Monday, June 21, 2010

The New Thalidomides

Recently, while on vacation in Boone, NC, I was enjoying an antique shopping adventure. I had not a care in the world, when suddenly I was reminded of the harsh realities of life. I came upon this LIFE Magazine cover from August 1962.  I was born in 1958 and somehow escaped the horrors of Thalidomide. Thalidomide was sold in a number of countries across the world from 1957 until 1961 when it was withdrawn from the market after being found to be a cause of birth defects in what has been called "one of the biggest medical tragedies of modern times".

Although thalidomide was not approved for sale in the United States, millions of tablets had been distributed to physicians during a clinical testing program. It was impossible to know how many pregnant women had been given the drug to help alleviate morning sickness.
The word “phocomelia” means seal limb. It describes an extremely rare condition in which babies are born with limbs that look like flippers. The long bones of the arms fail to develop, but fingers sprout from the shoulders. In some cases, the legs fail to develop as well.
Doctors began to see more and more cases, and it turned out that a drug called thalidomide, which pregnant women were taking for morning sickness, was responsible. Magazines and newspapers ran shocking pictures of seal-limbed children, and the drug was banned in 1962. By then thousands of children, had been born with thalidomide-induced birth defects.
Today, pregnant women face many decision in the childbearing year. As a doula and childbirth educator, I have seen and read about the tragic consequences of some of those choices.
Cytotec, among others, comes to mind.
Since Cytotec was introduced in 1988, a growing number of obstetricians have embraced it as a "miracle" drug -- in spite of data that leave serious doubts about its safety. Lacking FDA approval and scientific consensus on how to use it on pregnant women, doctors have taken it upon themselves to administer Cytotec to their patients, many times without the women's informed consent. Clinical trials suggest that Cytotec is effective at "ripening" the cervix and inducing labor.
"Cytotec enables doctors to practice daylight obstetrics," says Dr. Marsden Wagner, a neonatologist who served for 15 years as a director of women's and children's health in industrialized countries for the World Health Organization. "It means that as a doctor, I can come in at 9 a.m., give you the pill, and by 6 p.m. I've delivered a baby and am home having dinner."
The Cochrane Collaboration, an international body of independent analysts and physicians that publishes widely respected assessments of drug efficacy, cites numerous reports of uterine rupture and fetal distress involving the drug. "It cannot be recommended for routine use at this stage," the group concluded last year.
Searle sent out a memo to 200,000 health care providers warning them that "Cytotec administration by any route is contraindicated in women who are pregnant because it can cause abortion." The company noted that the off-label use of Cytotec has resulted in reports of uterine rupture, hysterectomy, and the death of mothers and infants. Without informed consent women and babies are being treated as little more than human guinea pigs. Wagner, the former official with the World Health Organization, notes that Cytotec is not used to induce labor in Europe, and chides American obstetricians for what he calls "vigilante obstetrics."  
 How many injuries from iatrogenic causes must women and babies suffer before we wake up ?
Thalidomide was introduces 50 years ago and we are still being treated like guinea pigs even in the light of warnings from the best collection of medical and scientific evidence ever known to humankind. Please ask questions and trust your gut. YOU are the best expert of what is safe for you and your baby.

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