Labor Induction and Cytotec

Posted: October 1, 2019 in Uncategorized
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This summer Mike and I welcomed a baby into our family! I was happy to have an easy pregnancy (especially after my miscarriage in 2017) and was hoping the labor and delivery would be easy as well. My mom was only in labor with me for three hours, and my grandma had been in labor for six hours or less with both my mom and my uncle, so I had high hopes that quick labors were in my genes. Unfortunately, I reached 41 weeks and had not gone into labor. I was okay with waiting longer, especially since tests conducted at 41 weeks indicated our son was perfectly fine; however, the midwife at my 41-week appointment did not want to wait much longer, since the risk of complications and stillbirth increases slightly the longer you are overdue. Many of the induction appointments for the next few days were already taken (the hospital only scheduled four per day and fewer on the weekends), so we ended up with an appointment for 5 p.m. at 41 weeks and 3 days.

At my 41-week appointment, the midwife explained that if I was not dilated at the time of my induction, then they often used Cytotec (misoprostol) to start the induction process, rather than Pitocin, which seems to be the drug you mostly hear about in childbirth classes and from others who have been induced. Prior to her talking about it, I knew Cytotec was sometimes used and had already decided that I probably did not want it. I had first heard of Cytotec in October 2017 when it was offered as an option to complete my missed miscarriage. I did some research on the drug at that point in time, and, after reading about some potential scary side effects–which were made even scarier by the fact that you took this drug at home for a missed miscarriage and not in the hospital under medical supervision–decided on a D&C.

Cytotec is not approved by the FDA for use in pregnancy (not that I rely on the FDA for everything, but still, it makes you think twice). Cytotec is supposed to be used to treat gastric ulcers. When it is used for the off-label purpose of pregnancy, it can be used to cause an abortion in the early weeks of pregnancy, complete a missed miscarriage, or induce labor of a live, healthy, full-term baby. The midwife assured me that they only use a small percentage of this drug for induction compared to its use in a missed miscarriage, and that the hospital has never really had any issues with it. I still find it concerning, though, that it is used for both aborting a baby and delivering a healthy one. Also, Cytotec dissolves instantly, so if there are problems from it, you can’t remove it. Some of Cytotec’s worst potential side effects include uterine rupture, death to mother and/or infant, and brain damage to the infant. It can either be taken orally or inserted vaginally. Obviously, if it’s inserted vaginally, it’s awfully close to your infant’s head, which is concerning if you consider the brain damage side effect.

If I had not heard of Cytotec previously, I probably would not have researched it for my induction. I would have just assumed that pill was what they used and tried not to worry about it. Since I wanted to avoid that drug if possible, though, I decided to pick a different option. Two other options my hospital offered were mechanical dilation with a Foley catheter and Cervidil. I wanted to use the catheter option because it has the fewest risks associated with it, but you have to be dilated a certain amount on your own in order to pick the catheter, and I was not. So my last option was Cervidil, and I am glad I picked that rather than Cytotec. Cervidil is inserted vaginally but can be removed easily (similar to a tampon) if it is causing any side effects or problems. It does, of course, have its own list of side effects (which at this point in my induction decisions I mostly tried to avoid viewing, since Cervidil was my last option), but it is actually approved for pregnancy. The midwife acted surprised that it worked so well on me (I went from basically not being dilated at all to 3 cm in the span of about 12 hours). Normally, they would administer Pitocin at that point to continue the induction, but I requested to see if my body would continue the labor process without the use of Pitocin, and they agreed that was fine. One of the downsides of being induced is that the contractions can come closer together right from the beginning, and mine did–they were roughly three minutes apart for almost all of my 27-hour labor.

I wrote this post because I want women to be aware that they have options when it comes to labor induction. Ask questions of your OBGYN or midwife and do your own research as well. Also, if you reach 40 weeks in your pregnancy and have not started labor on your own yet, schedule your induction date. You can always cancel it if you don’t need it. I waited until 41 weeks to schedule mine because I kept hoping I wouldn’t need to be induced. I would have been given the green light to wait until 41 weeks and 5 days to start induction, but they were booked full. Perhaps I would have gone into labor on my own if I had had those extra couple of days.

If you would like to read more about Cytotec, please check out these resources:

The Freedom to Birth–The Use of Cytotec to Induce Labor: A Non-Evidence Based Intervention

Inductions and the Use of Drugs in Labor and Delivery

The Risks of Cytotec for Inducing Labor

Misoprostol Information from the FDA

Cytotec Unsafe for Labor Induction (This page is from an attorney’s website–continue down to the bottom of this webpage to read comments from women who have had complications during a Cytotec induction.)

**I am not a doctor. Please consult your healthcare professional before trying any health advice I offer on my blog.**

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Comments
  1. Sarah Steele says:

    You are so well-informed, Angela; what a gift you are to your child! Glad you had a safe delivery and healthy baby!

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