Introduction
Birth is one of the most natural processes in human history. It is a time when new life enters our world and creates a memory that will last until we die. Unfortunately, birth rates have declined significantly over the past few decades due to medical interventions such as Cesarean sections (C-sections) which are performed on more than 1 out of every 4 babies born today in the United States (according to Centers for Disease Control & Prevention). Cesarean section rates were higher before 1980 but have been rising steadily ever since then due to factors such as obesity, socioeconomic status and lifestyle choices among other things (Wyatt et al., 2018), making it more difficult for women who want to give birth vaginally without any medical intervention at all (Brucker et al., 2017).
Given the increasing number of Cesarean sections and the associated complications, there is a shift towards a more patient-centered maternal care (Brucker, Althabe, Belizán, Gülmezoglu, & Betrán, 2017; World Health Organization, 2018).
Given the increasing number of Cesarean sections and the associated complications, there is a shift towards a more patient-centered maternal care model. In this model, women are encouraged to make their own decisions about their birth experience and should be respected as individuals with rights to autonomy over their bodies (Brucker et al., 2017; World Health Organization [WHO], 2018). This includes being able to decide how far along they are in labor before having an induction or undergoing a vaginal delivery (Hussein & Kotwal, 2011). The WHO recommends that there should be no limits on how many inductions may be done prior to labor onset; however most countries have policies limiting this number either through legislation or common practice within hospitals (World Health Organization [WHO], 2018).
The most common policy put into place to reduce rate of Cesarean sections is the restriction of labor inductions for nulliparous women.
The most common policy put into place to reduce rate of Cesarean sections is the restriction of labor inductions for nulliparous women. This policy is based on the assumption that spontaneous labor is safer than induced labor, which has been shown to be untrue in many studies. While there are some benefits associated with having a vaginal birth, they are outweighed by the risks associated with a surgical delivery and neonatal outcomes postpartum (1).
The term “spontaneous labor” describes all types of spontaneous deliveries, both natural and induced; however, this term does not indicate whether these deliveries occurred naturally or through medical intervention.
Cytotec has been approved for more than half a century for uses other than induction of labor.
Cytotec is an anti-ulcer drug that has been approved for more than half a century. It is also used to treat stomach ulcers, Crohn’s disease, and ulcerative colitis.
Cytotec is not considered evidence-based for induction of labor because it has not been studied in randomized controlled trials (RCTs). The FDA does not require that drugs be studied before they are sold or distributed; instead, companies can provide safety data based on postmarketing surveillance reports.
Cytotec use to induce labor has been associated with risks greater than those associated with physiological childbirth including uterine rupture and postpartum hemorrhage (Räisänen & Heinonen, 2018).
- Uterine rupture: The use of cytotec to induce labor has been associated with risks greater than those associated with physiological childbirth including uterine rupture and postpartum hemorrhage (Räisänen & Heinonen, 2018).
- Postpartum hemorrhage: In addition to the risk factors for postpartum hemorrhage that are common during childbirth (e.g., increased blood loss), one study found that women who had given birth or undergone an abortion using Cytotec had an increased risk of developing postpartum hemorrhage compared with those who had not used the drug (Peltonen et al., 2002; Tynkkynen et al., 2003).
In early 2000s, Pfizer made some modifications to the original design (Mather et al., 2010).
In early 2000s, Pfizer made some modifications to the original design (Mather et al., 2010). The second-generation agents are preferred over prostaglandin E1 in comparison with Dinoprostone induction due to less side effects but longer time required for induction.
The effect of prostaglandins was confirmed by Brantsaeter et al. (2006) in a study that found that women in induction group have a higher risk of uterine rupture compared to those in spontaneous labor group regardless if the induction agent was used or not.
The effect of prostaglandins was confirmed by Brantsaeter et al. (2006) in a study that found that women in induction group have a higher risk of uterine rupture compared to those in spontaneous labor group regardless if the induction agent was used or not.
In addition, there have been several studies showing an increased incidence of postpartum hemorrhage and uterine atony among women who undergo induced labor compared to those who deliver naturally (Brantsaeter et al., 2006). These complications can lead to serious outcomes including fetal distress and neonatal asphyxia which may result in death for both infants and mothers respectively (Joosten-Vanderlinden et al., 2007).
Second-generation agents are preferred over prostaglandin E1 in comparison with Dinoprostone induction due to less side effects but longer time required for induction (Carlson et al., 2017).
Second-generation agents are preferred over prostaglandin E1 in comparison with Dinoprostone induction due to less side effects but longer time required for induction (Carlson et al., 2017).
Second-generation prostaglandins include misoprostol and dinoprostone, which induce labor by causing uterine smooth muscle contraction.
Conclusion
The use of induction agents to induce labor has been shown to be more effective for low-risk patients and women that have a strong desire to give birth (Brucker et al., 2017; World Health Organization, 2018). Cytotec is an excellent choice in this case because of its ability to be used without any side effects or complications.
