Meet my son Steven, a 3-year-old boy with a head of dirty blond hair who loves to swim. At the moment, he is running around the house in his swimming suit despite the below-zero wind chill outside, begging for another trip to the YMCA's heated pool. Just another kid in my trio, just another ordinary day being a mom and wiping up grape juice stains. What's not so ordinary is that Steven was born at home. With Cytotec.

Cytotec? At a homebirth? What's an ulcer pill doing at a homebirth?

Cytotec, otherwise known as Misoprostol, is a medicine that is used to prevent or treat ulcers. It is FDA approved for this use only, but caregivers have discovered that in doses of 25 and 50 micrograms, Cytotec can bring on labor. The pill is often obtained in doses of 100 micrograms and cut in half or quarters to obtain a smaller dosage. The pill is either taken orally or inserted vaginally to start labor.

My first two children were born by cesarean. During my third pregnancy I decided to have my baby at home after reading a couple of books and meeting homebirthers in my area. I contacted several caregivers, received care from some of them and tried to decide which one of them would give me my best shot at a VBAC. During my search, I was referred to "one of the best" midwives in Michigan, one with a 100 percent VBAC record in over 400 births.
Impressed, my husband and I made contact and drove up to meet her. As someone who was very new to midwifery, I dove headfirst into it. In some ways, I still hadn't learned to trust myself, choosing instead to place my trust in the midwifery model of care. I certainly didn't expect chemical inductions, vacuums, forced pushing or fundal pressure to be a part of midwifery. Even at the first visit, however, the idea of using Cytotec came up. The name wasn't used; I was simply told that she and her midwife partners had a pill that successfully started labor. Because I lived six hours away, the midwives were originally going to have me take the pill home and insert it into my cervix so that I would be in labor when they arrived.

The more I thought about it, the more I realized my apprehensions about the pill. I called the midwife and expressed my concerns about safety. She reassured me and said—and I quote—"It's perfectly safe." I figured that she and her partners had far more experience than I did, and I trusted them, just as I had earlier with my doctors.
To make a long story short, the midwives arrived around my due date and Cytotec was inserted. I was told it would take about three hours for labor to begin.

About five hours later, labor kicked in. I experienced back labor during transition and it was really intense. Because I supposedly had a low pubic arch and the baby in a compound position, I ended up "alley-ooped" in the McRobert’s position with my knees up to my ears, fundal pressure applied twice after a mere 10 minutes of pushing, and my baby torqued out. I was told I had a normal birth.
For the longest time after Steven's birth, I had nothing but praise for the midwives who attended. After all, there were many wonderful memories of being served dinner and breakfast, laundry being done and words of encouragement being spoken. There was the ultimate triumph of birthing vaginally after two cesareans. And surely midwives would never use an intervention unless it was necessary, I reminded myself. After all, they're the experts in normal, natural childbirth. Aren't they?

When my baby was a couple months old, we purchased a computer. Little by little I started learning more about Cytotec. I learned about all the niggling side effects that my midwives neglected to mention, such as ruptures, hyperstimulation of the uterus, fetal distress and fetal death. One site that listed the side effects had a warning: This drug is not to be used on pregnant women! I learned that Cytotec was definitely not recommended for women with prior uterine surgery.

Thank goodness I had the uterus of steel, as a fellow ICAN (International Cesarean Awareness Network) member once said. I wrote to my midwives, sending them studies and asking questions about the interventions. I was basically told that without them, I would have ended up with another cesarean. As for the Cytotec, I was told, "The only side effect of Cytotec is maternal contractions." I was also told to quit second-guessing and to "lighten up."
Lighten up? Highly unlikely. I became angry instead. Angry that I naively exposed my son to something that is highly experimental and with risk. I am also sad and dismayed to find other midwives using Cytotec in homebirths. All the books that I read in preparation for homebirth described midwives as attendants who let nature take its course and as experts in natural birth. That is the ultimate betrayal—to plan a homebirth, hire a midwife and end up with obstetrics at home. Without internet access, nothing prepared me for the medicalization of Steven's birth.

Orally, vaginally, rectally—there isn't an orifice that Cytotec hasn't been popped into. We now have thousands of women participating in a huge, uncontrolled experiment, many of them without informed consent. Doctors and midwives are experimenting with dosage, placement of the pill, and frequency and duration of placement—you name it. Some controlled studies have been made and some are still ongoing, many of them done with small sample sizes. This means that women are consenting to be guinea pigs for something that can harm them and their babies. The studies reveal a list of side effects, including death. Lawsuits are being brought as a result of widespread Cytotec misuse.
Women choose midwifery to get far away from obstetrics. They certainly don't expect Cytotec to be a part of that picture, especially not in a homebirth. There are still many midwives out there who staunchly believe in women and their beautiful ability to birth their babies as nature intended. However, women today have to be savvy consumers to be able to interview a midwife and weed out the medwives.

Medwives are midwives who practice the science of medicine instead of the ageless art of midwifery. If you are a midwife reading this, you certainly won't be offended by it if you are practicing true to the midwifery model of care. If you find yourself offended by this article, I hope that you will look deep into your heart and remember just why you became a midwife in the first place. Toss away the Cytotec and go back to giving women "the gold standard of care."

Author note: This was published in the book, "Don't Cut Me Again!" by Angela Hoy