(There is a connection – stay with me here!)
Cytotec (misoprostol) is a drug for stomach
ulcers. However,
it is used "off-label" in the USA to induce labour, per obstetrical
guidelines. It’s not approved by the FDA for such use. In fact the manufacturer issued a written
warning against use of Cytotec for labour induction as it can cause hyper-contraction
of the uterus, which can lead to uterine rupture, which can obviously lead to
death.
So, when Cytotec is used as directed by the ACOG (American Congress of Obstetricians and Gynecologists),
a well documented, possible side effect is uterine rupture.
Ina May Gaskin started a quilt project in which each square represents a woman who died in childbirth. Many of these squares are dedicated to women who
received Cytotec induction.
This issue was raised by some classmates today. Many good points were made; the most obvious
being, why are Cytotec inductions allowed, despite ample evidence
to show it's a dangerous practice. It was suggested that this demonstrates
the extent of disregard for women and their bodies. My friend and classmate,
Kelly Graham, a passionate advocate for women's health, speculated, "I wonder how many (of these same) doctors would
prescribe Viagra if a side effect was penis explosion.” Or - another analogy - would we use a drug to help asthma if a possible side effect was ruptured lungs?
Enough said.
Want to explore further?
- Ina May Safe Motherhood Quilt Project: http://www.rememberthemothers.org/
- Ina May Gaskin article, Induced and Seduced: The Dangers of Cytotec: http://www.whatisaids.com/cytotec107.htm
- ACOG Induction Guideline: http://guideline.gov/content.aspx?id=14884
- A comparison of the American and UK guidelines for induction: http://guideline.gov/syntheses/synthesis.aspx?id=24079
- RCOG Induction Guidelines (UK), which recommend: “Misoprostol should only be offered as a method of induction of labour to women who have intrauterine fetal death or in the context of a clinical trial.” http://www.nice.org.uk/nicemedia/live/12012/41255/41255.pdf
- Canadian Induction Guidelines (discussion of Misoprostol starts at the bottom of p4): http://www.sogc.org/guidelines/public/107E-CPG-August2001.pdf
- Cytotec Pharmaceutical Insert, which begins with an all-caps warning enclosed in a text-box: “CYTOTEC (MISOPROSTOL) ADMINISTRATION TO WOMEN WHO ARE PREGNANT CAN CAUSE ABORTION, PREMATURE BIRTH, OR BIRTH DEFECTS. UTERINE RUPTURE HAS BEEN REPORTED WHEN CYTOTEC WAS ADMINISTERED IN PREGNANT WOMEN TO INDUCE LABOR OR TO INDUCE ABORTION BEYOND THE EIGHTH WEEK OF PREGNANCY.” http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019268s041lbl.pdf
- Warning sent to physicians from Searle, the Cytotec manufacturer: http://www.aims.org.uk/Journal/Vol13No3/searle.htm
- Henci Goer’s blog, ACOG’s 2009 Induction Guidelines: Spin Doctoring Misoprostol (Cytotec): http://www.scienceandsensibility.org/?p=467
