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

This is on a reading list to go on a midwifery course. SO I would suggest to read it. Pithy and to the point that is all this review is going to say.

I am a birth junkie: I admit it. If you are too, or even if this is your first foray into learning more about birth in the US, you'll find this book enlightening.After giving birth the first time and suffering for years afterward because I felt so traumatized, I was determined to improve on the experience. It has taken a lot of work and research, but within our flawed system, it can be done. (Long story short: get a midwife, hire a doula, do your homework.)This book is a great primer on how our current system works and what can be done to improve it--both in the big picture and by individuals.This book is written by a doctor who knows his stuff: he dissects the system under which obstetricians work (whether they are aware of it or not) and demonstrates how very faulty research and belief systems about birth impact the experience of every woman who has a baby. What I admire about Dr. Wagner is that he isn't afraid to confront the inherent biases that exist today, and he can back up everything with solid facts.Read this book! I may not agree with all of Dr. Marsden's suggested solutions, but the reader will take its primary lesson to heart: birth is a NORMAL PHYSICAL AND PSYCHOLOGICAL PROCESS and not a frightening medical crisis fraught with danger, despite overt efforts by the medical establishment to paint it as such.

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.

This book is chock full of really important information that is not widely disseminated. Dr. Wagner uses his experience in the US maternity system, as well as his time with the WHO, to effectively demonstrate the shortfalls of maternity care in the US from an understandable, extremely expert perspective. Of all the many books written on this topic, this is one of the few that explores how doctors, as well as patients, are trapped by the current system, and offers alternative solutions that would help everyone. Dr. Wagner's experience as a clinician makes him a powerful advocate for patient safety and provides useful insights into how to avoid unnecessary interventions during labor.That said, the writing in this book isn't great. It is easy to follow and understand, but often laced with redundancy and oversimplification.

I think everyone should read this book. I realize that this book was written to get a rise out of people, but I think it brings awareness to several areas that we could improve on in our maternity care.