Expecting Trouble: What Expectant Parents Should Know About Prenatal Care in America [Paperback]

Jr. Thomas H. Strong (Author)

Book Description

ISBN-10: 0814797792 | ISBN-13: 978-0814797792 | Publication Date: March 15, 2002

In this controversial volume, Dr. Strong dispels widespread misconceptions about the effectiveness of prenatal care in its current form and explains how mothers themselves may influence the course and outcome of their pregnancies to a greater degree than do their obstetricians. He provides specific questions that parents should be asking their health care providers to ensure that they and their babies receive the best care possible.

Editorial Reviews

From Library Journal

Drawing from the literature of medical and epidemiological research, Strong"a second-generation obstetrician"presents compelling evidence that prenatal care in the United States does little to improve birth outcomes. The current trend toward universal prenatal care is fueled not by evidence that it is effective, he argues, but by unexamined assumptions as well as political expediency and economic greed. While stressing that access to prenatal care should not be impeded, Strong recommends that the technology and costs for uncomplicated pregnancies be scaled down, noting that prenatal care for these pregnancies could be shifted from obstetricians to midwives whose care is as effective but less costly. Obstetricians, in turn, could then focus on what they do well"assisting pregnancies with medical complications that respond to treatment"and the routine use of costly, high-tech procedures that do not improve outcome could be halted. In support of his vision, Strong explores a range of medical and public-policy issues currently under debate. Provocative and stimulating, this book performs a valuable service by bringing evidence on this vital issue out of the research literature and into public discourse and providing the tools for a long-needed paradigm shift. Recommended for public and academic libraries."Noemie Maxwell, Seattle Midwifery Sch.
Copyright 2000 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

From The New England Journal of Medicine

"What makes this book important is its comprehensiveness, its general readability, and the fact that it has been written by a practicing obstetrician…" --This text refers to an out of print or unavailable edition of this title.

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Product Details

• Paperback: 258 pages
• Publisher: NYU Press (March 15, 2002)
• Language: English
• ISBN-10: 0814797792
• ISBN-13: 978-0814797792
• Product Dimensions: 9 x 6.1 x 0.6 inches
• Shipping Weight: 12.2 ounces (View shipping rates and policies)
• Average Customer Review: 4.9 out of 5 stars  See all reviews (8 customer reviews)
• Amazon Best Sellers Rank: #982,391 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

41 of 44 people found the following review helpful:

5.0 out of 5 stars A problem in need of a different solution, January 31, 2001

By 

Kathryn Schrag (Tucson,, Az. United States) - See all my reviews
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This review is from: Expecting Trouble: What Expectant Parents Should Know about Prenatal Care in America (Hardcover)

"If we as a nation want to take care of our children, we must first take care of our mothers". Kitty Ernst CNM MPH

I was thrilled to hear of and read this much needed book. Dr Strong, a perinatologist, had the courage to remind us that we as a nation are doing a shameful job in attending to the needs of our childbearing mothers and their unborn children. He begins with the disturbing data on babies born too soon and too small, and goes on in a thoughtful and scholarly way to explore the issue.

It seems to be human nature that when we recognize a problem, we knuckle down, determined to keep doing what we have been doing but doing it in a "better" way. That is exactly the problem with our system of prenatal care... and its not working. Its time to look at how we can serve pregant women in a different and better way.

As a practicing nurse-midwife, i have long believed that pregnancy and birth must be addressed not as a medical event, but as a "mind-body-spirit" event, occuring within a social context, and that the "midwifery model" rather than the "medical model" of care is the appropriate approach for low risk women. Dr Strong suppports this point of view as one of the solutions to the problems he identifies in the delivery of health care during pregnancy and birth.

I would recommend this book to EVERY student and practitioner of maternal-child nursing, midwifery,or obstetrics. THose people working within public health and public policy will also find it enlightening. Parents to be who have chosen nurse-midiwfery care for their pregnancies will be pleased to see the scientific and philosophical support for their decision coming from an expert in "high-risk obstetrics".

If I ever return to teaching, it will be required reading for my students; i am circulating a copy among the obstetricians and nurse-midwives with whom I work. Enjoy!!!

23 of 25 people found the following review helpful:

5.0 out of 5 stars Most lucid articulation of a faulty maternity care system, December 8, 2000

By 

Loren R. Harmon (Phoenix, AZ USA) - See all my reviews
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This review is from: Expecting Trouble: What Expectant Parents Should Know about Prenatal Care in America (Hardcover)

This book supports with facts, figures and irrefutable statistics that our current system of delivering care care to pregnant women is failing miserably. Despite increased expenditures and so called advances in medicine and medical management, Strong presents a strong case for an illnesss based system. It fails to adhere to the "do no harm" oath and is not a system of health care. Rather it causes it's own problems in illness care and then congratulates the system when tyhe outcome is at least mediocre at best and then only in spite of the system, not because of the system.

It validated and expanded on what I have believed to be true for the past 25 years of my experience as an advanced nurse practitioner.

Judith S. Harmon, MS, RN, C-FNP Perinatal Clinical Nurse Specialist Certified Nurse Practitioner Co-author Manual of High Risk Pregnancy and Delivery, Mosby.

18 of 19 people found the following review helpful:

4.0 out of 5 stars A strong contribution to the sociology of birth, January 19, 2003

By 

Courtney L. Lewis "Sassy Librarian" (Kingston, PA USA) - See all my reviews
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This review is from: Expecting Trouble: What Expectant Parents Should Know about Prenatal Care in America (Hardcover)

Thomas H. Strong has written an excellent account of the inherent flaws of prenatal care in the United States, highlighting where Western medicine succeeds and where it fails. Looking critically at other health care systems around the world, he demonstrates how alternative health care for birth when delivered by midwives has higher success rates in preventing premature birth and various birth problems. If anything prevented me from giving this excellent work five stars, it was the fact that Dr. Strong, while praising health care systems like the Netherlands, decided not to address the fact that those same praiseworthy birth traditions are delivered by lay midwives, not the nurse-midwives found in other countries. While both lay (or direct-entry) midwives and nurse-midwives contribute important care to pregnant women, Dr. Strong failed to address the prejudices surrounding direct-entry midwifery in the United States despite its affordability and accessibility in remote areas.

I think this is an important book for mothers to read, but be aware that it presents research and, while well-written, is not written in the accessible format of many books destined for the expectant parent. It would be an excellent book for anyone interested in the sociology or medical anthropology of birth and its inclusion in women's studies classes would enrich any curriculum.