I'm scheduled to go in tomorrow night to start Cytotec. I'll be 41w4d. I'm terrified of Cytotec for the obvious reasons but agreed to it because I'm more scared of being put on pitocin first and not progressing at all because my cervix is unchanged. There are no hospitals within 300 miles of me that offer Cervidil or anything else to ripen the cervix.
I was checked last night at 41w2d and was almost a fingertip dilated and a little soft. So, basically, it's just not likely to happen.
How do you all feel about Cytotec? Does anyone have any experience? Please help calm me down. I'm terrified.
TIA!
ETA: Oh, I forgot to mention, I've been planning a natural, HypnoBabies birth this entire pregnancy and am still planning on no epi. I'm very disappointed with having to be induced, but things just don't seem to be progressing no matter what I've done.
Re: Cytotec Induction Tomorrow
That seems incredibly strange that they wouldn't offer Cervidil as an alternative. I just can't imagine that they wouldn't be able to get their hands on any.
I personally would not be comfortable with Cytotec. The risks seem too high to me, especially knowing that Cervidil is an option. On the other hand, I totally understand why you don't want to jump straight to Pitocin. Do you have any other options? Certainly they could try something else besides Cytotec or Pitocin.
Also, I know you didn't really talk about this, but are you being induced for medical reasons? You mentioned "not progressing", but you still have PLENTY of time to go into labor on your own and your current dilation/effacement mean nothing as far as when you'll go into labor. Most FTMs don't go into labor on their own until 8-10 days after their EDD (so, right around where you are!). You certainly don't need to justify your reasons to me, so please don't feel like you have to! But if it were me, I would really try to avoid the induction unless there was a medical reason and the pros of undergoing induction outweighed the cons. Especially considering they're trying to get you to use Cytotec. JMHO!
GL!
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I agree with both PPs. You're wise to be leery of Cytotec. It isn't approved for obstetric use. I cannot understand why they are still using it! I would push hard to get to at least 42 weeks before induction and even then I would opt for more monitoring and as long as you and babe are doing well, let it go even longer. if you're a little soft and a little dialated there is no reason to think you can't become more soft and more dialated. You deserve the birth you want. Don't let these guys take it from you.
Good luck, mama.
unless there is a medical reason, I would totally opt out.
1) you said "it isn't likely to happen." Maybe, but you don't know that. You can go from nothing to completely dilated in a short period of time. Just because you don't dilate slowly doesn't mean that you won't dilate.
2) Cytotec is not approved. Most hospitals won't use it.
These are all red flags. I wouldn't show up to the induction. Your provider can't force you, and he won't drop you from care unless he can transfer your case to another provider.
I will not agree to using cytotec unless they actually do the testing required to insure it is safe. I would take pit without a ripening agent first.
Is the foley bulb an option if you do consent to induction?
Lurker here:
I was induced in June with Cytotec. Prior to the induction, I had a long conversation with my OB regarding Cytotec vs Cervadil, and in the end felt reassured that Cytotec, as used in my hospital, was safe. He conducts clinical research trials and explained that the preliminary results from one comparing Cytotec to Cervadil was showing the former more effective in inducing labor and thus a lower risk of ultimately needing a C-section. I was 2-3cm dilated and 75% effaced when I checked into the hospital. After eight hours of Cytotec overnight, I was all of 80% effaced, and so I required pitocin to actually start labor. It all went just fine in the end, though I was not planning on a med-free childbirth.
As for many of the arguments against Cytotec, here's something that offers a different perspective: https://doula2you.com/2011/06/30/the-great-cytotec-debate/#comments
Whatever you decide, good luck, and congratulations on your new baby!
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Is there any reason why your OB wants to induce you tomorrow as opposed to giving you a couple of more days? In my experience dilation and effacement have not been accurate predictors of my LOs arrival. DS arrived at 41w6d and I was hardly effaced or dilated the day before he arrived. With DD I walked around 4cm dilated for a couple of weeks. Best of luck!
Honestly, I'm all about doing your own research and making peace with whatever you feel is right so you are totally entitled to have arrived at the conclusion that Cytotec was the way to go for you, but I just wanted to point out that they may feel that it's more effective at inducing labor, but it is generally thought to be riskier to mother and baby. The FDA (while they haven't made any move to actually keep the drug from being used for induction, and of course plenty of drugs are used in "off-label" ways) they have come out with a statement that they have no proof that the drug is safe to be used in this manner. Package inserts from the manufacturer are totally CYA so it doesn't surprise me that the manufacturer has included info to say it's not approved for inductions, but the FDA making a statement against it certainly sways me in the direction of it not being safe. Plus, just the nature of the drug (it can't be removed if there are adverse effects) is really scary.
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Very good link jess9802
There are actually many hospitals that will not even carry cervidil anymore, where I work is starting to become one and completely phase out cervidil and will only be using cytotec or foley bulb if the pts cervix is open enough to be able to insert it.
One reason that they are switching to cytotec only is that you are able to use cytotec in pts with asthma where cervidil is risky for asthma pts due to it can cause very bad bronchospasms. And ever the last 5yrs we have seen a significant increase in the pts that have asthma, almost every pt you admit has asthma.
Bottom line you have to choose what is right for you.
I think this was important to bring up. I was induced with cytotec. It has a good safety record if used properly and it is very inexpensive. I was induced with cytotec before moving in to pitocin. I had uterine hyper stimulation from the cytotec after 2 doses, so they quit administering it, and things calmed down.
The cytotec did ripen my cervix though and I only had pitocin for 2 hours. I then had my medical team try turning it off yes, this can be done! I had a non medicated birth with all this stuff. Just because you are being induced doesn't mean an automatic epidural or c section.
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I am a few days late to this post but thanks for sharing that link. The fear-mongering about Cytotec/misoprostol in the NB community makes me crazy. Many, many drugs are used off-label. That does not mean it is unsafe. In fact, there are numerous studies showing that miso is safe and effective for labor induction. Its risks are comparable to Cervidil's and miso is more effective. And we should consider that a more effective induction agent will lead to lower cesarean rates, lowering the risk to the mother of all the complications associated with c/s (assuming for the sake of argument that these are medically-indicated inductions).
Many many many women have died from Cytotec. It is NOT a drug used for pregnancy. I am shocked your doctor even said he/she would use it.
Here is the info I have on it. I would highly recommend NOT getting it.
Cytotec/Misoprostol
Approved Use: Prevention of stomach ulcersUnapproved Use: Abortion, pregnancy, labor, delivery and lactation
Common Off-Label Use: Labor induction, abortion, cervical ripening agent, postpartum bleeding
Specific Warnings: "Cytotec is not approved for the induction of labor and delivery or abortion. Cytotec is a synthetic analog of prostaglandin E1, and as such can induce or augment uterine contractions. Cytotec has been used outside of its (FDA) approved indication, as a cervical ripening agent for the induction of labor or abortion, in spite of specific contraindications to its use during pregnancy." Both the FDA and its manufacturer issued statements in 2000 that it is not to be used for induction of labor, delivery, or abortion. Drug has a picture of a pregnant woman with a line through it as a universal symbol to avoid while pregnant.
Documented Risks: Uterine rupture, maternal death, fetal death, uterine hyperstimulation, uterine perforation, amniotic fluid embolism, vaginal hemorrhage, retained placenta, fetal bradycardia, hysterectomy
Source: Physician's Desk Reference page 2991