Cytotec: just the name sparks argument. Some providers use it for induction, some say no way, it's just too dangerous.
I have seen Cytotec used for inductions. It either doesn't do anything, or it creates a very hyperstimulated uterus. That is from my point of view as the nurse. It either doesn't work, or works too well.
I have personally caught a baby, in the caul, that preciptiously was born with a complete abruption. After one dose of Cytotec.
I have personally cared for multiple women who have horrific, painful contractions every 1-2 minutes after one single dose of Cytotec. The labors are fast, furious, and they usually move far too quickly for them to receive any kind of pain management (a.k.a. an epidural).
I have personally cared for multiple women who have received multiple doses of Cytotec for induction, and NOTHING has happened.
I have never seen a baby die from a Cytotec induction. Doesn't mean that it hasn't happened. Read Marsden Wagner's book Born In The USA. There are multiple tales of wickedly bad outcomes from Cytotec for induction.
That being said, I think Cytotec does have it's benefits.
(Wow! What did she just say? Cytotec is GOOD?!?)
Not for induction, my friends. Cytotec can work wonders for postpartum hemorrhage prevention and treatment. You need to have a high dose for it to work well, and it's placed rectally or given orally, after the birth of the baby and placenta. Cytotec is cheap, easily placed (rectally) or given orally, and is stable at room temperature. Put it simply: it works well, and works in all locations of birth (especially in 3rd world countries, where postpartum hemorrhage can kill women after birth). Here is a nice piece about cytotec for PP hemorrhage.
Thoughts? Comments? Personal stories about Cytotec?
41 comments:
I use cytotec for incomplete miscarriages. Works pretty well to avoid surgery.
Works wonderfully for PP hemorrhage.
Also nice for the second trimester IUFDs - better than pit.
Useful in GYN pre-operatively for hysteroscopies or D&Cs.
Will not risk inducing a term pregnancy with it.
FWIW, YMMV, etc
I had cytotec after my 8 week prenatal appt. revealed that the fetus I was carrying had stopped developing at 6 weeks and had no heart beat. It was nicer, if that is even possible with a miscarriage, to be at home with my husband.
I completely agree with your assessment of cytotec for induction. There is no safe dose for induction and I personally HAVE seen a baby killed by cytotec. Mom was a young primip. 3 doses of vaginal cytotec did nothing to change her cervix all day (despite very strong ucs q1-1.5 mins). 4 hrs. after her last dose monitoring was discontinued and mom was sent home. The next morning she called the MD because baby wasn't moving. Arrived on L&D with pain, bleeding (abruption) and a dead, full-term, baby girl.
OTOH - it works VERY well rectally for PPH!!
As a doula I see Cytotec placed very occasionally at the hospital where I usually attend births. I asked why not Cervidil (which seemed to be the standard of care in some of the other hospitals I had been to) and I was told, basically, "Cytotec is cheap and Cervidil is expensive".
Generally though, they use a foley bulb to begin an induction - once it falls out (mom is 3ish centimeters) they start Pit. I did see Cytotec used to soften up the cervix once because it was so high and closed that neither the resident nor the attending could reach it to put in the foley bulb. (You know THAT'S gonna be a long induction...) It did work well enough for them to reach the cervix the following morning and put the foley bulb in, so I guess that's a very minor success story? (And yes, after that it took another 48 hours until delivery.) Other than that, I can't say I've had enough experience with it to say how effective I think it is.
I have heard some midwives be very defensive about using Cytotec. They feel it's effective and when used appropriately is one of the better tools for labor induction... it's interesting to hear the mixed takes.
I think if given the choice, I would decline it for myself and request Cervidil or a foley bulb instead. What would you request?
Same thoughts here. Never seen it work in a positive way during labor induction, but think it works great for PPH.
Another L and D nurse chiming in. We use cytotec a fair amount at my hospital and I'm not generally a fan. I will say, I'm not usually opposed to one dose. I find that it's more of a problem with multiple doses that dissolve at the same time. For me it also really depends on the induction reason. Do we really need to get a baby out? And are we using it as the first line of induction? I prefer to use it after cervidil hasn't worked, but our MDs also cite the cost difference.
