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| Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First | 
 enlarge | Author: Marsden Wagner
Publisher: University of California Press
Category: Book
List Price: $16.95
Buy New: $10.47
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Avg. Customer Rating:  32 reviews
Sales Rank: 80092
Media: Paperback
Edition: 1
Number Of Items: 1
Pages: 312
Shipping Weight (lbs): 0.9
Dimensions (in): 8.8 x 5.9 x 1
ISBN: 0520256336
Dewey Decimal Number: 362
EAN: 9780520256330
ASIN: 0520256336
Publication Date: May 21, 2008
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Product 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 expose 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 USA examines 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 USA tells:
* 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
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| Customer Reviews: Read 27 more reviews...
 Thank God for Marsden Wagner!! November 17, 2006
39 out of 40 found this review helpful
I just finished reading this wonderful book and could not wait to write a review for it. I am a registered nurse, certified in obstetrics and also a nurse midwife. I am currently practicing as an RN in Labor & Delivery in a hospital with doctors that believe all medical intervention is what will save the mother and the baby! I also teach childbirth education classes for this hospital, but I do not toe the company line! I tell it like it is and this book will be "required reading" for my classes!!
This book does an excellent job of describing what the medical establishment is really like. I especially liked the quote of the news journalist who stated (to paraphrase) "are you saying we can not trust our doctors to tell us the truth?" I have seen many, many times physicians who do not use informed consent and blatantly lie to patients. It is very frustrating to see women just accept advice from a physician because he is a physician!
Dr. Wagner is very forthright with the evidence and the book is easy for all to understand. If you are a pregnant woman, please get this book. It has information you need to know about, if you are planning on delivering in a hospital. The information in the book is backed up by a very thorough bibliography, so one can research the information considered for themselves.
The only thing I disagree with is part of Dr. Wagner's solution to the problem of maternal health care and the obstetric monopoly. I do not believe in a national health care system. I think anytime you involve the government it will only gum up the works more. I do believe in a grass roots effort ( as does he), as well as more midwife and maternal health groups working together. I think a couple well placed lawsuits aimed at restraint of trade against some hospitals and insurance plans with full media coverage will help to make the public aware of their lack of choice. There needs to be awareness by the public that they do not have all the choices presented to them. America was founded on compeitition. If a few well placed laws made midwives more accessible, I think American women would choose them for their attendants. It will be a long, uphill battle, but one that I believe, as does Dr. Wagner, can ultimately be won.
Thank you Dr. Wagner for saying what all of us have been thinking and working so hard for!!
Eye Opening February 6, 2007
23 out of 23 found this review helpful
This book has opened my eyes to many unknowns about obstetrical care in the US. I had a home birth and am very interested in these issues. The difference between midwifery care and OB care for low-risk women is immense (I've had both). The basic premise is that midwives should care for healthy, low-risk pregnancies and births with OBs acting as backups. Most other western countries use this model, which has healthier outcomes. (None of this applies for pregnancies with complications - although we need to be careful about how we determine if women are "high-risk")
One thing I have seen about this debate is that some people think that women who want natural, drug-free births want it just for the "experience". Some women have expressed "pressure" to do a natural birth and they resent this. What needs to be communicated - and Wagner does this in his book through citing many, many studies - is that natural births are HEALTHIER for women and babies. It's like complaining that people are pressuring you to lose weight if you are obese. It's just the right thing to aim for.
Wagner makes his cases with lots and lots of statistical backup. He points out that much of OB care is based on common practices instead of evidence. He doesn't make that mistake in his book! That's my only warning to readers - be ready for a lot of detailed studies.
Finally, Wagner proposes a solution to the problem. I am also working on trying to educate women about these issues with my website [...] and blog. If women understood that they are the consumers that need to start demanding better care, we might see change. The only problem is that most women think all these interventions mean they ARE getting the best care, but the statistics don't support that.
A great achievement November 2, 2006
19 out of 19 found this review helpful
This book includes the most comprehensive description of what's wrong with the US maternity care system and what should be done about it that I've ever read. It's well organized, well referenced, and--considering the scope of the problem--even optimistic. Dr. Wagner used to work in maternal child health in the World Health Organization, and his wide experience of maternity care systems all over the world adds necessary perspective to the discussion about how women should give birth, who decides, and why one might want to consider about all this before having a baby, instead of afterward.
The chapter on the witch-hunt against US midwives is essential reading for anyone who cares about the status of women and babies. The chapter on the culture of medicine and how this is enforced is fascinating and horrifying.
The book is must reading for those who think that our country can't hope to put together a system that works better for mothers and babies--and waste less money while we're at it. It should be required for anyone in the field of maternity care: nurses, physicians, midwives, childbirth educators, doulas, policy makers, lawmakers, judges--the list goes on and on.
Truly a great achievement. I hope this book gets the reading it deserves.
If it does, I believe that people will make our lawmakers follow the recommendations that Wagner makes at the end of the book.
 One good editor away from being a masterpiece April 9, 2007
18 out of 26 found this review helpful
This book is one good editor away from being a masterpiece.
Dr. Wagner is well informed on the topics of pregnancy and childbirth, and his passion for "humanized birth" is clear. I could not agree with him, his thesis, or his data more. He presents fascinating (real) stories, he gives wonderful first-hand accounts from dozens of other countries, and the whole book is quite compelling. I'm a slow reader, but I got through the book in just a few sittings.
There are three problems here: 1. he editorializes and interprets too much; 2. the book is a disorganized polemic; and 3. his recommendations are a little unfocused and overreaching.
1. Dr. Wagner's book suffers from what I'd call the Henci Goer problem: he interprets data in the text of the book (and editorializes) rather than simply presenting the studies and allowing the reader herself to draw her own conclusions. Readers on this topic are obviously interested in data. Let us see the data. Comment if you must, but do not leave out the data or put it in footnotes.
2. This book is a rambling polemic, the angry ramblings of a man possessed. It skips around from subject to subject; there are no subheadings between chapters. You could never use it as a reference on any topic. People who agree with you already will like the book. People who don't won't read or believe it because of its angry tone.
3. Some of his recommendations are a little unrealistic. Dr. Wagner makes ten recommendations for the "humanizing" of birth in the US. Unfortunately, the first is a universal healthcare system. It seems sad to think that birth cannot be improved without a trillion-dollar overhaul to the US healthcare system.
By the time you arrive at this book, you probably already agree with Dr. Wagner and are looking for a book to recommend to other people. Sadly, this can't be that book.
An Eye-opening Read March 9, 2007
11 out of 11 found this review helpful
This book was an eye-opener for me and I was aware of many of the problems with the maternity system before I read it. It goes much deeper than I thought. Dr. Wagner presents a great evidence-based objective analysis of the problems with maternity care in the U.S. I chose a homebirth with my last child for some of the things he talked about- the lack of choice I had as to whether I could VBAC because I had 2 previous c-sections. For anyone who doubts his book- you have been blinded by mainstream hype. This book really is what goes on. I've seen it myself in many ways, and Dr. Wagner presents evidence to show that the system indeed is broken.
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