HW 40 - Insights from Book - Part 3

You find yourself at a cocktail party with the author of the book you just finished reading. To demonstrate that you really read it, you say,


-"Hey - thanks for writing "Born in the USA". Your main idea about how there are hidden themes behind a Cesarean section besides delivering a baby made me rethink pregnancy & birth."


-"Really, which parts were most effective or important for you?"


-"Well, in the last third of the book you focused on how obstetricians perform C-sections to avoid being sued , which contradicted the first 2/3rds of the book. But let me be more specific:
1. In chapter three, you clearly state that obstetricians mainly do C-sections in order to have a convenient schedule, "It means that they can split their time between seeing patients in the office, doing gynecological surgical procedures in the hospital, and attending births, on a timetable of their choosing, and reduces the chance that they will be required to attend births at inconvenient times." (38)
2. However, in chapter 7, you wrote that "The decision to do a C-section (…) is often based not on medical need but on a desire to avoid litigation." (154) Even though the two statements do not necessarily exclude each other, they are contradicting.
3. The thesis about doing C-sections to avoid litigation seems strange, taking into account your statement from p.38 "Put simply, C-section, even when it is 'elective' increases the chance that the woman and/or baby will die.". If this is the case then why would obstetricians insist on continuing to perform elective C-sections? Having a bigger chance of killing the mother and/or baby also increases the possibility of ending up in court."


-"But what could I have done to make this a better book - that would more effectively fulfill its mission?"


-"Well, let's be clear - your text sought to provide narratives and data analysis from the perspective of a doctor who is aware of what patients think/expect, for the book-reading-public to better understand pregnancy & birth in our culture. Given that aim, and your book, the best advice I would give for a 2nd edition of the text would be to include even more real life stories and examples. I found that, reading this book, these where the parts which most attracted my attention. But I don't want you to feel like I'm criticizing. I appreciate the immense amount of labor you dedicated to this important issue and particularly for making me think about the consequences of inducing labor, how Cytotec can kill rather than help speed up labo, & that the atmosphere and stress when giving birth is very important for the mother and the baby. In fact, I'm likely to be more careful about obstetricians and choosing my own specialist when I, myself, become pregnant, as a result of your book."


-"Thanks! Talking to you gives me hope about our future as a society!"