Read Online Born in the USA by Marsden Wagner - Free Book Online Page A
Authors: Marsden Wagner
Ads: Link
doubled from 10 percent to 20 percent of births in the 1990s, an increase almost certainly due to the rampant use of Cytotec. 10 A survey in 2002 showed that 44 percent of all births are induced with uterine stimulant drugs. 11 Furthermore, data from the CDC tell us that much of this induction was done for convenience, as it parallels an increasing trend during the 1990s for vaginal births to take place Monday through Friday during daylight hours. So doctorsâ convenience has led to unnecessary labor induction, which has led to womenâs deaths.
The convenience factor is strong motivation for obstetricians to induce labor. Scheduling a labor induction, like scheduling a C-section, is a godsend to a busy, often sleep-deprived doctor. It offers the hope of practicing âdaylight obstetrics.â Many doctors have told me with satisfaction that when they bring a woman to the hospital in the evening and induce her with Cytotec (weekday evenings only, never on weekends), she will typically give birth by late the next afternoon, so the obstetrician can be home in time for dinner.
Induction of labor is an important convenience not only for obstetricians but also for hospitals, as it allows hospitals to organize an induction assembly line, with slots into which doctors can fit their patients. This assembly-line approach is confirmed by the printed protocol in a large hospital in Florida, âScheduling Induction for Labor.â 12
In about 10 percent of all births there is a medical reason to induce labor with drugs, and before 1990, 10 percent was the rate of induction in most industrialized countries. Pitocin, which is a synthetic version of the naturally occurring hormone oxytocin, has been used to induce labor for decades. It has been approved by the FDA for this purpose after adequate, careful scientific assessment of its efficacy and risks, and we know a great deal about how best to use it.
Given that there is already a well-tested drug that can be used for induction, why did obstetricians start using Cytotec? There are several reasons. One is that Pitocin is administered with an intravenous drip (IV), whereas Cytotec doesnât require an IV, so itâs easier to administer. It is in pill form and is given orally or inserted into the vagina. However, the form of the drug presents special difficulties when used for labor induction. Because Cytotec is made for patients with stomach ulcers and was never intended for use on pregnant women, it comes only in 100 and 200 microgram tablets. After a decade of unauthorized experimenting, 25 micrograms hasemerged as the usual dose for labor induction. Have you ever tried to break a tablet that does not have a line down the middle or used a razor blade to cut it in half and then into quarters? Needless to say, the size of each quarter is never exact. Nevertheless, this is what some hospital pharmacies all over the country are doing. (Other hospitals find this unacceptable and do not allow induction with Cytotec because their pharmacies refuse to dispense inaccurate dosages.)
The convenience of using Cytotec is also a liability in that the drug is quickly absorbed and stays in the body for hours. Whereas a Pitocin IV can be pulled if any adverse effects arise, thus stopping the effect of the drug in seconds, when problems develop with Cytotec, there is very little that can be done to reverse its effects.
Another benefit of Cytotec that is frequently discussed among doctors is that it costs less than other drugs used for labor induction. It is surprising to hear doctors talk about saving money since, unless they have a financial interest in the hospital or clinic where they practice, it is not really their money. Cytotec is indeed far cheaper than other drugs used for induction of labor, but the question is, why is it so cheap? It is cheap because the pharmaceutical company has not spent the money on experimental clinical trials that would be required by the FDA to
The convenience factor is strong motivation for obstetricians to induce labor. Scheduling a labor induction, like scheduling a C-section, is a godsend to a busy, often sleep-deprived doctor. It offers the hope of practicing âdaylight obstetrics.â Many doctors have told me with satisfaction that when they bring a woman to the hospital in the evening and induce her with Cytotec (weekday evenings only, never on weekends), she will typically give birth by late the next afternoon, so the obstetrician can be home in time for dinner.
Induction of labor is an important convenience not only for obstetricians but also for hospitals, as it allows hospitals to organize an induction assembly line, with slots into which doctors can fit their patients. This assembly-line approach is confirmed by the printed protocol in a large hospital in Florida, âScheduling Induction for Labor.â 12
In about 10 percent of all births there is a medical reason to induce labor with drugs, and before 1990, 10 percent was the rate of induction in most industrialized countries. Pitocin, which is a synthetic version of the naturally occurring hormone oxytocin, has been used to induce labor for decades. It has been approved by the FDA for this purpose after adequate, careful scientific assessment of its efficacy and risks, and we know a great deal about how best to use it.
Given that there is already a well-tested drug that can be used for induction, why did obstetricians start using Cytotec? There are several reasons. One is that Pitocin is administered with an intravenous drip (IV), whereas Cytotec doesnât require an IV, so itâs easier to administer. It is in pill form and is given orally or inserted into the vagina. However, the form of the drug presents special difficulties when used for labor induction. Because Cytotec is made for patients with stomach ulcers and was never intended for use on pregnant women, it comes only in 100 and 200 microgram tablets. After a decade of unauthorized experimenting, 25 micrograms hasemerged as the usual dose for labor induction. Have you ever tried to break a tablet that does not have a line down the middle or used a razor blade to cut it in half and then into quarters? Needless to say, the size of each quarter is never exact. Nevertheless, this is what some hospital pharmacies all over the country are doing. (Other hospitals find this unacceptable and do not allow induction with Cytotec because their pharmacies refuse to dispense inaccurate dosages.)
The convenience of using Cytotec is also a liability in that the drug is quickly absorbed and stays in the body for hours. Whereas a Pitocin IV can be pulled if any adverse effects arise, thus stopping the effect of the drug in seconds, when problems develop with Cytotec, there is very little that can be done to reverse its effects.
Another benefit of Cytotec that is frequently discussed among doctors is that it costs less than other drugs used for labor induction. It is surprising to hear doctors talk about saving money since, unless they have a financial interest in the hospital or clinic where they practice, it is not really their money. Cytotec is indeed far cheaper than other drugs used for induction of labor, but the question is, why is it so cheap? It is cheap because the pharmaceutical company has not spent the money on experimental clinical trials that would be required by the FDA to
Similar Books
