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Born in the USA- How a Broken Maternity System Must Be Fixed to Put Women & Children First (05) by [Paperback (2008)]
Born in the USA- How a Broken Maternity System Must Be Fixed to Put Women & Children First (05) by [Paperback (2008)]
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First published January 1, 2006
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Displaying 1 - 30 of 88 reviews
March 11, 2008
After reading Birth by Tina Cassidy I was inspired to do more research on our maternity care system in the US. I was surprised about the high maternal-mortality rate in the US and wanted to read more. Born in the USA, by Marsden Wagner, was absolutely mind blowing. Wagner is the former Director of Women's and Children's Health for the World Health Organization (WHO) and refers to himself at one point as a "whistle blower". The book details the incredibly flawed maternity care system in the US and the over medicalization of the birth process and the use of unnecessary (and often not FDA approved) procedures on women in labor. Many of which, he believes, contribute to the US having one of the highest rates of maternal-mortality, compared to other industrialized nations. The statistics he cites in this book are absolutely eye opening.
If you have any interest in the health care system in the US, especially as it relates to women, this is the book for you.
If you have any interest in the health care system in the US, especially as it relates to women, this is the book for you.
October 28, 2011
If Dr. Wagner has presented his arguments and evidence with a little less vitriol I would have found this book to be much more compelling. I didn't necessarily disagree with anything he had to say, but he painted all OB-GYNs with such a broad, nasty brush and all participants of the midwifery model of care in such angelic terms that it was difficult to swallow. I do not believe that all maternity doctors are the selfish, stubborn control freaks Dr. Wagner would have us believe, nor do I believe that midwives and doulas can do no wrong and always have the best interest of the mother at heart. While he lambasted published studies for their poor scientific methods and erroneous results, he provided several interpretations of data and anecdotes himself that were clearly biased. (His example of the rural town in which the doctors refused to continue delivering babies, midwives took over, and infant mortality dropped precipitously comes to mind. I have no doubt this was true, but he should have at least mentioned the fact that there were probably fewer high-risk pregnancies being cared for under the midwives.)
All this makes it sound like I hated the book, but I didn't. I liked it. I gave it three stars. It was interesting. It had a lot of really interesting anecdotes and a lot of food for thought. I just wished it could have been written with at least a veneer of fairness.
All this makes it sound like I hated the book, but I didn't. I liked it. I gave it three stars. It was interesting. It had a lot of really interesting anecdotes and a lot of food for thought. I just wished it could have been written with at least a veneer of fairness.
June 16, 2011
This book is in the same vein as Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block. Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience by Ricki Lake, and The Thinking Woman's Guide to a Better Birth by Henci Goer. But Dr. Wagner also raises several interesting issues not in those books.
In the first chapter he points out that in the United States it is virtually impossible to find out exactly how a patient was treated, what the alternative treatments were, why that person received certain treatments instead of others, and who is responsible if there was negligence or malpractice without filing a lawsuit. While most American medical professionals don't comply with legal standard of informed consent, it's rather frightening to have this spelled out so clearly. He elaborates on this theme in Chapter 7, saying "Many people believe that physicians in the United States are resistant to the idea of national health care because they would make less money, but I think that an equally strong reason is the fear physicians feel around disclosing what they're doing and being held accountable for it" (206).
Chapter 2 takes the reader into the world of doctors and what Dr. Wagner terms "tribal obstetrics." Doctors keep each other's dirty secrets to the detriment of their patients. This chapter illuminates how in cases of malpratice or negligence medical professionals don't want to risk by shunned by their medical community and will rarely break ranks to report or testify against a colleague. As evidence, Dr. Wagner cites several examples about how he got into hot water by blowing the whistle on obstetric practices that violated the medical community's edict to practice evidence-based medicine.
Chapter 7 discusses legal protection afforded to pregnant woman. As mentioned in other critiques of American maternity care, obstetricians tend to pratice defensive medicine. "The constant threat of litigation also means that many obstetricians in the United States go about their practice with a defensive mindset. The decision to do a C-section, which we might call the ultimate intervention, is often based not on medical need but on a desire to avoid litigation" (154). Doctors -- in this field as in many others -- tend to do what is in their best interest instead of the best interest of their patients.