I was induced at 36 weeks (my first) because of high bp & gestational diabetes; I'd been planning a home birth using hypnobabies. They started induction on tuesday night with cervadil, pitocin all day wed, cervadil wed night, and after increased pitocin on thurs morn the resident suggested cytotec. When I declined she asked why, and I told her I'd read the manufacturer specifically said it wasn't to be used to induce labor. She seemed surprised. We continued with the pitocin and I had my baby (using hypnobabies) just after 9 pm on thurs. knowing it can be good for after is good to know but I'd never consent to start birthing.
I told a friend the EXACT same thing in your last paragraph...all the way down to cheap and accessible, a boon for poor countries. The friend had been given the cytotec to hopefully complete and incomplete miscarriage and she emailed me asking my opinion as she had only ever heard the induction horror stories.
Misoprostil definitely has it's uses just not as an induction tool of a viable baby.
Just stopping by to say hi and thanks for the word of encouragement about my stress level with school :)
And I happy to say that at our hospital pitocin use and cytotec are down...funny how when you ask the physician to talk to the patient about the risks and benefits they decide not to order the medication.
Women are still delivering...maybe a tad bit slower but more 'normal' and healthy.
Debbie
My first labor was induced with Cytotec. Two days of constant ( painless) contractions, no dilation at all, no stress to my daughter. Went home on day 3, came back in on day 5 to a pit induction and had her that night. hospital policy to induce with GD, I'd had a false diagnosis and din't know any better.
With my first baby I was induced because of PE. The doctor that admitted me wanted to use cytotec. It scared me to death. I cried. The nurse encouraged me to share my concern with the doctor. I was afraid to tell the doctor b/c she was the meanest lady in my OB office. The nurse took control, told the doctor and was a true advocate for me. We agreed on a 12 hour run of cervidil. 12 hours later equals no progress. I then agreed through a very groggy mag sulfate fog to go with the cytotec. I really wanted to avoid a c-section and no progress with elevated protein and low platelets was pushing me down that road.
4 hours later I had dialated to a 2 and had some softening/effacing. My personal doctor was then on call. She broke my water and gave me 2 hours to put it into high gear. I'm thrilled to report that I avoided a c-section. However, looking back, I probably should have relented when admitted and got the c-section. It was later discovered that I was a carrier of galactosemia which causes lowered liver enzymes. My body took a beating because my protein was high, platelets were low and enzymes were elevated but not over to top during delivery. After the galactosemia find, it was discovered that I was most likely in full blown HELLP and luckily had a wonderful outcome.
I am still having quite a time making my mind up regarding Cytotec. As a labor nurse, I never really liked it for the same reasons that you stated. As a childbirth educator I liked it even less. Had made up my mind before midwifery school that I would not use it with my patients, but some very interesting discussions during school made me at least be open to the option, but I was by no means convinced enough to actually say that I would use it.
Then, I finished midwifery school and joined a wonderful physician in his practice and he uses cytotec for cervical ripening ALL the time. Never uses cervidil (which would generally be my preference) due to the cost factor and generally makes for a longer induction. He has used Cytotec for years without any fatal effects and very good success. Therefore, I am still very much undecided about this drug for induction. However, I DO love it for some pp hemorrhage!
A question! When we agree that Cytotec is great for PPH, what does that mean as far as use? Do you routinely use it after every birth for PPH prevention?
I had the speedy, no intervention, and unmedicated hospital birth that I planned so was quite displeased that my OB tried to give it to me despite a complete lack of risk factors or complications. We had a little fight about it and it tainted an otherwise happy birth.
Now as a doula, I'd love to know the Whys of its use for PPH prevention.
-Kel
As a CNM, I really like using cytotec for cervical ripening for inductions. In my experience, one or two doses (25 mcg q6h) generally work very well to get an unripe cervix to 3 cm. Then we can either start pit or sometimes she starts labor with just the cytotec. I've only had one person who precipitously delivered with cytotec and have not had problems with tachysystole.
I'm not opposed to using cervidil and will if someone specifically asks for it (I don't do many inductions to begin with), but prefer cytotec.
I think the foley bulb is just cruel and unusual punishment! Ouch!
I don't like Misoprostol for IOL - can't be pulled like cervodil if the uterus starts tachysytole or for fetal distress, plus it requires placement every 4 hours verses 12 for cervodil. My hospital usually uses cervodil for rippening.
Unless we are inducing a 2nd trimester IUFD or TOP, and then it is the drug of choice. Or as, you say as a first line in the case of PPH.
cytotec should never be used for live inductions. In fact, any hospital I have ever worked in has never used it for this purpose. For TABs, ok, but not live birth.
