Journal of Obstetrics and Gynecology
, reporting alarming rates of uterine rupture when Cytotec was used for induction in women with previous C-sections. 14 In one study, 5.6 percent of women having VBACs induced with Cytotec had uterine rupture, and in the other study the rate of rupture was 3.7 percent. This is a twenty-eight-fold increase in the rate of rupture over having a VBAC without Cytotec induction. Furthermore, for one-quarter of the women who had uterine rupture, this resulted in the deaths of their babies.
Several months after these papers were published, ACOG came out with a recommendation that Cytotec not be used for induction in women who had previously had C-sectionsâshutting the barn door after thousands of horses were gone. It can be estimated that during the five years before ACOG finally made its recommendation, more than 25,000 women in the United States who had previously had C-sections were given Cytotec induction (see table 5 ). We can further deduce that more than 1,000 of them suffered ruptured uteruses, and between 50 and 250 ended up with dead babies. Though we do not have hard data on the number of maternal deaths caused by giving Cytotec to women with previous C-sections, we know enough about uterine rupture to know that probably ten to twenty women died from uterine rupture caused by Cytotec induction.
Strangely, obstetricians in the United States remain in denial about the tragedy Cytotec induction represents. In chapter 2 , I mentioned a
Dateline NBC
television program on Cytotec induction of labor that aired on November 4, 2001. Alisa Goldberg appeared as a guest on the program, among other guests. She had just completed her obstetric training at a reputable hospital and was working at the National Institutes of Health. She was also the senior author of a paper on Cytotec induction published in a prestigious journal. 15 The following dialogue took place between Dr. Goldberg and the interviewer:
Interviewer: âDo you think five years ago [i.e., 1996] doctors knew enough about Cytotec?â
Dr. Goldberg is unable to give any answer. She sits twisting in her chair and smiling.
Interviewer: âDo we know enough now about Cytotec?â
Dr. Goldberg: âWe are still fine-tuning. I think there is still more to be learned. Thatâs the way medicine evolves.â
Interviewer: âBut should we wait until after we learn it before we say it is safe?â
Dr. Goldberg: âItâs a catch-22. If you donât use it, then you donât learn.â 16
Of course, Dr. Goldberg could not respond to the question about whether we knew enough about Cytotec five years earlier, because if she said that we did, she would have to address the fact that it was only since then that we learned that the drug must never be used on women with previous C-sections because of the extreme risk of uterine rupture and the certainty that Cytotec has caused women and babies to die. If she said that we did not know enough, she would be condemning hundreds of her fellow obstetricians who were using this drug for induction five years earlier.
In effect, this obstetrician freely admitted on television that a vast, uncontrolled experiment is taking place on unwitting women without their knowledge, much less their consent, and there was no indication she felt remorse about that fact. Apparently, she saw no problem with using women as guinea pigs, most of the time in an unscientific way, without telling them. When she said, âIf you donât use it, then you donât learnâ (a classic anti-precautionary position), it was as if she had never heard of officially approved, carefully designed, controlled experimental trials in which the women involved give their informed consent. In other words, it sounds as though in obstetrics, valid science is dead.
You can be sure that this obstetrician is by no means alone. In 2005, five obstetricians from a prestigious Ivy League university