Born in the USA: How a Broken Maternity System Must be Fixed to Put Women and Children First by Marsden Wagner is a must read for anyone who has been born, given birth, or plans to give birth. But I warn you that it may upset those who have beliefs rooted in our contemporary maternity care system. You are in for a rude awakening. For others, you may end up with neck strain from nodding your head in agreeance so frequently on issues you may already be aware of. And you'll find reaffirmations in how pissed off you are. Like me.
Marsden Wagner is a perinatalogist whose background is quite extensive. He began his medical career in pediatrics and continued to train in the specialty of perinatalogy and perinatal epidemiology. He taught in the UCLA medical school and was also the Director of Maternal and Child Health for the California State Health Department. He later went on to become the Director of the World Health Organization’s (WHO) Women’s and Children’s Health division. He’s written multiple scientific papers and has been a consultant within many countries through out the world. He is an advocate for midwifery care for normal low risk women.
This book covers what is wrong with our current system, the history of obstetrics and midwifery in our country, and the politics behind maternity care. It includes compelling real life cases. He cites a multitude of scientific literature to further his points. However, he points out how many obstetricians in our country either ignore the scientific research, or make up their own to back up their unsafe and unnecessary interventions. For instance, the use of the drug Cytotec is extensively discussed. Cytotec is frequently used to induce labor. However, it is not approved for this use and furthermore both the drug manufacturer and the FDA have released statements against this use. And there are families that can attest to why these statements have been published.
Dr. Wagner’s chapter on the “witch hunt” against midwives in our country is appalling. His discussion as to why this still occurs certainly hits home. I found myself further inspired to fight for women’s rights over their body from conception to birth. There is a pervasive yet underlying belief in our country that birth is a medical event and it must be treated as pathological. And for a small percentage pregnancy complications do lead to necessary medical intervention and treatment. But for the rest of us, birth is a normal and natural process that remains a social event for the woman and her family. Midwifery care understands this difference, and supports it. Other industrialized countries that value this model have lower maternal and neonatal mortality rates. There are about 28 other countries that have better maternal mortality rates than the
Dr. Wagner also includes suggestions to change our current system and remains realistic in the progress. He advocates for midwifery care and a system that allows access of care for all women. He points out that nothing can change overnight, but is hopeful that change will occur. So am I, but only if we are willing to put in the work to do so.