproof, but they don’t have as many cases of infant or maternal mortality due to uterine rupture as does misoprostol. A “miso” tablet, once absorbed into the body, cannot be stopped. It is an all or nothing deal. Therefore, even if the contractions strain the uterus to the point of rupture, there is no way to reverse or slow down those contractions.

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Talking to that mother got me thinking… if you know something about a drug a woman is given for childbirth, what do you say? Should you just stay silent, even though you know it causes death, disability, or infertility? Is it even ethical to stay silent? Do you tell her that the drug is that dangerous? Do you tell her to research it, knowing that she probably won’t? What on earth do you do in a situation like that?

In my mind, it would be different if the information was well known and in the news, such as the dangers of smoking cigarettes or binge drinking or a mainly fast food diet. Then I wouldn’t say anything because I know she made a conscious, informed choice. But medical interventions or prescriptions are an entirely different ballgame. We tend to trust our doctors and what they give us, believing that they have done the research and will give us the most beneficial treatment. This is not always the case. Most women don’t even know the potential side effects of labor drugs until it is too late and they’ve experienced the damage.

Women like the one from the party are the reason I started this site. Every woman deserves the right to make an informed choice about what is done to her body, especially during one of the most normal and natural processes she experiences: bringing forth life.

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Induction is a term that describes the act of sending a woman’s body into labor. Technically, the word can be applied to both natural methods of induction, such as walking or sexual intercourse, and to unnatural methods, such as the administration of drugs or artificially breaking the bag of waters.

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Pitocin

Pitocin is a synthetic hormone that mimics oxytocin, the hormone that sends a woman into labor. It is administered via intravenous drip into the bloodstream, and causes contractions that are intended to either start labor or “jumpstart” a stalled labor. Since Pitocin is the most widely-used form of induction, I will dedicate a full post to it.

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Cytotec

Cytotec is a small pill that can either be taken orally, or is inserted in the vagina to induce labor. Once administered, it absorbs into the body and cannot be removed or its effects stopped.

Despite being quite popular among medical staff, this drug is not FDA approved for use on pregnant women since it frequently causes uterine rupture and can be fatal to both mother and baby. Uterine rupture means that the top of the uterus detaches from a woman’s body, often breaking open at the top and sending the placenta and unborn baby into her abdomen instead of through the birth canal. This occurs because the contractions created are too strong and hyperstimulate the uterus. Uterine rupture or danger of rupture is extremely serious and the baby must be born as quickly as possible, usually through cesarean, and the mother’s uterus must be repaired or removed.

Several years ago the manufacturing company sent out a warning to all medical practitioners against the use of Cytotec on any pregnant or laboring woman. Unfortunately, and extremely unethically, this pill is still used widely within the medical community.

Please read this article previously posted about Cytotec, and the serious dangers it represents to both mother and baby. If you decide to induce medically for any reason, please request Pitocin, and do not allow anyone to give you Cytotec, also called misoprostol.

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Prepidil and Cervidil

These two drugs, each a type of prostaglandin, work similarly to Cytotec in that they soften both the cervix and lower part of the uterus. They are frequently used in conjunction with Pitocin to enhance its effects. Prepidil is a gel applied directly to the cervix, and Cervidil looks like a tampon that is inserted into the vagina and releases the synthetic prostaglandin. Unlike Cytotec, these two drugs were FDA approved for labor induction in the mid-1990s. In case of hyperstimulation (overworking) of the uterus, the Prepidil can be wiped off and the Cervidil removed in order to halt the flow of prostaglandin. In this way the two are safer than Cytotec, which cannot be removed, but they can and do still cause uterine rupture occasionally.

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Breaking the Waters

For some women, labor begins by the bag of waters breaking. This happened to me with my first labor and it was pretty obvious to me when it broke. The break can cause harder contractions, but also greatly increases your chance of infection if the bag breaks before you are ready to be in labor. If labor doesn’t start soon after, most care providers will want to induce and administer antibiotics.

Breaking the waters refers to artificially rupturing the bag that holds the baby and amniotic fluid. This is a fairly common procedure and is considered safe because there is no danger of uterine rupture. If a woman’s body is ready for labor, breaking the waters effectively starts labor for 70-80% of women within 24 hours. The problem with this method of induction is that, for the other 20-30% who don’t go into labor quickly, danger of infection is high. In a hospital setting, this also places a time limit on how long labor is allowed to go. If breaking the waters does not start contractions within a specified period (usually 24 hours), then a hospital will begin other methods of induction, such as a Pitocin drip or the administration of one of the previously-mentioned interventions.

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Cytotec (generic name Misoprostol) first hit the market as a prescription drug for the prevention of ulcers. It was supposed to counteract the unfortunate side effects of certain medications for arthritis and pain relief that cause a higher rate of ulcers (I think I’d rather have the arthritis, personally!). The FDA ran trials and approved it for this use only.

However, it was soon discovered that, given to a pregnant woman, a low dose of Cytotec will successfully start labor contractions at a fraction of the cost of pitocin. So, doctors began giving the drug “off-label” to millions of women.

So, what’s the big deal? you may ask. It works, doesn’t it? Well, I’ll tell you what the big deal is.

Cytotec kills women and babies.

That’s a pretty big deal, right?

I’ll say it again: using Cytotec for induction can kill or seriously injure both the mother and baby.

One unfortunate side effect of misoprostol is that it can cause uterine rupture, which is life-threatening because the uterus detaches from the mother’s body. It causes severe bleeding, fetal distress, and the baby or placenta can be delivered into the mother’s abdominal cavity, rather than through the birth canal. Mothers who experience uterine rupture need an immediate cesarean to get the baby out and to repair or remove the uterus. The mortality rate for women who have a uterine rupture is extremely high, and their babies either die or are left seriously disabled.

The deaths of healthy mothers and babies should be enough to keep doctors from giving the pill to anyone. However, it gets worse. The most shocking part of the use of Cytotec in this way is that the manufacturing company, Pfizer, clearly labels each bottle with a warning against using the drug on pregnant women. When doctors ignored it, they sent out an extra warning to all healthcare practitioners involved in prenatal care and childbirth:

The purpose of this letter is to remind you that Cytotec administration by any route is contraindicated in women who are pregnant because it can cause abortion…

Serious adverse events reported following off-label use of Cytotec in pregnant women include maternal or fetal death; uterine hyperstimulation, rupture or perforation requiring uterine surgical repair, hysterectomy, or salpingo-oophorectomy; amniotic fluid embolism; severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain.

(This excerpt was taken from the actual letter. If I knew how I would scan the whole letter and add it to the post, but I’m not quite that technologically adept yet).

With all the reasons not to give Cytotec to any pregnant woman, you would think that no doctor would ever do so. And yet, even with the warnings and evidence of danger, women are still given this drug to induce labor and the fatalities continue.

The biggest question is, of course, why?! If it causes so much damage, why on earth would doctors continue to prescribe it? There are only two reasons I can think of that Cytotec would be given for induction rather than pitocin: money and convenience. Cytotec is much cheaper than pitocin to induce labor, and it is also extremely easy to use: just pop a pill early in the morning, and the baby is out by evening. Or dead by evening.

To all mothers-to-be, please, please do not allow anyone to give you Cytotec! Remember, it is also called misoprostol. If you choose to be medically induced for any reason, make sure you are given pitocin via IV rather than a pill that is either taken orally or placed in the vaginal opening. It is not worth the risk to you or your baby.

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