As Julia says...you cant pull it... if there is fetal distress.
Cytotec helped save my life (and my uterus) after the birth of my second child. I had gone into labor naturally, but had a fast and furious labor. I went from 5-6 cm to baby in arms in just 41 minutes. I was fine until about 10 minutes after the OB left the room and then I knew I was in trouble. I was being prepped for surgery when it helped stop my bleeding. I'm grateful it was available and my OB gave it so quickly.
I recommend to the healthcare provider to conduct a thorough research and study the advantages and disadvantages of using a cytotec for induce labor. Some country prohibited the used of cytotec because they think it's too dangerous.
I was induced with cytotec for my second child. After 24 hours of cervadil applications (to soften a very unripe cervix), I was given cytotec. Intense contractions started almost immediately. I went from being less than 1 cm dilated to delivery in about an hours time. My contractions were between a minute and a half to two minutes long with less than 20 seconds rest from the very start. Essentially, the entire labor was like being in transition, without the benefit of any warmup.
I have given birth without pain medication 3 times, but during my cytotec birth I would have done absolutely anything for relief. There was no time for an epidural, nor was there time enough between the contractions to allow me to manage the pain naturally. My baby was born with only two pushes - the midwife was still putting on her gloves as her head emerged.
Misoprostal is also very helpful in avoiding D&Cs in missed miscarriages (early ones) too. I personally prefer miscarrying at home then being more vulnerable in surgery.
Where I work, some doctors use cytotec to "soften the cervix". Personally, I prefer cervidil as it can easily be removed. Our docs tend to induce everyone and start pit on a pt that's cl/th/high! SOOOO frustrating!
I had an pretty quick birth with cervidil. If cervidil is 'slow' and cytotec is 'fast' I admit I am a bit scared to think what my bodies reaction to cytotec would have been.
It was my second VBAC, I was a week past EDD, cervix thick, high and closed, cervidil inserted at 8:45, first contraction at 9:30, 2 cm at midnight, 5 cm at 1, birth at 2:10.
This was 14 years ago, long before they stopped inducing VBAC's.
I don't know what kind of gel was used -- whether or not it was Cytotec -- but eleven years ago, I was 11 days overdue with my first child and I was seen by the most ... um ... assertive (bedside manner wise) of four women OB partners (not my regular OB). My non-stress tests were fine all along, but she'd been after me all week (the week between Xmas & New Year's) to agree to an induction. My research told me not to give in to that too easily, especially with a first baby. (Today, I have had four kids, and I have never once experienced spontaneous labor ... they say I am one of those that don't?)
At 11 days overdue, this Dr. stopped trying to persuade me and, in what appeared to be a fit of impatience (? maybe, maybe not? if it was more than that, she didn't explain her reasoning to me), she ordered me to the hospital.
My cervix was closed tight as a drum and the plan was to place gel that night and induce in the morning. Within an hour of receiving the gel, this was me:
" ... it creates a very hyperstimulated uterus."
"I have personally cared for multiple women who have horrific, painful contractions every 1-2 minutes after one single dose of Cytotec. The labors are fast, furious, and they usually move far too quickly for them to receive any kind of pain management (a.k.a. an epidural)."
I was having contractions one on top of the other with no break in between. My huband draws the monitor tracing in the air as escalating stair steps when he describes it. Each contraction registered higher than the last without ever retuning to a baseline.
Almost all of the L&D RN's I've ever had were fanstastic, but that very first one ever? Not so much. I was hanging in there, but it was getting a little hairy (no gradual build up of intensity, just BANG! Dysfunctional labor, full on) -- I think I just needed some support and encouragement. Literally one minute after I turned to my husband and confessed, "I'm okay for ~now~, but I'm really worried about how long I will be able to last like this ..." the RN breezed in with something in her hand and without discussing it with me, she announced, "We have to get these contractions settled down or you aren't going to last." It was like she read my mind; I couldn't argue with that statement. I knew the risks of analgesic pain relief, but I'd only heard enthusiastic endorsements of it without ever hearing the flipside of the coin. So I welcomed potential relief; it seemed only logical to accept it. But instead of relief, everything went down the drain. I felt stoned/dizzy for about ten (?) minutes (it wasn't really relief, it was more like one more sensation to cope with) and then ... the rug went out from under me. Whatever drug she gave me zapped my strength and made me feel like I hadn't slept in TWO DAYS. I panicked. How !!was I going to cope with the worst pain of my life in ~that~ condition -- feeling like I needed to sleep or DIE?!