Dr. Wagner provides a very important piece of information not mentioned in other books. This is that patients aren't required by law to sign a hospital's consent form and that they have the right to customize it to reflect their wishes about certain treatments. Not signing any blanket permission form that allows hospital personnel to do whatever they deem "necessary" is a great piece of advice although it should be given with the warning that the hospital may then refuse to treat anyone who refuses to sign away his/her rights. He also lists the fundamental legal rights of women protected by constitutional, federal, and international laws as well as ethical guidelines of the American Medical Association and the American College of Obstetricians and Gynecologists. The most important of these to remember being "The right to revoke consent to treatment at any time, either verbally or in writing" (174).
In Chapter 8, the author describes his vision of how American maternity care could be reformed based on more humane Dutch and European models. Dr. Wagner then goes on to outline ways that these changes can be brought about in Chapter 9.
Born in the USA is a worthwhile read for those interested in the crisis for American maternity care. Although, it is drier than other books on the same topic and lacks the plethora of personal stories, and the only first-hand accounts are from Dr. Wagner himself.
December 6, 2009
I have mixed feelings about this book. It was kind of shocking and negative through most of it, with a laundry list of horrifying anecdotes. The author redeems himself at the end with real, concrete suggestions for improving the maternity care situation in this country, but still.
Also, I'm not sure this lady is the one you want as your poster child for a woman's right to refuse a C-section. I'm just sayin'.
In short, this was like the man-version of Pushed The Painful Truth About Childbirth and Modern Maternity Care, but with a lot more hate for OBs. Like, a LOT more hate. If you had to choose one book to read on this subject, I would recommend Pushed or Birth The Surprising History of How We Are Born over this one for sure.
Also, I'm not sure this lady is the one you want as your poster child for a woman's right to refuse a C-section. I'm just sayin'.
In short, this was like the man-version of Pushed The Painful Truth About Childbirth and Modern Maternity Care, but with a lot more hate for OBs. Like, a LOT more hate. If you had to choose one book to read on this subject, I would recommend Pushed or Birth The Surprising History of How We Are Born over this one for sure.
November 19, 2024
5 stars for Wagner being fully FOR WOMEN (and babies). Agency abounds, empowerment, evidence based practices, what a guy.
3 stars because the tone oscillates between clinical and casual and because it took me so long to finish (:
3 stars because the tone oscillates between clinical and casual and because it took me so long to finish (:
July 12, 2007
Read this book if you are pregnant, your partner is pregnant or you want to know more about the mistakes being made in the birth industry. Well written and researched. An oby-gyn and former director of Women's and Children's Health at WHO spells out many problems with the current situation, from our high cesarean rates to our high infant mortality rates. These are not coincidences, but are outcomes of our overuse of interventions. With almost one out of three births by cesarean in the US, there is something wrong. Read about other options and how countries that use midwifes have much lower infant mortality.
April 2, 2015
This is a powerful, informative, detailed book. It is authoritative, researched and well-argued. I feel like the audience is other medical professionals rather than mothers-to-be. It is very informative about our maternity system, I just have read others I preferred. Maybe it was too many details & arguments I already prescribed too. Wagner does have an abundance of facts and information and perspectives to back up his claims. Recommended but as it is a bit detail-heavy, I'd only recommend it to those in the medical profession, midwives/doulas, or moms who are just crazy about learning about birth like me!
March 21, 2009
definitely a good read--agree with bonnie that it was refreshing that the book was written by a man. however, it scared the crap out of me. granted, i believe it was this book specifically that gave me the wherewithall to tell my obgyn to shove off when he suggested a c-section. but, my son's particular birth was fairly textbook. had there been bonafide complications, i'm sure i would have given him the greenlight. and, since it WAS textbook--i will continue to think of him as just another doctor who puts his own personal life/fear of malpractice before the birth of my son.
