Homework 38 - Homework 38 - "Born in the USA - How a broken maternity system must be fixed to put women and children first."

I am reading "Born in the USA" by Marsden Wagner. It is a book discussing the norms of giving birth in the States and criticizing American obstetric standards.

The book is divided into 9 chapters, each describing a different aspect of pregnancy and labor. A chapter begins with a brief introduction of the subject which is then followed by many examples and the author's experiences and data.

The topic of this book addresses and answers the question if the maternity system in the USA is well structured and how it compares to systems in other countries. According to the approach of most American obstetricians is far from appropriate. They do not treat women like they are deserved to be treated, often miss out important information and lead women in a way that is convenient for doctors themselves and not the patients. This would be unthinkable in most European countries where when it comes to pregnancy and labor, the woman always comes first. 

The major picture that the author is trying to depict is that the maternity system in the US is certainly not what it should be, and not how it used to be in the past. Wagner tries to make the reader realize that what is happening in this country in terms of gynecology is wrong and ought to be changed before all women and babies are killed by irresponsible, self centered obstetricians. In the first few chapters, the author managed to convince me and make me share his point of view. The proof and examples of stories he quotes make me believe that what is happening in hospitals during labor mostly should never take place anywhere in the world, and definitely not in one of the most civilized countries like the one we live in.

One of the aspects that the author and I agree is that obstetricians should never, under any circumstances induce labor when unnecessary simply to avoid having to rush to the hospital at inconvenient hours. I can't even imagine how someone ever came up with such an idea. The process interferes with the normal course of pregnancy and we should not interfere with nature, unless it really is an emergency.

Another idea that struck me as important and with mention is the issue of an increasing number of cesarean sections being performed on women, instead of vaginal birth. The most surprising thing is that many women chose giving birth through an operation rather than doing it naturally, like it has been done over centuries. What most of them do not know is that when performed without a medical explanation and not in an emergency, a cesarean section can be dangerous and sometimes even fatal. Women, however, want to avoid all the pain and stress of labor and simply want to have it done and over with. This is, again, a way of altering the nature of giving birth for another person's convenience, this time the mother's. Giving birth, however, is a very important moment in the life of a mother, while a c-section takes away the whole process. My mom always says that the moments when she saw me or my brother for the first time, right after giving birth to us, although painful, were the two most beautiful moments of her life. Through this example, I cannot imagine how a woman would chose not to experience such an important happening of her life. 

What also deserves public attention is the idea of the American College of Obstetricians and Gynecologists (ACOG) not publicizing important data or omitting information for their own benefit. People deserve to know the truth and they expect to find real information about pregnancy and labor in organizations like ACOG and it is no use when such groups cannot be trusted.

What also is an issue in the American maternity culture is the loss of midwives attending pregnancies. When labor has no complication, the presence of an obstetrician is almost redundant. Wagner even presents a good comparison for this: "(…)having an obstetrical surgeon manage a normal birth is like having a pediatric surgeon babysit a normal two year old". Midwives are appropriately taught how to attend labor and receive birth and there is usually no need for a surgeon to be present during low-risk labor. 

Most of the evidence the author uses in his book is either anecdotal and based his life experiences or statistics and data most of which come from sources quoted in a bibliography. Each bolder statement or statistic is followed by a sub-number which refers to an explanation or source, found at the end of the book. His accounts of meetings with doctors and his experiences seem very truthful, however, just like any other personal knowledge, it should not be trusted without supporting data. Wagner does include sources for most of his statements, thus most of the information in this book is trustworthy.

Even though this is not the type of book I would normally read, I feel like I will learn a lot from it. Also, I will have to get used to books like these since this is mostly what I will be expected to read as a college student…