Can you say, "Cascade Of Interventions?" HA. Guess what happened next.
They ordered me an epidural. Shocking. I know. My OBs weren't in the house or they were busy with other cases. The house OB, like my first L&D nurse, was edgey and distracted and not very friendly NTM I didn't know her (trust issue) from Adam. They ordered my husband out of the room (I don't know why, his behavior was not a liability in the least). And then the house OB proceeded to have a ~shrieking~ catfight exchange with the anesthesiologist about whether she would do AROM and install a scalp monitor (the baby was fine all along) BEFORE the epidural. FYI the only way I was tolerating the contractions and my hyperstimulated uterus was ON MY FEET. To say that laying down was intolerable is extreme understatement. Now these 'professionals' were fighting in front of me and the only person who was focused on ~me~ was banished to the hallway. The house OB won the argument. For some reason, the AROM took FOREVER (I have a retroverted uterus?). She kept trying and trying, contraction after contraction ... I was in AGONY. When my husband was allowed to return, he said the bed looked like a crime scene covered in blood. I still wonder what that was about.
Fortunately the epidural gave me the relief I needed. I was able to sleep off the bad drug effects and when they woke me up in the early morning to check me, I was almost complete. Pushing went really well at first, everything seemed back on track. But my daughter's head was persistently turned sideways and she was 'turtling.' I pushed for three hours. The epidural was wearing off and by then I was so exhuasted that I wasn't thinking clearly enough to ask them to turn it back up. I was pushing effectively, but I felt raw inside from all that turtling and every push felt like having to slam my battered head into a brick wall. My favorite OB was with me for the pushing. After 3 hours, she told me it was up to me ... push for another half an hour or have a c-section ... the baby was fine, but we were getting to the point where surgical delivery needed to be considered. I asked how likely it was that another half an hour would make a difference and someone estimated a 20% chance. At the time the discussion seemed rational, but in retrospect, I see so much wrong with it. If I knew then what I know now.
I tried to VBAC with #2 ... I got to 14 days overdue. No Labor, Repeat C.
So those two drugs ... the gel (Cytotec?) and whatever analgesic they game me (Demerol?)changed the course of my OB history. The management I received might have offset the consquences of the interventions, but unfortunately it didn't.
I have 4 healthy chilren and mostly no regrets. Hindsight is 20/20. I know there are many good OB's and health pros out there who aren't conspiring against patients for profit nor convenience, they are just trying to do the best they can in a difficult job. I blame the legal and political enviroment foremost. I am a liberal who almost always votes democrat, but we need tort reform as well as healthcare reform. JMO.
I am wondering what dosage is used at your hospital, because while I am not a fan of cytotec for plenty of reasons, I have not had the same experience you have. I just don't think it works very well. My hospital uses 25mcg and it's more the rule than the exception that it takes 3-4 doses, 4 hours apart, to get an unfavorable cervix to 3cm so that pitocin can be started. I have only seen two or three women end up hyperstimulated on the dosage that we use at my hospital.
What I truly dislike about cytotec is that having it available for use, and having this general attitude that using it off-label is acceptable, makes doctors at my hospital much more likely to induce women for completely bullshit reasons. Oh, her blood pressure was 139/87 when she came in at 37 weeks for questionable rupture of membranes? Her labs are normal, her urine dip is negative for protein, her exam was negative for SROM and her cervix is closed and thick and posterior, and her blood pressure now that she's not so nervous is 116/72, but we're going to keep her and induce her anyway because she's "term" and we don't want her "mild preeclampsia" to progress. It's complete bullshit and leads to failed inductions that end in c-sections.
So I dislike cytotec because it's used to start inductions when there's no indication other than that the doctor is bored or can't see the forest for the trees. It's absurd and I wish it was just flat-out unacceptable to use it, because I think that would help make unnecessary inductions less common.
I do agree with you though. With a postpartum hemorrhage, cytotec is a godsend.
Is there a difference between the way cytotec works pre-birth (i.e. for induction) and the way it works postpartum? Is there the same problem of "either it works too well, or it doesn't" when it is used for PP hemorrhage?
Also, wouldn't there be the risk of uterine rupture if it were used for INDF or incomplete miscarriage? I thought the only way cytotec was "safe" was if the uterus was empty---i.e. postpartum use.
