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Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First 1st Edition

4.5 out of 5 stars 62 customer reviews
ISBN-13: 978-0520245969
ISBN-10: 0520245962
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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


"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: 9.2 x 6.3 x 1 inches
  • Shipping Weight: 1 pounds
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (62 customer reviews)
  • Amazon Best Sellers Rank: #491,258 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By Ina M. Gaskin on November 1, 2006
Format: 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.
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By gilly on February 6, 2007
Format: Hardcover Verified Purchase
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.
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Format: Hardcover Verified Purchase
As a labor and delivery nurse and aspiring midwife, I can tell you that unfortunately, what Dr. Wagner discusses in this book is definitely occurring in hospitals. This book outlines with excellent sources why our country is such a mess with regards to maternity care. He explains how delivering in a hospital with an OB can actually end up being more harmful than safe for women with normal pregnancies. OB's have become so frightened of the small percentage of complications that can occur with normal labor that they have created interventions that interfere with the natural process and can actually cause other problems. The policies and procedures carried out in most hospitals are the least conducive to a normal delivery- beginning from the time the mother is strapped into bed to a monitor and ending with pushing on her back. Dr. Wagner points out that what is worse is that there is no scientific basis for many of the routine interventions that are carried out, and in fact, in many cases, scientific data that it is harmful. This book is a must read for everyone who cares about protecting pregnant women and their babies.

My only complaint is that at times the book is repetitive and disorganized. This however did not detract from the important information that is in it. I have been quoting it to everyone I know since I read it.
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Format: Hardcover
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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