Not a birth prof. but wanted to share my Cytotek experience. With my first baby, I was 42 weeks when the birth center where I was to deliver began to talk about sending me to a hospital for induction. A pitocin/cervadil induction with IV, CEFM, (and probably an epidural/emergency cesarean knowing I labored over 24 hrs and pushed for 3) At a hospital I had never visited and an OB I had never met. Basically the problem was they were not insured to attend a birth past 42 weeks, and so that was the problem--liability. I was very pro-natural birth and prepared to go late, but not prepared to find a backup care provider or plan a homebirth at 42 weeks. I had tried everything "natural"--accupressure, sex, castor oil, black and blue cohosh, I even consented to having my membranes stripped and my cervix manually stretched. The midwives at the birth center did some creative accounting and moved my due date back so that I wouldn't be "officially" 42 weeks until the following Tuesday.
At a checkup on a Friday (when I was 42 weeks 2 days) I consented to have 25 mg. of Cytotek inserted vaginally. I knew all about the drug and its risks. Basically, what we discussed was it was a small dosage (they manually quartered the 100mg pill) and I was to stay in close contact with them throughout the evening for ANY change. I accepted this intervention, knowing full well the risks, because
1) the data do show some increased risks for babies somewhere past 41ish weeks. . .not huge but still, enough that I was becoming concerned that the risk of waiting was becoming even or equal to the risk of intervening in some way to encourage labor. (now I know so many 42+ week women IRL and online I probably would not feel the same way)
2) I was very fearful of the hospital induction scenario. They actually called and scheduled me for an 8:00 Tuesday a.m. check-in for my induction. My midwives wouldn't be there, I didn't have a doula. . .I didn't even KNOW a midwife who did homebirths. . . I had no experience or wherewithal at that time in my life to pursue a UC or a homebirth--I would NOW, but I was not at that place in my life.
3) The amount was small and I was told that if it would work, it would work quickly. . .that it wouldn't kick in later over the weekend when I was on my own.
Well, it did absolutely nothing. No change to my cervix or dilation, no increase in contractions (just the same old BH) It was inserted at around 5pm on a Friday and my labor didn't even begin until very late Saturday night (close to bedtime, over 24 hrs later) I did not have a hard, fast Cytotek labor, rather, a pretty typical first-time labor, where I stalled at a 4cm on Sunday, went home, had dinner, and things picked back up overnight, by Monday 5am I was 10cm and had 3 hrs. of pushing. . .delivered by 8.