Cytotec: Ulcer Treatment or Abortion Pill?
Misopristol, a drug created to treat stomach ulcers is being used for an emergency contraceptive pill and labor inductions. How safe is Cytotec for labor?
What is Cytotec?
Cytotec is a common name for the drug, Misoprostol. Misoprostol is used to prevent the formation of ulcers in the stomach during treatment with aspirin or an NSAID such as ibuprofen. The FDA warns on the drug label "Do not take misoprostol for the prevention of stomach ulcers if you are pregnant or if you might become pregnant during treatment. If you do become pregnant during treatment with misoprostol, stop taking the medication and contact your doctor immediately."
Misoprostol is in the FDA pregnancy category X. This means that misoprostol is known to be harmful to an unborn baby. Misoprostol can cause miscarriage or spontaneous abortion (sometimes incomplete which could lead to dangerous bleeding and require hospitalization and surgery), premature birth, or birth defects. Misoprostol has also been reported to cause uterine rupture (tearing) when given after the eighth week of pregnancy, which can result in severe bleeding, hysterectomy, and/or maternal or fetal death.
However, Cytotec is being used on the black market as abortion pills.
Alberta Hackman, 17, a student was allegedly given Cytotec, an ulcer capsule being used as an emergency contraceptive pill, by the two suspects to terminate her two-month-old pregnancy.
When Alberta realized that she was pregnant, she told her acquaintance Portia Darko to help her abort the fetus. Portia in turn contacted Ama Nkrumah, a drug peddler in the area, to help them with the abortion.
Madam Nkrumah gave some tablets of Cytotec to Portia to be taken by the deceased when going to bed. “Instructions were that she should swallow five of the tablets and insert two into her vagina.”
Alberta Hackman carried out the orders but bled profusely for days. Mother of the deceased, Georgina Tei took her daughter to Amoah Hospital at Awoshie where Dilation And Curettage also known as D and C was carried out on her to remove the remaining fetus. However, Alberta was transferred to two other hospitals before being declared dead at Ridge Hospital.
Cytotec is also being used to augment, or induce, labor.
Marsden Wagner, a Washington, D.C., perinatal epidemiologist, estimates that every year at least 150,000 U.S. women (about 3 percent of all births) are given Cytotec to start labor. However, Ina May Gaskin, the United States' leader in midwifery says this number could be much higher. Physicians began incorporating Cytotec into labor in 1992.
Why is Cytotec being used to induce labor?
The first reports of the obstetric use of Misoprostol indicated that it could be highly effective for starting labor in women, whether or not their cervixes were ripe. Cytotec had already been used in combination with other drugs as a chemical abortive, so doctors keened the question, why not use it as an induction medicine? Lacking other information, many physicians began incorporating it into their practices.
What are the risks of using Cytotec during labor?
Cytotec can cause abnormally strong contractions, called hyperstimulation. This can cause severe problems to the mother's uterus and damage the fetus. Cytotec can cause the uterus to rupture, endangering the mother and the baby, and often leading to death.
In the study mentioned above by Ina May Gaskin, 100 births she observed that were administered Cytotec, 20 of the women suffered ruptured uteri. Generally, mothers do not due of uterine rupture, but often the babies do, and the mothers must have a full or partial hysterectomy, and gone forever is the possibility of having another baby.