March 27, 2020
A compelling and persuasive argument with some surprising statistics. Astonished to learn that America has one of the highest infant mortality rate of developed countries, and the maternal death rate in Europe is 70%! lower (and for 25 straight years the number of maternal deaths in the US has been increasing!). Despite this, we pay more per capita for maternity services than any other country in the world. Interesting read.
October 17, 2015
I can do dry reading. Heck, I'm a counselor, those texts aren't exactly a thrill a minute. But this has bored the living snot out of me and I LOVE and fully stand behind the topic. It's really that bad. Do yourself a favor and read a more personable book on birth choices. This one will leave you snoozing.
July 25, 2012
My hero. Dr. Wagner spills the beans on the horrific state of maternity care currently holding power in the United States. Time to topple the powers that be.
April 13, 2022
This book had a lot of interesting information presented in a compelling way. It made me think about the experiences that I and others in my family have had with the American maternity care system. It certainly highlighted some egregious examples of appalling care, like women being forced by the courts to have C-sections after they refused.
What I disliked about the book were Wagner's extreme views. He thinks that obstetricians are practically evil, whereas midwives can do no wrong. He makes this very much about gender, even saying that men are afraid of women who are in control of their own bodies. He describes the field of obstetrics as being male-dominated, although that was already rapidly changing when the book was written (and now females are the majority in the profession).
He also constantly refers to off-label prescribing as "experimental," and criticizes the medical profession for using pain medications for women in labor. I actually agree with his points that a lot of interventions are overused, that doctors are afraid of being sued, and that women should have more control over their childbirth experience. Some major reforms are obviously needed. But the way he makes his points is so divisive and vitriolic that it made the book less enjoyable to read. Several times, Wagner suggested that the links between autism and obstetric interventions should be investigated, because they both increased at the same time. I think he's venturing into fear-mongering there.
Possibly the most ridiculous aspect of the book was that Wagner claims to want women to have complete control over their birth experience, but then his proposed changes to the system would BAN low-risk hospital births! If he really wanted women to have choices and control, he would allow them the choice of a hospital birth if that's what they prefer. It's incredible how quickly he pivots from saying that women should be in control of their birth experience (when they want a home birth) to saying that women should be prohibited from choosing the wrong location to give birth (when they want a hospital birth).
These quotes are both in the book, in the same chapter, only a couple of pages from each other:
"A family must be allowed to own the birth of their child and to create the birth experience they want and need... It is the woman's childbirth. It is her life." (page 190)
"For these low-risk women, giving birth in a hospital would not be an option [in Wagner's ideal scenario] because it represents a considerable unnecessary drain on the economy and, more important, because it presents serious risks to both the woman and the baby." (page 188)
So... women should be able to create the birth experience they want and need... but only if it doesn't drain the economy or present any risks?
What I disliked about the book were Wagner's extreme views. He thinks that obstetricians are practically evil, whereas midwives can do no wrong. He makes this very much about gender, even saying that men are afraid of women who are in control of their own bodies. He describes the field of obstetrics as being male-dominated, although that was already rapidly changing when the book was written (and now females are the majority in the profession).
He also constantly refers to off-label prescribing as "experimental," and criticizes the medical profession for using pain medications for women in labor. I actually agree with his points that a lot of interventions are overused, that doctors are afraid of being sued, and that women should have more control over their childbirth experience. Some major reforms are obviously needed. But the way he makes his points is so divisive and vitriolic that it made the book less enjoyable to read. Several times, Wagner suggested that the links between autism and obstetric interventions should be investigated, because they both increased at the same time. I think he's venturing into fear-mongering there.
Possibly the most ridiculous aspect of the book was that Wagner claims to want women to have complete control over their birth experience, but then his proposed changes to the system would BAN low-risk hospital births! If he really wanted women to have choices and control, he would allow them the choice of a hospital birth if that's what they prefer. It's incredible how quickly he pivots from saying that women should be in control of their birth experience (when they want a home birth) to saying that women should be prohibited from choosing the wrong location to give birth (when they want a hospital birth).
