Cytotec for Labor Induction: What You Need to Know

Medically induced labor can be a nerve-wracking situation for many pregnant parents. It is necessary and can be comforting to be aware of the available options, like using Cytotec for induction. Understanding the risks and benefits of your choices will allow you to make a decision with your healthcare provider.

Cytotec, also known as misoprostol, is a common labor induction agent. However, as with any medication, there are concerns about its use, the impact on maternal and fetal outcomes, and the risks versus benefits. Advocating for yourself and your baby is a paramount responsibility. Read on to learn more about this method of induction.

There are several medical options for inducing labor. Mechanical methods such as membrane stripping, amniotomy, or the artificial breaking of water, and foley balloons may induce or augment labor. Medication options for induction include Cervidil (dinoprostone), Pitocin (oxytocin), and Cytotec (misoprostol).²

Cytotec is an FDA-approved medication for decreasing the risk of gastric and duodenal ulcers resulting from frequent consumption of nonsteroidal anti-inflammatory drugs (NSAIDs), especially in high-risk populations such as older people or smokers.⁴

Cytotec has been shown to produce uterine contractions that may jeopardize a pregnancy. Therefore, experts do not recommend misoprostol in childbearing-age persons unless birth control measures are in place. According to the FDA, Cytotec can cause abortion, premature labor, or congenital disabilities.^3,4

Doctors use Cytotec for labor induction because it can produce uterine contractions.^3,4

Misoprostol is a synthetic prostaglandin. Prostaglandins can encourage the onset of labor by stimulating the cervix to soften and stretch. This process may also cause uterine contractions. Using Cytotec to induce labor is appropriate once your baby is at term or you require a medical induction.¹

Cytotec is beneficial if an “unfavorable” cervix needs ripening. An unfavorable cervix can be long, firm, and closed. Cytotec can help to soften and shorten the cervix in preparation for active labor and delivery.⁶

Cytotec is an oral medication you can swallow or take as a buccal (between gum and cheek) or sublingual (under the tongue) medication that dissolves. Cytotec for labor induction can be given vaginally or orally. Hospital systems and providers have different policies, procedures, and protocols. Ask your provider how your choice of birthing place uses Cytotec.⁵

Traditionally, vaginal Cytotec is given as a 25-microgram tablet inserted vaginally every four hours. The body slowly absorbs vaginal Cytotec, which has a longer-lasting effect.^2,6

There is no professional consensus on a safe oral Cytotec dose. Doctors use a variety of dosing regimens. Traditionally, oral Cytotec of 50 micrograms every four hours until you achieve active labor.⁶

Conversely, low-dose oral Cytotec is successful at inducing labor while being cost-effective. You can receive low-dose Cytotec as an oral solution with a tablet crushed and mixed in water about every two hours until you achieve an active labor contraction pattern.¹

Oral Cytotec has a fast onset but quickly clears the body, making low-dose oral Cytotec a popular choice in labor management.²

Prostaglandin administration (Cytotec and Cervidil) for labor induction may cause:²

• nausea and vomiting
• diarrhea
• fever
• uterine hyperstimulation
• fetal distress associated with uterine hyperstimulation
• uterine rupture

It is important to note that Pitocin, or oxytocin, has similar risks.⁸

Here is what you need to know about the benefits of Cytotec for labor induction:⁵

• High-dose vaginal Cytotec (50 micrograms or more) and low-dose oral Cytotec solution (less than 50 micrograms) have produced the most vaginal births within 24 hours.
• Low-dose oral Cytotec is associated with lower rates of Cesarean birth.
• Low-dose oral Cytotec had less uterine hyperstimulation — contractions that are too strong, frequent, or long — than the vaginal insert Cervidil.
• Low-dose oral Cytotec gave the most benefit to the pregnant parent and baby.
• Cytotec labor induction decreased the need for Pitocin augmentation.⁷

Currently, the FDA does not approve Cytotec as a labor induction medication. This is because of its ability to terminate a pregnancy in the first and second trimesters. Cytotec for labor induction is considered an “off-label use,” though it has been widely studied and safely used.⁷

The risks associated with Cytotec and other induction medications sound dangerous for a pregnant parent and baby. It is essential to understand that when these medications are given, your medical team continually monitors your and your baby’s status and uterine activity to ensure your labor pattern is appropriate and your body and unborn baby are responding well.

Safety and appropriateness of medication administration are vital. If at any point this is not the case, your provider will take steps to decrease uterine hyperstimulation or fetal distress.

Cytotec for labor induction is effective and safe for parents and babies when used correctly, despite not being approved for this use. As a patient and as a parent, there are always options. Always bring any concerns you have about medical treatment to your team. It is also important to remember your medical team is highly specialized and has your and your baby’s best interests at heart.