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University of California Press

About the Book

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

About the Author

Marsden Wagner, a physician and scientist, is a former Director of Women’s and Children’s Health at the World Health Organization and a recipient of an Alumnus of the Year Award from the University of California at Los Angeles School of Medicine. He is author of many books, including Pursuing the Birth Machine: The Search for Appropriate Birth Technology and Tough Choices: In Vitro Fertilization and the Reproductive Technologies.

Table of Contents

Preface

1. Maternity Care in Crisis: Where Are the Doctors?
2. Tribal Obstetrics
3. Choose and Lose: Promoting Cesarean Section and Other Invasive Interventions
4. Forced Labor: Induction or Seduction
5. Hunting Witches: Midwifery in America
6. Where to Be Born: Here Come the Obstetric Police
7. Rights and Wrongs: The “Malpractice Crisis,” Legal Protections for Pregnant Women, and Regulation by Litigation
8. Vision of a Better Way to Be Born
9. How to Get Where We Need to Be

Notes
Index

Reviews

“A call to action, Born in the USA includes a list of sensible recommendations: for a national health care system that would provide care to all pregnant women, for more home deliveries, for increased use of midwives, and, of course, for increased scrutiny, transparency and accountability of the health care system. It’s hard to argue with any of this. What makes the recommendations compelling is the vast quantities of studies and court cases Wagner cites, his copious and careful footnotes, his fascinating use of cross-country comparisons, and the sheer volume of supporting information.”
Times Literary Supplement (TLS)
“I highly recommend this lucid, authoritative analysis of the state of maternity care in the U.S.”
Mothering
“Riveting for all women of child bearing age, lay and professional alike.”
Intl Lactation Consultant Association
“Speaking from his experience as a clinical perinatologist and a perinatal epidemiologist and supplemented by the hoard of credible sources cites in the copious endnotes, Wagner pulls no punches in advocating a woman’s right to control the entire reproductive process, from conception through birth.”
Booklist
"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, MD, author of Women’s Bodies, Women’s Wisdom