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.

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Off-label drug use

I understand that the off-label use of pharmaceuticals is a normal occurrence in the medical world. I get that. What’s not cool is that this is done in maternity care as well with dire consequences.

I’m not talking about the random, “uh-oh”, I’m referring instead to the drug company themselves issuing statements saying “We do not endorse the use of this product for any use other than that described on the label.” Yeah, they’re probably just covering their b*tts but still. They said it. Yet it happens everyday in the labor and delivery department of nearly every hospital in the country. It has become so commonplace to induce labor that not only have we stopped wondering how/if this affects the baby or the mother we have now started grabbing whatever drugs we can find that give us “a better induction outcome”.

Hrrumph.

Bishop’s score be damned. God created women’s body to birth. With consideration made for the odd-one-out with pituitary damage or other disorders that truly make her body hold onto her baby long past safely, using drugs to begin labor before the body begins to open up on it’s own is risky risky risky.

Births are kindof like bowel movements. They happen on their own. Can’t plan ’em, can’t stop ’em, can’t hurry them along. Bowel movements happen (errr… I can’t help but think of a certain bumper sticker I’ve seen alot of right now).

Birth HAPPENS as well. Babies are born when it is TIME. If we have accepted that every other body system has knowledge to know when to open and release, then why can’t we accept the body’s wisdom in birthing when it is time?

You might have had a Cytotec induction. And so did your sister, your friend, aunt, daughter’s 2nd grade teacher… and all went well. On the surface perhaps. But what did it do to that baby’s emotional/psychological health to be so rudely pushed into the world before he/she was ready to come? And what about the women reading this who is a victim of a cytotec induction who is grieving the loss of her womb? Suddenly hurrying a baby out seems less important when faced with an emergency cesarean to save your baby’s life and a hysterectomy to save yours.

All from a couple of tidy white pills manufactured to treat ulcers. Who’da thunk?