In midwifery school, it was always exciting when a student midwife would get her “first catch.” I was there when one of my classmates got hers. After a sluggish labor, the baby came out suddenly and quickly, and the student almost didn’t have time to get her gloves on. We were all impressed with how quickly the baby was born, since the mother’s labor seemed to have petered out. She had been given some tea with “herbs” in it, and within 15 minutes the baby came practically shooting out. It was a memorable birth.
It wasn’t until much later I learned why: the tea contained crushed pills of a drug called Cytotec. It was Cytotec tea.
Cytotec is a drug that is intended to prevent stomach ulcers, but it has a well-known side-effect of inducing contractions. It is often used to help women complete a miscarriage, and it is used in hospitals to induce labor. It can be very effective in controlling a hemorrhage after birth. Because Cytotec can overstimulate the uterus, women who are being induced with it need to be monitored carefully. It is illegal for nonhospital midwives to use Cytotec for any reason during pregnancy, but it is legal in some states to use it for treatment of postpartum hemorrhage. Cytotec can be given orally, rectally, and vaginally.
I don’t know how often we served Cytotec tea in Miami. It wasn’t something that the midwives openly discussed, the clients were never informed, and it certainly was never written down in anyone’s chart. But sometimes, with a little wink, they might indicate that they had given her “just a little Vitamin C,” and let the students figure out the rest. It was drilled into us in class that we should never give Cytotec to anyone who had had a previous Caesarean section because it dramatically increases the chance of the uterus rupturing, a deadly emergency. But giving just a little bit to a woman with no history of uterine surgery? It might just be enough to help a lazy labor pick back up! Cytotec was also administered vaginally to induce labor; the midwife would tell the client she was inserting evening primrose oil.
Giving women drugs without their knowledge or consent was something that I refused to do once I began practicing on my own. I knew that it was wrong to slip any kind of medicine into someone’s tea (or into their body) without getting permission. I also knew that it was against the law for a midwife to misuse Cytotec. Early in my career as a licensed midwife, an experienced local midwife called me on the phone. She told me that she had a friend who was newly pregnant, who didn’t want to be. “Do you know anything about using Cytotec?” she asked. “Not really, not for that purpose,” I replied. She pressed a little bit. I felt like she was hinting that I should provide her friend with Cytotec so she could induce an abortion at home, something that is expressly forbidden by South Carolina law. I gently refused, but made a mental note that a midwife who was very well respected by the community seemed to be cool with the illegal use of Cytotec. Maybe it wasn’t so bad, I thought. I wasn’t ready to consider that this midwife, who I held in high esteem, was a dangerous woman.
I developed strong bonds with many of my clients. They truly trusted me, and I had fondness and affection for them. If one of them was struggling with contractions that just weren’t quite strong enough to finish the job and we had exhausted all “natural” methods to strengthen them, it would have seemed like a kindness if I could just help out a little. If I had suggested that “I could put a little medication in your tea… I can’t tell you what it is, but it just might help… or we can go to the hospital, instead…” they probably would have trusted me and drunk it. And when it worked, they would have been exceptionally grateful to me. And when other midwives saw that it worked, they might have asked me exactly how I did it. And I might have instructed them, and then they might have done it. And it is entirely possible that their clients were told that it was just some tea with honey, “just to get your energy up.”
I do not know how pervasive Cytotec induction and augmentation is among Licensed Midwives and Certified Professional Midwives; I have heard anecdotes of its use from coast to coast, from the far north to the tropical south. Were you given “tea” or another beverage during labor that seemed to be exceptionally effective at increasing your contractions? Did your midwife insert evening primrose oil (EPO) capsules or another “natural” treatment vaginally for you? If so, it is possible that you may have been illegally dosed with Cytotec.
This post inspired Navelgazing Midwife to come out with her own confession regarding similar practices.