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My midwife uses Cytotec!!

post #1 of 69
Thread Starter 
Shouldn't I be concerned? I have heard such awful things about it and I know doctors still use it, although it's not FDA approved, but a midwife??
post #2 of 69
It's really disappointing, and frustrating!:
I see you're in NY, I'm in NYC and Cytotec is popular with some midwives who work in hospitals.

It's so beyond my comprehension why they choose such a controversial unsafe drug, they defend it when you ask them about it!

Does your Homebirth midwife use Cytotec at homebirths?
Change midwives if she does!
post #3 of 69
I'd personally be concerned. Doesn't mean that she will use it on you though...! Just make sure you dont let her.
post #4 of 69
Id ask why and how she uses cytotec before freaking out. My HB midwife gave me a cytotec after dd was born because my placenta only partially detatched and I was bleeding pretty heavily.
post #5 of 69
anyone want to add some of this info on cytotec? I just delivered at home and this was given to me b/c of bleeding.
post #6 of 69
A lot of HB midwives will carry it for PPH, usually as a last resort medication if Pitocin and Methergine still aren't stopping the blood loss. The potentially dangerous side of Cytotec (uterine hyperstimulation, rupture, fetal distress) is when it's used as an induction/ripening agent; it's a different issue when used for PPH. Now if your HB midwife were using it for induction/ripening, rather than just for PPH, I would be very concerned.
post #7 of 69
Quote:
Originally Posted by rixafreeze View Post
A lot of HB midwives will carry it for PPH, usually as a last resort medication if Pitocin and Methergine still aren't stopping the blood loss. The potentially dangerous side of Cytotec (uterine hyperstimulation, rupture, fetal distress) is when it's used as an induction/ripening agent; it's a different issue when used for PPH. Now if your HB midwife were using it for induction/ripening, rather than just for PPH, I would be very concerned.
:
post #8 of 69
What is she using it for? I think it works really nicely for PPH if pitocin isn't doing the trick.
post #9 of 69
Yeah, I had cytotec in the hospital (homebirth transfer after 44 hours of non-progressing labor) but I had it because I hemoraged real bad. I could have died...literally. I lost so much blood they thought about transfusion. Anyways, my midwife does carry it but as a last resort option and only of PPH not for induction of any sort. I would check on that and see why yours carries it. If it will save your life and they would use it in the hospital if you were there, is there really cause for oppostion??? Everyone has different reservations about things so I think you need to investigate further!!!
post #10 of 69
Thread Starter 
Quote:
Originally Posted by dewi View Post
It's really disappointing, and frustrating!:
I see you're in NY, I'm in NYC and Cytotec is popular with some midwives who work in hospitals.

It's so beyond my comprehension why they choose such a controversial unsafe drug, they defend it when you ask them about it!

Does your Homebirth midwife use Cytotec at homebirths?
Change midwives if she does!
Yes, she's a homebirth midwife.

And yes, it's for PPH. But even so, the risks with Cytotec are still very awful. I suppose others look at it in a "well, it's that or bleeding to death" sort of way, but frankly I'm worried about that.
post #11 of 69
Quote:
Originally Posted by Raene View Post
Yes, she's a homebirth midwife.

And yes, it's for PPH. But even so, the risks with Cytotec are still very awful. I suppose others look at it in a "well, it's that or bleeding to death" sort of way, but frankly I'm worried about that.
I would have to say, a completely untreated severe PPH has even greater risks than Cytotec. I would imagine she isn't giving it to every client, correct? If so, then I would find a new care provider. However, I would find it reasonable if it was her last-resort type of medicine for a severe PPH.

Is there something else you would prefer she uses? If so, discuss that with her and see what she says.
post #12 of 69
Quote:
Originally Posted by Raene View Post
Yes, she's a homebirth midwife.

