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

Marsden Wagner (Author)

Book Description

ISBN-10: 0520245962 | ISBN-13: 978-0520245969 | Publication Date: November 1, 2006 | Edition: 1

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 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

Editorial Reviews

From Booklist

*Starred Review* The outspoken former director of Women's and Children's Health at the World Health Organization believes maternity and perinatal care in the U.S. are seriously flawed. To make the point, he cites recent Centers for Disease Control findings that 28 countries have lower maternity-mortality rates; 41, lower infant-mortality rates. This despite the fact that the U.S. spends twice as much or more per capita on health care than any other industrialized nation. Wagner places responsibility squarely on the shoulders of obstetricians and the lobbying power of the American College of Obstetricians and Gynecologists. Interested in one thing above all else--maintaining control of a lucrative market--that group, he avers, foists unnecessary, expensive, and invasive medical interventions upon women when none are needed. Obstetricians are only necessary, he says, in a minority of cases in which serious medical problems threaten the life of mother or child. For the most part, childbirth isn't a medical condition, and infant and maternal mortality rates are lowest in countries in which midwives attend to it. Speaking from his experience as a clinical perinatologist and a perinatal epidemiologist and supplemented by the hoard of credible sources cited in the copious endnotes, Wagner pulls no punches in advocating a woman's right to control the entire reproductive process, from conception through birth. Donna Chavez
Copyright © American Library Association. All rights reserved

Review

"Dr. Wagner depicts the state of obstetrical care in the United States with clarity and accuracy. He is clearly an 'insider' who has the courage to tell the truth about how our love affair with birth technology adversely affects both mothers and babies. Importantly, he outlines a path toward much-needed change. Born in the USA should be 'must' reading, not only for all pregnant women, but also for all ob/gyn physicians, hospital personnel, and those who make public policy. Dr. Wagner has done all of us a great service with this book." - Christiane Northrup, M.D., author of Women's Bodies, Women's Wisdom"

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Product Details

• Hardcover: 305 pages
• Publisher: University of California Press; 1 edition (November 1, 2006)
• Language: English
• ISBN-10: 0520245962
• ISBN-13: 978-0520245969
• Product Dimensions: 9.1 x 5.9 x 1 inches
• Shipping Weight: 1 pounds (View shipping rates and policies)
• Average Customer Review: 4.6 out of 5 stars  See all reviews (44 customer reviews)
• Amazon Best Sellers Rank: #507,349 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

60 of 61 people found the following review helpful:

5.0 out of 5 stars A great achievement, November 1, 2006

By 

Ina M. Gaskin "Midwife" (Summertown, Tennessee) - See all my reviews
(REAL NAME)   

This review is from: Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First (Hardcover)

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.

67 of 70 people found the following review helpful:

5.0 out of 5 stars Thank God for Marsden Wagner!!, November 16, 2006

By 

Holli A. Askren (Phoenix, AZ) - See all my reviews
(REAL NAME)   

This review is from: Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First (Hardcover)

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!!

37 of 37 people found the following review helpful:

5.0 out of 5 stars Eye Opening, February 6, 2007

By 

gilly (Vermont, USA) - See all my reviews

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This review is from: Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First (Hardcover)

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.