These quotes are both in the book, in the same chapter, only a couple of pages from each other:
"A family must be allowed to own the birth of their child and to create the birth experience they want and need... It is the woman's childbirth. It is her life." (page 190)
"For these low-risk women, giving birth in a hospital would not be an option [in Wagner's ideal scenario] because it represents a considerable unnecessary drain on the economy and, more important, because it presents serious risks to both the woman and the baby." (page 188)
So... women should be able to create the birth experience they want and need... but only if it doesn't drain the economy or present any risks?
March 27, 2018
Deeply informative, and clearly written by a passionate expert in the field - Born in The USA is an important read for anyone interested in maternal/child healthcare in the United States. Wagner will change the way you look at not only maternal health studies - but all medical studies. Sometimes his scientific background gets the worst of him, and the jargon/ dense writing feels overwhelming at best, and boring at it’s worst. If you have the stamina to power through - there is much to be unraveled.
February 7, 2018
I've known for years how messed up the US maternity system is, and read a bunch of other books, but THIS Is the book that all pregnant women should read. (And then they would all leave the traditional hospital setting, get midwives, and we'd have REAL change.) This book will horrify you and enlighten you (even if you already knew a lot abt this sort of stuff). Such an amazing book. So glad I'm working with a midwife who agrees with this sort of POV on things.
June 29, 2023
Wow, what a devastating and inspiring read! I knew the maternity care crisis was real but hearing it from the mouth of an actual OBGYN is very sobering. I LOVE the step by step plan he feels needs to occur and he has the qualifications and experience to speak on these things. So many OBs have no experience beyond what they've been trained in surgical birth and it shows. A good read for anyone capable of giving birth or loving anyone who gives birth.
April 24, 2025
Excellent overview of the U.S. maternity system and its many flaws due to the obstetric monopoly, politics, and a witch hunt against midwives. Dr. Wagner, an obstetricion, perinatologist, and scientist breaks down all the evils in the U.S. maternity system, shows how practices in the U.S. are leading to more maternal and infant mortality, and contrasts these practices with other nations who have much lower rates of maternal and infant mortality due to actually practicing evidence-based methods whereas American obstetricians want to practice freely even against scientific evidence. Dr. Wagner advocates for a safe, women-empowering maternity system in the U.S. and outlines action steps to achieve that.
January 29, 2020
الولادة الطبيعية
عن الولادة في امريكا وكيف كانت الولادة الطبيعيه محاربة هناك ومنه القابلات وغيره وكيف فالنهاية اخذوا الامهات حقوقهم وساروا يولدون في مراكز ولادة او فالبيت مع قابلة وفيه قصص كثير مرت عالدكتور المؤلف تكشف الجانب المظلم للمستشفيات والاطباء وكيف ان مصلحة الطبيب ومصالح شركات الدواء دائما فالمقدمة على مصالح المرضى
عن الولادة في امريكا وكيف كانت الولادة الطبيعيه محاربة هناك ومنه القابلات وغيره وكيف فالنهاية اخذوا الامهات حقوقهم وساروا يولدون في مراكز ولادة او فالبيت مع قابلة وفيه قصص كثير مرت عالدكتور المؤلف تكشف الجانب المظلم للمستشفيات والاطباء وكيف ان مصلحة الطبيب ومصالح شركات الدواء دائما فالمقدمة على مصالح المرضى
May 19, 2017
wow, what a book. Full of cited sources, studies and relevant cases, this was a book a layman or a doctor could read and find relevant and informative. M. Wagner is an amazing voice on behalf of evidence-based care for women and babies.
December 4, 2018
Sheds a lot of light on issues in maternity care in the U.S. That being said, for a book that harps on the necessity of checking sources, it doesn't always provide sources for its claims. Be prepared to do a lot of independent research on claims.
May 3, 2018
This is a very well done scientifically based book on the maternity system in America. Every pregnant woman, OB, Midwife, Doula should read.
August 3, 2018
This book provided great insight of our very broken maternity system.
April 18, 2019
Do you want a real look at the maternity system in the US? Read this book. Be prepared, though, especially if you already have high blood pressure.
