Dear Danielle: My heart goes out to you in your loss. I also don't want you to think that I support the use of cytotec for induction of labor, I totally agree with you regarding the cavalier way it is used and I cringe every time I read of its use in this way. I witnessed this first hand when I was assisting a midwife with a woman (primip) who was planning a homebirth and at 43 weeks gestation. Both she and her midwife agreed to try ripening her cervix with prostaglandin gel for induction at 43 weeks: her cervix was still " long, thick and closed" and not at all appropriate for castor oil induction at home. We were admitted to the hospital for monitoring and insertion of the gel and we requested that our client not be given cytotec and that cervadil/prostin be used instead. The obstetrician completely contradicted the information we had given our client regarding uterine hyperstim and uterine rupture associated with cytotec and persuaded our client that cytotec was the most efficient and cost effective cervical ripening agent available, that she had not seen any adverse effects with its use, and that this hospital only recommended using the other prostaglandins with VBAC moms. I have no doubt that had we not raised the issue regarding the safety of cytotec it would not have been raised and certainly no informed consent form was used/signed in this case. Despite our client being persuaded to use cytotec she did not rupture, but neither did she dilate, so she did go on to have a cesarean birth.
All this being said, while in my opinion, use of cytotec for labor induction is not a safe option, the drug does appear to have other obstetric uses which appear to be safe. I do believe that studies are being done around the world on these uses. There needs to be a moratorium on its use to induce labor, at least until the appropriate trials have taken place. Once again, I am truly sorry for your loss Danielle and also sorry for any pain my email may have caused you. Kind regards, marilyn -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
