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Re: Cytotec vs. Cervidil

From: Amy (anonymous@obgyn.net)
Thu, 11 Feb 1999 12:46:52 -0600 (CST)

>Neither you nor your midwife may like my answer. Cervidil is a good system, but Cytotec is better, cheaper, faster, and safer (the last is my own opinion, though I think it is supportable in the literature). Frankly the two have slightly different indications, also in my opinion. Cervidil is good for ripening an unripe cervix. The fact that you
delivered so quickly with it tells me that your baby needed just the smallest nudge to hit the road so to speak. Cytotec takes you to contractions faster, as well as ripening the cervix. The time to labor, and the time to delivery are shorter, with no increase in complications. You can also dose more frequently if necessary.

>I do not understand being afraid to use Cytotec for a VBAC, when she appears to be willing to use the other agents. There are those that will not use any agent for a VBAC, but all agents have the same results, contractions. If you are willing to use one, you should be willing to use the others, at least in principle.

>Pitocin is not a good agent for use with an unripe cervix, but if you are contracting, the other two agents are contraindicated. Plus, pitocin (after all, this is the very hormone your own body makes to have contractions) is adjustable, has a short half life (so it goes away
quickly if you need it to), and most importantly, gets the job done.

>Why do you need an induction? Maybe you will go into labor on your own.
That is the best way of all.

Dr. McIntosh.

I am not convinced that Cytotec is better than Cervidil. From what I have been reading, the dosage of Cytotec that is applied to the cervix is not as controllable as Cervidil, and may cause frequent, tetanic contractions, which I believe is a contraindication, especially in a woman with a uterine scar (though ruptures can occur in unscarred uteri as well).

I disagree that Pitocin is "the very same hormone that your own body makes to have contractions." Pitocin is synthetic oxytocin and not the same thing. Michel Odent is doing research on Pitocin and is finding evidence that the pituitary gets "tricked" into thinking it has already produced enough Pitocin and therefore stops making it... therefore requiring more Pitocin to keep the labor going. He also says that oxytocin (the natural stuff) is the "hormone of love" and is at the highest levels it will ever be in both mother and baby in the first few hours after birth. If Pitocin has been used continually, natural oxytocin won't be present, which can hinder the bonding process in those crucial first hours after birth.

>Why do you need an induction? Maybe you will go into labor on your own.
That is the best way of all.

Agreed!! 

--
Amy DeRuyscher
Provisional Birthworks CCE
Provisional Birthworks Doula



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