December 11, 2020
Fantastic insight in to the broken gestational care system of the US; evidence supported care systems that do work, from around the globe, are referenced. An eye-opener that makes one think!
July 20, 2023
I've never made so many highlights in one book before
June 12, 2011
I highly recommend this book to every woman and father out there. The maternity system in this country is in need of some serious reform. This book brings all the disturbing, political, selfish issues to light and is jam packed with facts and studies to back up the research. It's not often that I pull out a highlighter to mark in my book, but I did with this one. Women in this country have come a very far in the way of our rights, but when we look at the maternity system our rights are being violated left and right. I urge women in particular to get educated about the risks of inductions (specifically cytotec), medicated pain relief in labor, and c-section before you decide to just let your doctor tell you what have to do. Know your rights. This book is a great way to start on that journey.
"...a women giving birth is not a passive sick person but someone who is experiencing a profound life-cycle event."
We need to stop treating pregnant/birthing women like they are sick and need medical intervention. 80-90% of women are in the low-risk category for pregnancy. I believe that God specifically made our bodies in order to handle this natural life cycle event and we need to trust in our bodies and not have fear.
This book talks so much about midwifery care and I am convinced, even more now, that low risk birth should be put in the hands of midwives in out-of-hospital settings. I could go on and on about this but instead I just encourage you to read it and come up with your own conclusions. Put yourself, your baby and your rights first! Let's make a change!
The only thing I didn't like about the book was how often I felt like it was repeating itself and sometimes the amount of statistics being used made me tune out. That being said, I think that those aspects are really important for the book because people need the stats/evidence and people need the repetition of the information so it can get through to us and change can be brought forth.
"...a women giving birth is not a passive sick person but someone who is experiencing a profound life-cycle event."
We need to stop treating pregnant/birthing women like they are sick and need medical intervention. 80-90% of women are in the low-risk category for pregnancy. I believe that God specifically made our bodies in order to handle this natural life cycle event and we need to trust in our bodies and not have fear.
This book talks so much about midwifery care and I am convinced, even more now, that low risk birth should be put in the hands of midwives in out-of-hospital settings. I could go on and on about this but instead I just encourage you to read it and come up with your own conclusions. Put yourself, your baby and your rights first! Let's make a change!
The only thing I didn't like about the book was how often I felt like it was repeating itself and sometimes the amount of statistics being used made me tune out. That being said, I think that those aspects are really important for the book because people need the stats/evidence and people need the repetition of the information so it can get through to us and change can be brought forth.
June 2, 2015
This is a brilliant book by an internationally known medical doctor that should be required reading for any young person interested in obstetrics.
Marsden Wagner, M.D., is not afraid to critique the American maternity system from the inside out.
He reveals the shocking truth about Cytotec-- a drug originally approved for stomach ulcers and known to induce abortions that is now being used off-label to induce pregnant women. The wrong dosing causes amniotic fluid embolism and the company that manufacturers it have asked doctors not to use it for induction. No one's listening.
Dr. Wagner also details how the tribal loyalty of many obstetricians results in compromised safety and poor patient outcomes, as well as exposing how unnecessary and wrongheaded so much of modern obstetrics really is. His claims are not just his personal and professional opinions. They are solidly backed up by scientific study that any thinking person can access and read.
Born in the U.S.A. is a must-read for health care professionals, public health officials, pregnant women, and anyone interested in medical reform. I could not recommend it more highly. I love books written by thinking doctors and also recommend How to Raise a Healthy Child In Spite of Your Doctor by the late Robert S. Mendelsohn, M.D. and the wonderful memoir, The Color of Atmosphere by Margaret Kozel, M.D.
Marsden Wagner, M.D., is not afraid to critique the American maternity system from the inside out.
He reveals the shocking truth about Cytotec-- a drug originally approved for stomach ulcers and known to induce abortions that is now being used off-label to induce pregnant women. The wrong dosing causes amniotic fluid embolism and the company that manufacturers it have asked doctors not to use it for induction. No one's listening.