Brittany
I was given cytotec to help with removing excess ____ (don't know the word) from a miscarriage. I never felt any cramping or anything. I don't think it did anything...Maybe it wouldn't work on me for induction either.
@Brittany-
For early miscarriages and second trimester inductions, the uterine wall is significantly thicker than at term - hence the risk of rupture is significantly lower.
And, the risk-benefit profile now does not need to take into account the fetal condition, which tips things in favor of cytotec.
I have seen all the things you mentioned (except for causing death), but I have also seen Cytotec work great! I prefer it over Cervidil for cervical ripening. About half of our providers use it for induction. All of them use it for hemorrhages.
At my hospital, we use Cytotec (100 mcg po) aka "miso" frequently for inductions. Our patients must fit within the parameters of a very strict protocol, however. Term gestation, clear fluid if ROM, no uterine scar, reassuring FHRT, etc. I have seen everything from no response to rapid labors to a few stat c/s. Our drug of choice for PPH is prostin, which is expensive and comes with a most unfortunate nasty side effect. Miso first sounds interesting....
Erin in Tex.
I personally had a cytotec induction for my first (FT/Thick/High, pre-ecclampsia, 39 5/7 weeks). I got 4 doses of 25 mcg (midnight, three, six, nine am). I did have contractions every 2 minutes, but had no idea I was having them until my water broke on its own right before noon. From noon until four I went from 1 to 9 cm, and delivered (once I finally got my epidural working and could relax enough for the last couple of contractions) shortly before 7 pm. CindyLou never had any distress, and I was overall very happy with the induction efficacy (I was envisioning days of ripening). And, as my induction was a medically necessary "cascade of events," I felt no mourning for how my labor and delivery went.
As a physician, cytotec is in my rotation. Definitely for PP hemorrhagge (600 mcg PR) and for missed ABs. For labor, I usually will use cytotec for medically necessary inductions in very unfavorable cervices, because, anectdotally, I think it is more efficacious. Never for an elective induction (if your cervix isn't favorable, I discourage elective induction entirely). I never discontinue fetal monitoring once it has been initiated, although they may get intermittent monitoring if the baby is tolerating the contractions well. They don't get sent home, either.
I do think the nursing staff is more comfortable with cervidil, and that is all they would use at my previous hospital unless the MD was in house to administer the medidcation and watch the strip. One because it is less "intense" and two, because they can pull it if the strip makes them nervous. I think it is a matter of comfort level for how much more responsibility lies with the nurses as opposed to the physician. YMMV.
@Anonymous: 100 mcg of cytotec p.o. for inductions? On LIVING fetuses? Whoa, man, that is way too much. We only ever give 25 or 50 mcg per dose. I see the more tetanic contraction patterns with the 50 mcg doses.
To the other anonymous about the difference between induction vs for postpartum hemorrhage: for induction of a living fetus/baby, you need to think "start low, go slow". You don't want to cause massively strong contractions, it would stress the baby out too much, as well as be putting too much tension on the very thin lower uterine segment that is present in a full term pregnancy.
Higher doses can be used for 2nd trimester inductions when the fetus has already died. This is because you don't need to worry about stressing the baby, since the baby is already deceased. Also, the lower uterine segment is very thick, and there is little to no risk of uterine rupture.
Even higher doses can be used for postpartum hemorrhage, because the cytotec works by making the uterus contract. Since there is no baby in the uterus, there is no risk to a baby. The uterus is not distended from the pregnancy anymore, so the risk for uterine rupture is rare to non-existent (help out on the data/stats on this ladies!!). Postpartum, you WANT the uterus to contract and stay contracted to decrease the bleeding from the open blood vessel sites where the placenta was embedded in the uterine wall.c
I'm just a layperson, but I've had cytotec with 3 deliveries.
(Baby #4) I had SROM, but nothing happened. One 25 mg pill of cytotec, baby was out 6 hours later, I didn't require any pain meds.
Baby #5 was a straight induction (had complications from going overdue in a previous pregnancy, docs & myself not comfortable with waiting on the baby), used cytotec a couple times and it didn't really go anywhere. Had pit in the morning, it was about 2 hours from pit starting to baby out. No pain meds.
