Born in the USA

I read this wonderful book a couple years ago.  I think it should be mandatory reading for women and doctors (especially if you are contemplating kids in the near future).

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

by Marsden Wagner

This book is written by an obstetrician who has been in practice as well as research.  He worked for the WHO in London and still consults on cases when needed.  Keep in mind that this is a book by a doctor who believes that his place is ONLY in high-risk pregnancy – a far different opinion than most OB/GYNs these days.  An OB is a specialized surgeon.  Having an OB attend your low-risk birth is the equivalent of having a brain surgeon check out your head when you bump it or a heart surgeon do your yearly physical.
It was one of the scariest things I’ve read and if you had an “emergency c-section” I suggest you do read it for information on VBACs but you will probably want to skip over all the facts regarding c-sections because you may quickly come to realize that your surgery was pre-emptive and not truly needed, had the doctor just slowed down, stepped back, and let the laboring woman’s body do its job.
He answers the question “Are Epidurals Safe?” Though your doctor may lead you to think otherwise, they can hardly be considered safe when 23% of women receiving one have complications.  There is a longer excerpt at the end about how unsafe an epidural block is if you are interested.
Following are some facts for the book and a few excerpts you may be interested in.  It’s sad that SOOOOO many women are scared about something that women have done for tens of thousands of years.  Only in the last 100 years has giving birth become a medical process needing “treatment”.  The question is, when statistics show that women don’t need medical help, why do we seek it?  This book gives the information on pregnancy and birthing that so many doctors don’t tell you and many don’t even know.
I only wish I had read this before having Eli.  Feel free to comment based on your own experience, but until you have read the book, know that you don’t have all the facts!
Just keep in mind, if my friend could go through 17 hours of labor, 5 hours of pushing, and have a 10-pound baby with a 15-inch head all the in comfort and safety of home with no complications, then you, too, can have an average-weight baby without the need for medical intervention.

Quick facts (pgs. 242-246):
There are twenty-two industrialized countries with lower infant mortality rates than the US.  All 22 provide universal prenatal care.

25% of US women receive little or no prenatal care. 1 in 2 of these women with give birth to a low-birth-weight baby (less than 5.5 pounds) or a premature baby (less than 37 weeks of gestation).

60% of infant death is linked to low birth weight.  It costs 2.5-times as much to raise a low-birth-weight baby to the age of 35 than a baby of average birth-weight.

Intensive care for one infant: $20,000-100,000.  This amount would cover prenatal care for 30 women.

Percentage of births attended principally by midwives:
US: 10%
European nations: 75%
Percentage of countries with lower infant mortality rates than the US in which midwives are principal birth attendants: 100%

Average cost of a mid-wife-attended birth in the US: $1,200
Average cost of a physician-attended vaginal birth in the US: $4,200

Number of scientific studies in which routine electronic fetal monitoring during every birth has been proven more effective than the use of a simple stethoscope to monitor the fetal heart: ZERO
Cost per year of using routine electronic fetal monitoring during every childbirth: $750 million

US C-section rate:
1965: 5%
2004: 29.1%
C-section rate targeted by the WHO and the U.S. Department of Health and Human services: 12%

Percentage of women in the US with C-sections who undergo repeat C-section: 91% (totally unneeded in eight-nine out of ten births).

Ratio of women dying from C-section to women dying from vaginal birth: 4 to 1

Average cost of C-section: $7,826

Evidence shows that when the c-section rate goes over 15%, the maternal mortality rate increases.
Evidence shows that midwives are safer than doctors to attend low-risk births.
Evidence shows that planned home birth for women with low-risk pregnancies is as safe as hospital birth.

“The key issue in the question of where to give birth, however, is who is in control.  Physicians, hospitals, electronic fetal monitors, and drugs do not have babies – only the mother of the child can do that. . .All maternity services should reflect this fundamental fact and should be designed to assist and support the woman.  Most of the present care system for birthing women in the US is designed not to assist the mother but rather to control her.
“Doctors control women with fear.  They have succeeded in convincing the great majority of American women that they cannot safely give birth outside the hospital; that nearly half of them have uteruses that are non-starters and need to have labor induced or augmented with powerful drugs; that up to two-thirds of them cannot tolerate labor pain and must be made numb from the waist down with an epidural block so they cannot feel the birth of their babies; that one-third of them cannot push out their babies but must have it pulled out with forceps or a vacuum or cut out by c-section.  When we try to make women believe that they can’t give birth without the help of men, machines, and hospitals, we take away their confidence and their belief in their own bodies – and with their confidence gone, any feelings of power and autonomy also disappear…” (pg. 190)

“Women who have epidural block for normal labor pain have risk of dying that is triple that of women who do not. . .”A woman also has a 15 to 20 percent chance of developing a fever after receiving an epidural block. When a woman in labor developed a fever, it means that a diagnostic evaluation must be done to determine if there is an infection in her body or in the baby’s body. These diagnostic procedures can sometimes be invasive, including doing a spinal tap on the baby, which is a painful and risky procedure in and of itself.”Another known complication of epidural block: between 15 and 35 percent of women who are given an epidural will suffer from urinary retention after the birth, a condition which, if it continues, necessitates putting a catheter in the bladder until bladder function returns.”. . .Studies show that around 10 percent of epidurals don’t work at all; there is no pain relief. Even when pain is blocked during labor, about one-third of the women given an epidural will trade a few hours of pain-free labor of days, weeks, or months of back pain after the birth. Studies show that 30 to 40 percent of women who receive an epidural during labor will have severe back pain after the birth, and 20 percent will still have severe back pain a year later.”The fact that when an epidural block is given labor does not progress normally has consequences as well. A great deal of scientific research has shown that women who receive epidural block for normal labor pain will have a significantly longer second stage of labor, and thus the epidural block means a four times greater chance that forceps or vacuum extraction will be used to extract the baby, and at least a two time greater chance that a C-section will be performed. . .”Although many women might be willing to take risks with their own bodies for pain relief, very few women are willing to put their babies at risk. But that is what a woman does when she agrees to an epidural. One common complication when a woman has an epidural is that there will be a sudden drop in her blood pressure, leading to a sharp drop in blood flow through the placenta to the fetus. This drop in blood flow can result in mild to severe lack of oxygen getting to the fetus, which if not quickly treated can result in brain damage in the baby. . .Studies have shown that in 8 to 12 percent of cases in which a woman is given an epidural block for normal labor pain, the electronic fetal heart monitor will show a severe lack of oxygen to the baby. In a further study, after having an epidural, three-quarters of the babies of healthy women in normal labor had episodes of slowing of the fetal heart rate, a symptom of fetal distress” (pgs. 54-55).

Epidurals also lead to sleepy babies and if you want to get off to a good start in breastfeeding with as few complications as possible, a sleepy baby is the last thing you want right after birth.


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