Dr. Wagner also details how the tribal loyalty of many obstetricians results in compromised safety and poor patient outcomes, as well as exposing how unnecessary and wrongheaded so much of modern obstetrics really is. His claims are not just his personal and professional opinions. They are solidly backed up by scientific study that any thinking person can access and read.
Born in the U.S.A. is a must-read for health care professionals, public health officials, pregnant women, and anyone interested in medical reform. I could not recommend it more highly. I love books written by thinking doctors and also recommend How to Raise a Healthy Child In Spite of Your Doctor by the late Robert S. Mendelsohn, M.D. and the wonderful memoir, The Color of Atmosphere by Margaret Kozel, M.D.
May 18, 2011
"Forty-one countries have better infant mortality rates than the United States dodes. In 2002, our infant mortality rate went up, not down, and if the US had an infant mortality rate as good as Cuba's, we would save an additional 2,212 American babies a year....Women are 70% more likely to die in childbirth in America than in Europe, and the rate of women dying in chidbirth in America has been going up every year for more than twenty years."
I sooo wish this book had been out when I was writing my master's thesis. It's so relevant to the work I was doing back in '98. Had to keep reminding myself the author was a man and a doctor. A lot of this was old news to me, but the organization of the information and the presentation was hard-hitting and impossible to ignore. The US lags so far behind other countries who are handling maternity care better, cheaper, and with lower infant and maternal mortality. This conversation fits centrally into the health care reform happening right now.
I sooo wish this book had been out when I was writing my master's thesis. It's so relevant to the work I was doing back in '98. Had to keep reminding myself the author was a man and a doctor. A lot of this was old news to me, but the organization of the information and the presentation was hard-hitting and impossible to ignore. The US lags so far behind other countries who are handling maternity care better, cheaper, and with lower infant and maternal mortality. This conversation fits centrally into the health care reform happening right now.
September 26, 2012
Marsden Wagner, MD, MS, is pissed. He’s pissed about the American maternity system and how it’s currently running. In Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First, he explores (in great detail) the many reasons why our maternity system is failing mothers and their children. And he doesn’t sugarcoat at all. In fact, he’s quite blunt about what’s wrong with the system and what needs to be done to right all of the wrongs. You can’t read this book and not be at least a little bit alarmed. The “against label” use of Cytotec, for instance, is a huge issue. And the same goes for the criminalization of midwifery. Wagner explains the power structures and politics of medical organizations like the American College of Obstetricians and Gynecologists (ACOG), as well as what goes on in hospitals and the “fraternity” of doctors. After reading this book, I agree that there are many reasons to be upset with our current system. Luckily, Wagner also has a suggestions on how we can empower patients and save the lives of mothers and babies.
March 31, 2008
An absolutely enlightening read and full of supported claims examining the difference between c-section and normal births. As the author points out, he is less an advocate of out-of-hospital births than of evidence-based maternity care. And the evidence shows what is going catastrophically wrong with child birth in the US has less to do with out-of-hospital planned births than the unhealthy practice of obstetrics on unconsenting on misinformed mothers who are treated as patients during a normal life-event. There are also many research ideas floating in this book and so it is also a good read for a social scientist or any epidemiologist or clinician. The link between frequent ultrasounds, drug-induction, c-sections and long term consequences after birth such as increase in rates of autism, allergies, learning disabilities, and other functional changes are unknown and need to be examined. If its the one non-fiction you read this year Ladies- Read this book!!
October 5, 2009
Marsden Wagner, the former director of the Womens and Childrens Health division of the World Health Organization, delivers a scathing review of the American maternity system in Born in the USA How a Broken Maternity System Must Be Fixed to Put Women and Children First. This book is an empowering, insightful call to action for women and birth workers everywhere. Though I believe that Dr. Wagner is a bit too critical at times, the points he makes are very well-supported and eloquently articulated. Wagner speaks frankly about a bevy of subjects, from condemning Cytotec inductions to criticizing the ACOG for failing to protect the interests of those it serves, the women of America. This book is a compelling must-read for any woman who receives obstetric health care in the USA, as well as birth workers.
Displaying 1 - 30 of 88 reviews