The Truth About Cytotec for Labor Induction (From a Mom Who’s Been There)
The Truth About Cytotec for Labor Induction (From a Mom Who’s Been There)
When I was 39 weeks pregnant with my first baby, I was told I’d be getting induced. I agreed, but only after pressing my OB to explain how they planned to do it. That’s when she mentioned Cytotec and a Foley bulb—but didn’t really say what those were until I started asking. We asked ahead of time what the side effects were, and all she said was, “Women use it every day.” That was it. No real risks explained, no alternatives offered.
That induction ended up setting off a cascade of interventions that led to a C-section after stalling at 6 cm and laboring for 30 hours. At the time, I had no idea how risky Cytotec could be—or that it wasn’t even approved for labor induction. It wasn’t until I was pregnant again, two years later, preparing for a VBAC and read the book Ina May’s Guide to Childbirth, that I finally learned the full picture. I had already lived through the trauma, but only later understood how it started.
Cytotec is used all the time in hospitals—often as the first option for inducing labor. But that doesn’t mean it’s safe, and it definitely doesn’t mean you’re fully informed.
What is Cytotec (Misoprostol), Really?
Cytotec is the brand name for misoprostol, a drug originally created to prevent stomach ulcers. It’s not FDA-approved for labor induction—yet hospitals across the U.S. use it off-label to jumpstart contractions.¹ Ina May Gaskin explains, “This E1 prostaglandin was approved by the FDA to prevent ulcers, so its use for cervical ripening and labor induction is considered ‘off-label’—legal but ethically suspect, since no formal, carefully planned research preceded its widespread acceptance into the pharmacopoeia of obstetrics.”²
Here’s how it works: Misoprostol causes the uterus to contract by acting on prostaglandin receptors. That’s why it’s used to “ripen” the cervix or get labor going. The pill can be inserted vaginally, between your cheek and gums (buccally), or placed under the tongue (sublingually), depending on your provider’s protocol.²
But the key thing to know is—once it’s in, you can’t take it out. You just have to ride it out, even if your body responds too intensely. Unlike Pitocin, which is given through an IV and can be dialed back or turned off if contractions become too strong, Cytotec keeps working until it’s fully metabolized—no pause button. That alone can make a big difference in how safely your body is able to respond to labor.
And here’s the kicker: It was never designed for this purpose. Misoprostol was developed to protect the stomach lining—not to trigger full-body labor.⁴ That’s part of what makes it so risky when used without thorough discussion.
If you’re interested in learning more about Foley bulb induction (which was also used during my first labor), you can read my blog Foley Bulb for Labor: Pros, Cons & What It Felt Like.
The Known Risks of Cytotec (Misoprostol)
Here are just a few of the risks associated with Cytotec, many of which are listed in Ina May’s Guide to Childbirth:
• Uterine rupture (especially dangerous for women with prior C-sections)²
• Hyperstimulation of the uterus, which can cause back-to-back contractions and fetal distress²
• Postpartum hemorrhage
• Amniotic fluid embolism
• Increased likelihood of emergency C-section³
One devastating detail Ina May shares: a special quilt honoring women who died from Cytotec use—a reminder that these risks can be very real and irreversible.²
Overused, Under‑Explained
It’s not just the risks that go unspoken—why Cytotec is prioritized often doesn’t come up either. Ina May Gaskin highlights that a major reason hospitals use it is because it’s so cheap—sometimes just a few cents per dose—compared to more expensive induction options like dinoprostone.² ³
When your OB hands you a pill and says everyone uses it daily, it’s easy to feel caught off guard. But what “routine” doesn’t tell you is that Cytotec carries an FDA black-box warning and was never intended for use during full-term childbirth.²
That was my experience—and unfortunately, it’s far too common.
Safer Induction Alternatives
If you’re being offered an induction—or just thinking ahead—here are some other options that are often safer or more transparent than Cytotec:
1. Wait for Labor to Begin Naturally
If mom and baby are both healthy, waiting for spontaneous labor is usually the gentlest and safest option.⁵
2. Membrane Sweep
A provider manually sweeps around the cervix during an exam to release natural prostaglandins and potentially start labor.
3. Foley Bulb
A small balloon catheter gently inserted into the cervix to help it dilate without drugs.⁶
4. Artificial Rupture of Membranes (AROM)
If your cervix is already a bit open and softened, your provider may offer to break your water to help labor progress. This isn’t for everyone—but it’s another method that doesn’t involve pills.
5. At-Home Natural Techniques
While these won’t force labor, they may help encourage it if your body is ready:
• Red raspberry leaf tea
• Acupuncture
• Walking or curb-walking
• Sex and nipple stimulation (natural oxytocin!)
• Midwife’s brew or castor oil (only with supervision)
You Deserve to Know All Your Options
I’m not here to scare you—I’m here to empower you. You deserve more than “We use it every day.” You deserve informed consent and real choices.
If your first birth felt out of your control, I see you. And if you’re preparing for another, you absolutely can move forward with knowledge, confidence, and peace.
That’s exactly why I created my Birth Trauma & Empowered Birth Prep Series—to help women reflect, prepare, and heal in a way that feels safe and supportive.
Are you hoping to feel confident and informed going into your next birth—or healing from a past birth experience?
I’m launching a Birth Trauma & Birth Prep Workbook Series that is made to support you in prepping for your next birth and in recognizing and healing from birth trauma.
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Sources
1. U.S. Food and Drug Administration. (2020). Cytotec (misoprostol) tablets label. https://www.accessdata.fda.gov
2. Gaskin, I. M. (2003). Ina May’s guide to childbirth. Bantam Books.
3. Alfirevic, Z. (2014). Oral misoprostol for induction of labour. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD001338.pub2
4. Harman, J. H. Jr. (1999). Current trends in cervical ripening and labor induction. American Family Physician, 60(2), 477–484. https://www.aafp.org/pubs/afp/issues/1999/0715/p477.html
5. American College of Obstetricians and Gynecologists. (2020). Practice Bulletin No. 222: Clinical Management Guidelines for Obstetrician–Gynecologists: Induction of labor. Obstetrics & Gynecology, 135(2), e100–e119. https://doi.org/10.1097/AOG.0000000000003660
6. Jozwi, M. L., Dodd, J. M., & Mitchell, M. D. (2012). Foley catheter versus vaginal prostaglandin E₂ gel for induction of labour at term: A systematic review of randomised trials. BJOG: An International Journal of Obstetrics & Gynaecology, 119(1), 5–13. https://doi.org/10.1111/j.1471-0528.2011.03189.x
7. Mozurkewich, E. L., Chilimigras, J. L., Berman, D. R., Perni, U. C., Romero, V. C., King, V. J., & Keeton, K. L. (2009). Methods of induction of labour: A systematic review. BMC Pregnancy and Childbirth, 9(1), 6. https://doi.org/10.1186/1471-2393-9-6
8. Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., & Herrlich, A. (2013). Listening to Mothers III: Pregnancy and Birth. Childbirth Connection. https://www.nationalpartnership.org/our-work/resources/health-care/maternity/listening-to-mothers-iii-pregnancy-and-birth.pdf
