On my soapbox again…

I just can’t believe it… I don’t WANT to believe it. That midwives (the “guardians of normal birth”) are using cytotec (also known as misoprostyl) to induce labor at home. The fact that they are using it in hospitals doesn’t shock me, makes me mad, but I just add it to their list of sins again women and babies. Nothing new there. But midwives… sweet, caring, lovely homebirth midwives. Thinking this doesn’t harm anyone. I hear it over and over again, “I’ve used it judiciously for years and have never seen a problem with it.”

Well good for you. Tell my blog-friend Anne that you’ve never had a problem with it’s use. That you’ve never seen a baby die from it, or a mother die or lose her uterus from it. Good for you. Put some flowers on her baby’s grave and say, “Well, we don’t know for SURE that cytotec caused her death.” That you have played the tables and had good luck doesn’t change the fact that this is a potentially dangerous drug that you are using for an OFF-LABEL situation. There are no safe dosing limits or instructions, no risks to inform your clients of because the company that makes cytotec has no intentions of marketing it for obstetrical use. I doubt their lawyers would allow them to. Too much of a liability perhaps?

Here is a quote about misoprostyl that sums up my own position and one that, I believe, should be taken by all birth workers:

Belinda Phipps, chief executive of the National Childbirth Trust, said she was “absolutely incredulous” that any hospital would give the drug to women outside of clinical trials.
She said: “This drug is not licensed for use in labour, and the NICE guidance is categorical on that point. In this country, misoprostol should only be used in labour if the baby is already dead, or after the birth, because otherwise the risks are simply too great.” [ click here for the newspaper story ]

I’m not likely to stop beating this drum for awhile yet. In fact, you might want to cover your ears because frankly? I plan on beating it louder.

4 thoughts on “On my soapbox again…

  1. Really?!!! I’m shocked. I haven’t had the opportunity to Utilize a hombirth midwife yet, but I have certainly worked with quite a few…It never occurred to me that they would dabble in such a drug…so many HORRIBLE and TERRIFYING risk factors accompany it!

    How did you find out about this? Do you know how common it is to use it in natural birth/homebirth situations…I’m imagining that it must be used even more in birth centers?

    *sigh* Just when you think you have a safe, protective, looking out for your interests option in childbirth!

    • Motherhood,

      I don’t think this is COMMON. But the fact that it’s being used at all is too “common” for me. It is a question I would certainly ask any midwife I interviewed to use. “Do you use cytotec for inductions?” or better, “Will you induce me if I want you to with meds?” This will revela MUCH about her practice philosophy. One that you may or may not be comfortable with.

  2. Yes, it’s disappointing to hear, isn’t it? I’d heard the same thing. Sad.

    I have one MW friend who has said that if miso was available for MW in this state that she would use it for severe postpartum hemorrhage, but nothing else. That might be more sensible – use it only when there’s not a baby involved, and in severely controlled amounts. I don’t know enough about its use for that purpose to know how useful it is, but I agree completely that its use in labor is nothing short of criminal.

    Keep the drum beating!

  3. Would it be alright with you if I included this article – name and link – as well as your blog link in my “Fully Dilated” birth blog carnival?

    It’ll be my first one and I am hunting down really outstanding posts. This one about miso was great! …If you have suggestions or recommendations for other articles/blogs, I’d be grateful for the direction!!

    Thank you for considering!

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