Baby #6 was another induction (4 days past EDD, again due to previous history/concerns about baby's size, he turned out to be 9#10). Had cytotec, contracted all day, then baby moved into transverse with cord presenting and I got an emergency c/s. So I don't know how that one would've turned out... I did have a scary moment at the beginning when they offered me the dosage for PPH (4 pills) instead of the dosage for induction. A staff member caught it before anything happened, though I knew I wasn't supposed to have THAT much.
great post! and SURPRISE, a new article in the BJM(via Medscape)"agrees" with you about cytotc for PPH (though why they single out homebirth is beyond me, it works the same no mater where you are... LOL)
http://www.medscape.com/viewarticle/735783?src=nl_topic
No experience with Cytotec for induction. But I'm one of the lucky ones who received 800mcg rectally for PPH after the vaginal birth of my twins. Definitely not something I expected.
I had cytotek placed in my cervix to induce a miscarriage. Baby had been dead for about 6 or 8 weeks I think. I was about 14 weeks pregnant at the time. Body was carrying on as usual. HCG level like 50,000 or something. Uterus the size of a 14 week pregnant person. Worked well. Don't know about for inducing a living baby...
I was induced 2.5 years ago due to "Pre-E", but that's another story. When discussing it with my midwife she suggested cytotec and I declined stating what I had read about it. She LAUGHED at me and said I read on the internet to much. She ended up letting me use cervidil, which put me into labor quickly. I don't even want to know what cytotec would have done!
P.S. I will NOT be going back to her for a second pregnancy!
A friend of mine was given Cytotec for induction a few weeks ago. Seven minutes after she took it, the baby's heart rate dropped to 60 and stayed there. The nurses and doctors ran in, turned her on her side, put oxygen on and reached up into her vagina to stimulate baby. When my (terrified) friend asked if the episode was due to the Cytotec, they said no, that the baby was just obviously not tolerating labor well. No surprise that a few hours later, baby still showing signs of intermittent distress, a c-section was suggested (at 5pm, I might add) and performed. Meconium was present upon delivery. Again, no surprise.
My friend was not informed of the risks of Cytotec and is now very angry that her birth was hijacked by it and that it put her baby into such distress. It sickens me that this drug is used on women without explaining that is actually not a recognized induction agent and that it has serious possible side effects.
On a side note, I thought I would mention that during my final semester of nursing school I had to do a cost analysis of an L&D service and I chose cytotec because I had seem it done a few times. The hospital billed $650+ for cytotec insertion, which consists of pretty much sticking it in the womans cervix on a sick and takes all of 10 seconds. The pharmacy I called said one cytotec pill costs about $0.20 and agreed that it has NOT been approved for that use.
Years ago when they still did that sort of thing, I was induced as a VBAC mom (VBA2C mom, to be exact) with Cytotec. Can you believe it? 50 mcg, vaginally. Fortunately, the dose fell out a couple of hours later while I was going to the bathroom. Still, it put me into one HELL of a labor. Very intense. Not pretty. I was fortunate that I had a uterus of steel and baby and I were fine, but scary now to think about what they exposed us to.
Cytotec works well for a few indications, like PPH or 2nd trimester IUFD. It should deflinitely be in the arsenal for that. It works well for inducing women at term with unripe cervices BUT at a price, which is higher rates of hyperstimulation, and some rare but scary cases of abruption, rupture, and amniotic fluid embolism. www.tatia.org
The lower doses they use now present less risk than the higher doses common 10 years ago, but there is still risk. A friend of mine is an L&D nurse and she reported that they recently had a mom induced with cytotec have a rupture....in the fundus. One 25 mcg dose, and the mom had had prior vaginal births. Hardly high-risk for rupture....and it still happened.
So I'm leery of the stuff. It has many benefits, but the risks are significant too.
My due date was January 22nd, 2011. My CNM induced me with 50mcg orally (I think - half of a tablet) mixed into an herbal tea, on February 7th at 10:30am-ish. She monitored me for maybe 20 minutes, then I went home. First painful contraction was at 12:19...another one five minutes later...and then they quickly became 2-3 minutes apart, but lasted only about 30-45 seconds. At one point we called the CNM and she said contractions shouldn't be so close together and had them put me in a tub. We ended up going to the birthing center around 3 or 3:30, and stayed there till baby came at 2:31am. I had back labor pretty much the entire time, which is what someone told me caused the quick contractions, but I really do think it was probably due to the Cytotec/induction.
Both baby and I were fine, but I do feel like I dodged a bullet. If I ever need to be induced again I'll go with just the tea and move on from there..and probably *skip* the Cytotec.
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