Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First
No one challenges obstetricians. I’ve seen the effects of this in all aspects of the profession, but it is especially frightening in a court of law. The tried and true defense for obstetricians who are sued is “only we can judge what we do.” I will never forget two obstetricians practicing in partnership in a small rural town in Idaho- the only obs in town. When testifying in a deposition in preparation for a court case, they were questioned about giving a patient a dose of Cytotec for induction that was two to three times the maximum dose generally used. They replied that the dose was the standard of practice in their community. When asked where this standard of practice came from, the two obs replied simply: “We are the standard of practice.” This insistence that only members of the tribe can understand what tribal members do and why they do it results in standards of practice that tribal members want- doctor friendly practices. What it comes down to is that what is euphemistically called a “standard of practice” in a given community simply means whatever the local doctors do, regardless of whether or not it is good practice as defined by scientific evidence- a frightening level of power and control.”
4 Comments
One of the best – and most eye-opening – books I’ve read on American Maternity Care. A good book to read with it is “Pushed.” Scary stuff, and one of the many reasons we have our babies at home!
I have not yet read this book. But at this point, after reading the information given about it and its author on Amazon, I’m sad to see it recommended here on a blog I otherwise enjoy. Dr. Wagner might try to appear to simply be offering a book full of useful “information,” but we must remember he is the former director of Women’s and Children’s Health at the World Health Organization. This is a group that is almost always at odds with the American medical system, and in large part because we do not (or did not, until Obamacare) ascribe to a national health care system.
The statistics noted in the summaries I read, on how the proportion of infant and maternal mortalities in the US far exceed those in many other “developed” nations, are blatant misstatements of the truth – most of these other nations have a very different concept of the value of life and don’t count infant deaths before a certain point to be deaths at all – for example in England, babies born before 23 weeks are, according to medical guidelines for their Health Service hospitals, not to be given any form of medical intervention; and as I understand it, are not counted as an infant death but rather a type of abortion. This is just one tiny example, I’m sure that many other of these developed nations with their very anti-God interpretation of “human life” also do not count many of the infants who die there as actual human deaths, thus sweetening their statistics.
Further, we also must remember that the United States, for better or for worse, provides reproductive assistance, medicines, and technologies that few other countries have even heard of. As a result, women who, had they lived in other countries, would never have become pregnant to begin with, can now find a way to conceive with the assistance of interventions American doctors provide. However, such pregnancies are almost always high risk, and with such things as in-vitro fertilization, often result in more than one fetus being developed. When some of these artificially assisted pregnancies result in the deaths of some or sadly, sometimes all, of the babies, those again count against our American system. But they really shouldn’t, because what occurs is not usually a failure of the American medical system to properly care for the mother and infant(s), but a very risky pregnancy that was often started artificially and could not be maintained despite doctors’ best efforts. Again, most other developed nations offer nowhere near the level of prenatal care or reproductive assistance that the US does, so comparing the US to other countries on these fronts is like comparing apples to oranges.
Sorry for the long monologue there, I just want to caution potential readers of this book that it’s statistics and viewpoint are likely not simply neutral, factual, or unbiased. It’s writer has an anti-US agenda, and readers need to remember that agenda and read warily.
Liz,
Thank-you for your comment. The Equuschick had debated writing a longer review with more detail but didn’t due do to time constraints, but perhaps she should have, simply to clarify why she was recommending (and still to continues) to recommend the book in the first place. Of course she does not support Dr. Wagner’s politics, but in spite of his bias his information, for the most in part, is correct, and well-documented elsewhere. This would be why all of The Equuschick’s births have been at home, under the care of a Certified Nurse Midwife.
While The Equuschick is not in favor of Obamcare, she is also, frankly (though for different reasons) at odds with American medical care, particularly obstetric care, and *not* because she wants a national health care system.
You are correct that the statistics he (and many others) quote regarding *infant* mortalities alone in the US are misleading because of the way other countries count (and don’t count) their infant deaths and in the past the DHM herself has posted regarding this, but this does not address the discrepancies of rising maternal mortality rates, nor the claim (that he is, again, not the only one making) that within the US itself, these rates are *rising*.
And regardless of his politics, which The Equuschick is certainly not in line with, what he has to say about the obstetrical intervention rate, the well-documented and proven risks of these interventions, and the ignorance of the American public on these issues, is sadly still spot on. Frankly, one of the most striking things about his book is that so much of it has been documented elsewhere and is still being widely ignored. (As the previous commenter mentioned, “Pushed” is another good one, as is Henci Goer’s “The Thinking Woman’s Guide to a Better Birth.” Not to mention the classic, “Silent Knife.”) These interventions, and other practices such as restricting a woman’s diet and movement when she’s in labor, are so widely proven to be detrimental to a healthy labor and birth and yet so commonly practiced in our country as opposed to other countries, that The Equuschick really doesn’t think the fact that the USA’s increased rate of high-risk pregnancies due to artificial insemination and the like have nearly as much to do with our increased rate of mortalities than you seem to think. (Neither is she certain that the USA really does have such an increased rate of high-tech pregnancies compared to other industrialized counties such as the Netherlands or Great Britain.)
The Equuschick did not recommend Dr. Wagner’s book for its politics. But for its information, she would still recommend it to anyone who wants to understand the pros and cons of the obstetrical system versus the midwifery system.
Thank you for your clarifications regarding why you recommended this book. I won’t become one of those commenters who will refer you to myriad websites to back up my assertions regarding the US’s leading role in reproductive assistance or technology, or the articles out there that dispute the statistics upon which assertions that maternal and infant deaths are increasing in the US even after all variables are taken into consideration are based. I have dear friends who also would agree with your concerns on the American obstetrical practice, and for those reasons also home birth.
Suffice it to say, there is a lot of information out there to support your concern with American obstetrics. There is also a lot of information out there to support a view that the American obstetrical practice, while of course not perfect, is a helpful and often life-saving resource for mothers and their babies, without which many, many more mothers and babies would not have survived. As you can probably tell, I tend to agree more with the latter. I am thankful for US ob and intensive neonatal care services, without which my oldest son would likely not be alive. But I am also thankful that, at least currently (again until Obamacare bureaucrats, in their infinite wisdom, decide otherwise), women in the US are able to choose whether or not to utilize those services and can choose the birth -hospital, midwife-assisted, home, or otherwise – that suits their particular situation best.