The Cytotec Pandemic- Losing her uterus, her life, her baby.
A story of a mother, a mother I personally know; a victim of this system, a system that was supposed to protect her? A system she trusted to keep her safe failed her. Before coming to US, she gave birth to beautiful kids in a place which is considered unsafe, a place where there are no monitors, a place where people there was no access to blood transfusion, a place where she was surrounded by loving friends and families. She had her babies, safe and sound there.
After coming here, she become pregnant. She started her prenatal care at one of the “biggest hospitals, new buildings and knowledgeable doctors” as she said. She trusted the care she was receiving whole heartedly. She followed all directions they were giving her and never asked why; she didn’t know she can ask why they recommend what they recommend, that she can make a choice, that she can say ‘NO’ to some of the recommendations if she thought she doesn’t need it or is not necessary for her. And also, she doesn’t know most of the things they recommend because of language difference too.
This same woman lost her uterus, was transfused three liters of blood, almost lost her life and her baby is well alive but has to do bunch of checkups because the baby lost oxygen for some time, until they recognize her uterus has ruptured and rush her for emergency i would say laparatomy. She was given Cytotec twice three to four hours apart and she didn’t feel any contraction. Then she felt back pain and told the nurse, where the nurse encouraged epidural. Mom thought epidural would help with progress of labor so she said okay, not understanding what it does. Fifteen minutes after the epidural, she felt her belly dropping to one side, kind of, and provider came to check. I think they saw baby’s heart beat change? Just my thinking. She checked her cervix and told her to push, then heart beat went low. (Again, I think when she felt her belly dropping to one side was when her uterus ruptured and she doesn’t feel any pain since she’s on epidural. The provider actually told her to push without knowing then lost fetal heart beat).
So, in the biggest hospital, with available continuous fetal monitoring and best trained providers, this poor woman who walked into the hospital healthy (I’d say healthy because blood pressure might rise because of many circumstances. I also believe that she may have had some problem and their decision to induce her might be right too) lost her uterus and almost her life and her baby. This is not the first time I heard this kind of story specially from black, immigrant women. Lots have lost their uteruses, lots have lost their lives, lots have lost their baby’s lives and others, live with a disabled child.
What’s Cytotec anyway?
Cytotec (Misoprostol) is a prescription medicine mostly used as a prophylaxis to prevent ulcer and also to terminate pregnancy or cause abortion. This medication is not approved for labor induction use by FDA ,and it is cheap to get. According to FDA, there is no scientific evidence so far to show its use to induce labor is safe. Use of cytotec is linked to uterine rupture specially in women who have previous surgeries that involved the uterus and women who had multiple births.
Lots of researches had shown that risk of rupture is higher with this medication and yet it is the number one choice in hospitals for cervical ripening medication. Usually, when labor is induced with cytotec hyperstimulation of the uterus happens and labor goes really fast. Women are traumatized by their birth experiences because everything happens so fast and is sometimes scary. They are not told that there is a chance they might have a precipitous labor or that there is a chance their uterus might rupture. With accidental uterine rupture, the chance of repair is almost none mostly and removal of the uterus is most likely. I don’t want to even start talking about complications that come with losing a uterus at a young age. The mom told me one of their friend who is a doctor himself said to her “Women choose to even do hysterectomy by choice so don’t worry, you’ll be fine. You should be thankful you and your child are safe”. I just wish that I was there when he said this and slap him? It makes me so mad!
It’s data for the hospitals, for the system. It is life for us! WE are losing our organs, our moms, our babies. I have seen a lot of complications with this medication. I have seen a mom traumatized by a less than three hour birth, not able to wrap her head around what just happened. I have seen a mom with the story, who lost her uterus and has a child that she can’t leave for a second because the child is disabled from loosing oxygen. I have heard a lot of stories in the immigrant community, pretty common there. They don’t know and they don’t ask. They don’t even know what losing a uterus means. Many don’t understand what they’re told due to language issue, they are not told the truth either.
After saving her life, and expected her to be thankful for that, her baby was in the NICU for about two weeks because they have to be sure to discharge him. She has to go to the hospital everyday with a wound on her belly to see her child. She was told not to breastfeed. They told her to pump and then they will test and give it to the baby (I don’t know what they test it for). It was very sad to see her suffer like that. She was very depressed, was not able to eat properly, all she wanted was to sit there and look at her baby. She was confused and disoriented.
This is a mom, a black mom, an immigrant mom who walked to the hospital with a healthy pregnancy baby and walked out of the hospital with no uterus, without her baby. This is the mom who has to do two or more trips to the hospital to see her baby until baby is discharged, There is more to the story but I’ll leave it here. We have enough evidence to show less is better. We have options and moms deserve to know this options as they can understand and make an informed decision. We have a responsibility to protect them.
For the people who are new to this developed world, for who English is their second language and doesn’t know the communication system, I think the ‘system’ should do more than handing them a paper to sign and jump to procedures and interventions. When that person agrees to sign, they are signing either because they understood what they have been told, or they are scared to say no and deal with the consequences, or they are terrified thinking they might loose their baby or their own life (mostly because providers use scare tactics) or they don’t want to admit they don’t understand English very well and they agree to everything they have been told (THIS IS A BIG DEAL FOR MANY OF OUR PEOPLE AND WELL, SPEAKING ENGLISH IS PORTRAYED AS BEING MODERN SO WE TEND TO PRETEND TO KNOW MANY TIMES!) and are shy to ask for an interpreter which many hospitals have now but the providers have no idea this even exists. So we need solutions from every corner. Understanding cultural differences exist and being sensitive is also important. Because they don’t know what options they have and they don’t usually say no to many unnecessary interventions, this people are suffering a lot without even knowing what happened. It is becoming very hard to find a woman who has her child naturally these days. This is true for everyone but mostly true for immigrant families.
We do have alternatives to use of Cytotec for induction of labor including doing nothing specially when mom and baby are doing good. Most common reasons for induction these days are not life threatening to mom and baby. So, in avoiding these unnecessary inductions with dangerous medications, we safe lives, we prevent complications and we prevent traumatic birth experiences.
A data for them, an organ for us, a life for us!