BOOK REVIEW for BORN IN THE USA, WRITTEN BY MARSDEN WAGNER

             As I began reading Born in the USA I was using a highlighter to underline things that stood out to me and that I wanted to remember. I realized I was underlining a huge portion of the book so I dropped the highlighter and began to soak it all in. I loved this book; I wish everyone who was pregnant in the United States could have a chance to read it, I wish I would have read it before having children. I believe the author has laid out the problems with current maternal healthcare we are facing, as well as come up with great solutions to help us have a healthier outcome for both the mother and baby.  It is clear that the medicalization of birth has brought many problems and the skewing of the perception of women over time about birth being a medical event has exacerbated the problem. I remember speaking with my husband’s grandmother about her births, this was during the time where they would almost knock out the woman entirely and rip the baby from their bodies as they lay there on their backs as a “patient” in some atrocious medical event. She told me they would give her a “whiff of gas” to assist her as she was laboring. The first birth for my Mother was traumatic they would not allow my Father to be in the room and she said it was the most demeaning and horrible experience she had ever had. The doctor yelled expletives to her to get her bottom on the table as she was trying to give birth and then later reached into her body for the placenta and pulled it out breaking her coccyx bone. I am assuming my Dad would have punched this doctor out if he would have been in there. Another generation later as I was giving birth to my first son, I had all my requests laughed at or ignored and was sent through the medical shoot of epidural and vacuum extractor to get my baby out as I felt like a bystander to this “medical event.” I should have felt happy to have my baby alive and in the world but I didn’t feel like I was present and that I had missed the whole thing. I felt like there must be a better way. Luckily, I found a better way by my third and fourth child but I still wish I knew what I know now. I am on my journey to help others find a better way for them.

            The main premise in Born in the USA is that we need to un-medicalize birth and realize the data shows that planned homebirth is just as safe as or safer than hospital births. Birth for 80-90% of women is uncomplicated and is not something that is done to a woman but something she does. It has also been shown in the research that when cesarean sections begin to raise above the 10-15% rate the mortality rate increases for both mother and baby. So he makes the point that if most women have healthy births we need to have more midwives to serve that population and save the 10-20% high risk patients for the obstetricians and encourage healthy women to use midwifes. This would dramatically decrease the financial costs of maternal care as well as decrease the mortality rate for unnecessary interventions such as augmentation, epidurals, pitocin, and cesarean sections. It is atrocious how experimental the obstetric world is in trying new procedures. I was surprised to read that experimentation was how the use of epidurals was started as well the drug cytotec was also used this way even without patient knowledge or consent when it was even warned for usage by the FDA and the drug manufactures. It seems so irresponsible that medicine can be done in this way when monitoring in other situations in the United States is so vigilant. 

            I found the chapter entitled “Hunting Witches” very eye opening. I loved at the beginning of the chapter he speaks of the history of midwifery and defines the words for midwifes such as “The word midwife is early English for “with woman.” The French word for midwife, sage femme (wise woman), goes back thousands of years, as do the words in Danish, jordmar (earth mother), and Icelandic, ljosmodir (mother of light)” (page 100) those are so beautiful and respectful.  It wasn’t until the last 100-150 years that the name of a midwife was not respected as the medical establishment (men) pushed them out so they could push their way in.  I also like how the author states that he feels men are threatened and scared of empowered women birthing their babies and that is the reason they want control of the birth. The great lengths that obstetricians and others to try to put midwives out of business is horrible. I really agree with the author that it should be required of all doctors to view homebirths before they get their license so they can see the beauty of women listening to her body and birthing the way they wish. I believe if everyone was more educated with a better understanding of midwifery and home birth there would not be this negative stigma attached to it, or at the very least be taught in the different schools of thought for example the midwifery model of care versus the medical model. I know I wish I had read this book and a few others before I had my first child. I think it is a little unfair we don’t get educated with more options. Especially since we know of other countries like the Netherlands that show how well this model can work. I love that 50 years ago they had 50% of their babies at home with a midwife. I also love that everyone has a midwife and has the option to choose where to have her baby and if there are complications they work well with the together with an established relationship. The percentage of midwives to obstetricians is 90% to 10% where in the United States that is flip flopped.

            I also recently read the article Deadly Delivery which in addition to the data shares real quotes from families and care providers in the United States and it is very powerful.  It really gives you a sense of what women are facing and the information gap between the patients and care providers with economic and cultural issues. One quote given by a doctor where they were treating a pregnant Hispanic woman and they couldn’t communicate with her and he said something to the effect of we are practicing veterinary medicine here. This was sickening to me, as in it doesn’t matter what we do to them or it doesn’t matter if we understand them or not because of the language barrier and most appalling comparing humans to animals. Reading this really brings to light how important the humanizing of birth movement is in the United States. It is hard to see the data from the Women’s Health USA that shows mother and babies of color are dying at much higher rates than white women. In my communication class, a student presenter (who is black) had created a presentation to give to women of color in her area to broach this topic and became tearful when she got to the slide that showed the mortality disparity between the different races. I believe many of us were also crying as this is not something we want in our country. I believe that is why most of us who are attending MCU are in this field to try to make things better than they were for them or want to make it better for their own daughters and all women everywhere. Humanizing birth is imperative. We are finding that there is a “better way” and I want others to know about it. 

Written by Rebecca Madsen