And yes, it's for PPH. But even so, the risks with Cytotec are still very awful. I suppose others look at it in a "well, it's that or bleeding to death" sort of way, but frankly I'm worried about that.
But the risks with cytotec are not very awful when used postpartum. Diarrhea, blood pressure changes, nausea, afterpains. About the same for other drugs used for PPH, like methergine. All of the really bad stuff, like uterine rupture, aren't an issue postpartum.
post #13 of 69
Thread Starter 
Okay, this is good to know. Thank you!!
post #14 of 69
I would generally run in the opposite direction. Pit is approved for those postpartum uses, why not just use that?

I am curious about why uterine rupture is not an issue postpartum. It was my understanding that you did not have to have a baby inside to have UR. They are supposed to be extremely violent, constant contractions. Also there is the issue that there is no correct dosing for Cytotec and doctors just give whatever they think is good. You can't turn it off once you've taken it, and I've read (admittedly very rare) stories of Cytotec contractions going on for days.
post #15 of 69
Because pit doesn't always work. I had a severe postpartum hemorrhage that was not responsive to pit, methergine or anything else.
post #16 of 69
All the homebirth midwives here in San Diego carry it. It is for severe emergency bleeding, not induction.
post #17 of 69
Quote:
Originally Posted by Sk8ermaiden View Post
I would generally run in the opposite direction. Pit is approved for those postpartum uses, why not just use that?

I am curious about why uterine rupture is not an issue postpartum. It was my understanding that you did not have to have a baby inside to have UR. They are supposed to be extremely violent, constant contractions. Also there is the issue that there is no correct dosing for Cytotec and doctors just give whatever they think is good. You can't turn it off once you've taken it, and I've read (admittedly very rare) stories of Cytotec contractions going on for days.
Uterine rupture is very rare (if at all, I don't know if there are postpartum cases of it or not) because your uterus is no longer totally stretched out. Think of it as popping a balloon that is fully inflated versus one that just had a bit of air in it by squeezing. The one that is full will pop much easier than the one with just a tiny bit of air in it.
post #18 of 69
Quote:
Originally Posted by Raene View Post
Yes, she's a homebirth midwife.

And yes, it's for PPH. But even so, the risks with Cytotec are still very awful. I suppose others look at it in a "well, it's that or bleeding to death" sort of way, but frankly I'm worried about that.
What risks? Once the uterus is no longer pregnant, there is no risk of UR. There have not been any documented cases of UR with misoprostol used postpartum. It's like turning off a frigging faucet most of the time. Miso is my go-to drug, over methergine, hands down for a PPH.

Fear is not a good place to make decisions from.
post #19 of 69
Quote:
Originally Posted by Sk8ermaiden View Post
I would generally run in the opposite direction. Pit is approved for those postpartum uses, why not just use that?

I am curious about why uterine rupture is not an issue postpartum. It was my understanding that you did not have to have a baby inside to have UR. They are supposed to be extremely violent, constant contractions. Also there is the issue that there is no correct dosing for Cytotec and doctors just give whatever they think is good. You can't turn it off once you've taken it, and I've read (admittedly very rare) stories of Cytotec contractions going on for days.
Pitocin doesn't work everytime on every person. It also has a much shorter duration. That is fine for some people as they stop bleeding and that is the end of it. Some people though will stop bleeding and then as the pitocin wears off (about 30 minutes later), they begin gushing again. Cytotec lasts much longer, so it can be given in addition to pitocin, if needed. Yes, it can't be stopped once it has started, but IM pitocin can't be stopped either.... once the shot has been given, that is it, there is no getting it back. Absolutely the contractions with cytotec can be stronger and that is what stops the PPH. If a uterus isn't wanting to contract in order to stop bleeding and pitocin isn't working, then something needs to be used that will make the uterus contract.

As far as the uterine rupture goes... it is thicker after the baby is born. It shrinks up and the walls are thicker, so that also means they are stronger against a rupture.
post #20 of 69
If she's using it for PPH, I would not be concerned. I would perhaps talk to her about what her PPH protocol is, and see about getting a shot of pit first if you would prefer that (I would expect she'd try pit first anyway). But IMO cytotec is OK for PPH and can be lifesaving if necessary.
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