Born in the USA

Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First

MARSDEN WAGNER
Copyright Date: 2006
Edition: 1
Pages: 305
https://www.jstor.org/stable/10.1525/j.ctt1pp0zn
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  • Book Info
    Born in the USA
    Book Description:

    In this rare, behind-the-scenes look at what goes on in hospitals across the country, a longtime medical insider and international authority on childbirth assesses the flawed American maternity care system, powerfully demonstrating how it fails to deliver safe, effective care for both mothers and babies. Written for mothers and fathers, obstetricians, nurses, midwives, scientists, insurance professionals, and anyone contemplating having a child, this passionate exposé documents how, in the most expensive maternity care system in the world, women have lost control over childbirth and what the disturbing results of this phenomenon have been.Born in the USAexamines issues including midwifery and the safety of out-of-hospital birth, how the process of becoming a doctor can adversely affect both practitioners and their patients, and why there has been a rise in the use of risky but doctor-friendly interventions, including the use of Cytotec, a drug that has not been approved by the FDA for pregnant women. Most importantly, this gripping investigation, supported by many troubling personal stories, explores how women can reclaim the childbirth experience for the betterment of themselves and their children.Born in the USAtells:* Why women are 70% more likely to die in childbirth in America than in Europe * What motivates obstetricians to use dangerous and unnecessary drugs and procedures * How the present malpractice crisis has been aggravated by the fear of accountability * Why procedures such as cesarean section and birth inductions are so readily used

    eISBN: 978-0-520-94174-8
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. PREFACE
    (pp. vii-x)
  4. ONE MATERNITY CARE IN CRISIS: WHERE ARE THE DOCTORS?
    (pp. 1-12)

    Scene: A large hospital in Oregon. (This is a real-life story, as are the other stories in this book.)

    Grabbing the telephone from the maternity ward secretary, the nurse blurts out, “Doctor, I have tried and tried to find the baby’s heart beat and then I got my charge nurse who tried and tried. We can’t get a fetal heart tone at all. We need you. Please come quick!”

    The obstetrician replies, “Right. I’m leaving home now. I’ll be there in fifteen minutes, depending on traffic.” Click.

    “But doctor, what should we do in the meantime?! Oh damn, he’s gone.”...

  5. TWO TRIBAL OBSTETRICS
    (pp. 13-36)

    While lecturing to a roomful of doctors, I will sometimes say, “I remember the first time I killed a patient.” The hostility in the room is immediate and palpable. I have committed treason. Although no doctor can practice for many years without at some point making a mistake that results in the death of a patient, when it happens, most doctors either go into intense denial or quickly come up with ten reasons why they are not at fault. My statement that I made a serious error goes against an unspoken rule among physicians—we must never admit to mistakes...

  6. THREE CHOOSE AND LOSE: PROMOTING CESAREAN SECTION AND OTHER INVASIVE INTERVENTIONS
    (pp. 37-69)

    After more than a decade of trying to bring down the number of cesarean sections (C-sections), some obstetricians are now reversing themselves and promoting more of them. In fact, a growing number of American obstetricians now urge women to “choose” a cesarean even when there is no medical indication that they need one.

    The following statement is from a popular book titledThe Girlfriends’ Guide to Pregnancy:

    With a scheduled cesarean section, you and your doctor have agreed to a time at which you will enter the hospital in a fairly calm and leisurely fashion, and he or she will...

  7. FOUR FORCED LABOR: INDUCTION OR SEDUCTION
    (pp. 70-98)

    Two weeks before Ms. S is due to give birth, she and her husband leave their three young children with their grandmother and go to the local hospital in their small town. The year is 1999. Ms. S is having occasional contractions, and they want to find out what’s going on, though they are not overly concerned. Ms. S has had three normal births, with no cesarean sections, and considers herself a childbirth veteran.

    At the hospital, a nurse examines Ms. S and determines that the contractions are too infrequent and irregular for her to be in active labor. The...

  8. FIVE HUNTING WITCHES: MIDWIFERY IN AMERICA
    (pp. 99-125)

    After working as a practicing physician for several years, I became a perinatologist and perinatal scientist, as well as a full-time faculty member at the Schools of Medicine and Public Health at UCLA. Then I became a director of maternal and child health for the California State Health Department. In that capacity, I learned that in the rural town of Madera, California, doctors had decided that they no longer wanted to attend births in the Madera County hospital. They complained that it took too much of their time and didn’t pay enough. So in 1968, two out-of-state midwives were recruited...

  9. SIX WHERE TO BE BORN: HERE COME THE OBSTETRIC POLICE
    (pp. 126-151)

    Women in the United States have the right to choose who they want to attend the birth of their child, and they also have a choice regarding where the birth will take place—in a hospital, in an alternative birth center, or at home. These are two different choices, though if an American woman chooses a doctor as her birth attendant, she cannot choose a home birth, since doctors in the United States no longer attend home births. Home births are attended only by midwives, and since that represents a loss of business for doctors, doctors attack home births with...

  10. SEVEN RIGHTS AND WRONGS: THE “MALPRACTICE CRISIS,” LEGAL PROTECTIONS FOR PREGNANT WOMEN, AND REGULATION BY LITIGATION
    (pp. 152-181)

    On the same day in May 2002, I learned two related pieces of information. At a press conference on “the malpractice crisis” called by the American College of Obstetricians and Gynecologists (ACOG), obstetricians were complaining bitterly about the expensive malpractice insurance premiums they have to pay. Later that day, I got a phone call from a lawyer telling me that a case against two small-town obstetricians practicing in Idaho (discussed in chapter 4) had been settled. The doctors’ insurance company would now have to pay millions of dollars to a family whose son was severely brain-damaged because labor had been...

  11. EIGHT VISION OF A BETTER WAY TO BE BORN
    (pp. 182-211)

    In this chapter I offer my vision for a better way to be born in the USA. I consider it a guide to keep us heading in the right direction, a goal to work toward. In chapter 9, I will offer some practical ideas for getting from where we are to where we need to be.

    My vision of a healthy maternity care system for our country is built on two sets of principles. The first set of principles guides the work of the Coalition for Improvement in Maternity Services (CIMS).¹ These are included in chapter 1 but are worth...

  12. NINE HOW TO GET WHERE WE NEED TO BE
    (pp. 212-250)

    We Americans are consumed with the need to believe that we are number one. But here’s a wrenching fact: forty-one countries have better infant mortality rates than the United States does. In 2002, our infant mortality rate went up, not down, and if the United States had an infant mortality rate as good as Cuba’s, we would save an additional 2,212 American babies a year.¹ And mothers? Women are 70 percent more likely to die in childbirth in America than in Europe, and the rate of women dying in childbirth in America has been going up every year for more...

  13. NOTES
    (pp. 251-282)
  14. INDEX
    (pp. 283-295)
  15. Back Matter
    (pp. 296-296)