Reddit reviews Pushed: The Painful Truth About Childbirth and Modern Maternity Care

I think things have to change with malpractice insurance. It has to. We are losing MDs doing births at all because of this. Our cesarean rate is also rising - we are losing any resemblance to natural birth in the hospital. In fact, I hear the word "natural birth" to mean "vaginal birth".

Doctors are given lower malpractice premiums when they have higher cesarean rates. This is not acceptable!

We used to be shocked at Brazil's 95% cesarean rate. I think we're well on our way. In my community, 40% of first time moms have cesareans.

I hope that we can find inroads that are free from malpractice protocols that allow docs to collaborate with midwives for teaching, safety, and general empowerment of women. I see other countries doing it, but unfortunately, our healthcare and malpractice system does little to help this goal of mine. :(

Our maternal and infant mortality rates are dismal. And it's not because we're using less technology or interventions. It's because we're using more. I really recommend a book called Expecting Trouble: The Myth of Prenatal Care in America by Thomas Strong, MD. He's a third generation MD, second gen OB and he has some amazing insights. Mainly, leave high risk and surgical birth to OBs, turn all other care over to midwives for better outcomes...and look at technology more judiciously.

Other books I recommend are:

Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First by Marsden Wagner, MD

Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block

Birth: The Surprising History of How We Are Born by Tina Cassidy

Lying In: A History of Childbirth in America

Above all, I wish that more providers would see that the motherbaby is one unit. They are not antagonists towards each other. Less intervention is better and if we could move towards more evidence-based practices we might see better outcomes.

Again, it all boils down to allowing doctors to practice freely. We have to see malpractice reform.

I'm of the mind that happily pregnant women who engage in bad practices during pregnancy are typically 1) ignorant of or don't believe in the effect it is having on the fetus (i.e. "My mom smoked with me and I turned out fine!"), or 2) are deeply struggling with addiction (and furthermore, scared to seek help, as they know they will be judged and potentially prosecuted/jailed).

With this in mind, I think most in most cases, women need information, education, and non-judgmental assistance to keep their pregnancies as healthy as they can manage. I really don't see it as a point on the "my body, my choice" continuum, you know?

Also, for what it's worth, discussions like this always remind me of Lynn Paltrow, quoted in Jennifer Block’s Pushed: The Painful Truth About Childbirth and Modern Maternity Care: "[We live in] … a culture that celebrates the woman who conceives quadruplets after multiple fertility treatments- treatments that put the fetuses at risk for severe prematurity, neurological damage, and death- yet imprisons the woman who puts her fetus at far less risk with illegal drug use."

Giving birth is a natural process, not a disease. Giving birth outside the hospital with a midwife is pretty common in Europe and is the recommended way to go unless you have complications. It in no way contradicts "traditional medicine." Excessive medicalization of maternity care is motivated by the same factors that cause the overuse of other medical care in the US.

(reference: Pushed by Jennifer Block)

this is somewhat true, though in the days of twilight sleep they used very "high forceps" to pull babies out.

and with twilight sleep, you didn't really sleep. it was a combo of a heavy anesthetic with an amnesiac. essentially, women were strapped down because they would writhe and kick and sometimes hallucinate. if you received twilight sleep, you just never remembered.

here are a couple good looks at the history of childbirth:

http://www.amazon.com/Pushed-Painful-Childbirth-Modern-Maternity/dp/0738211664

http://www.amazon.com/Birth-Surprising-History-How-Born/dp/0802143245/ref=sr_1_3?s=books&ie=UTF8&qid=1348108086&sr=1-3&keywords=tina+cassidy

You might appreciate the book Pushed by Jennifer Block.

I felt it did a good job illustrating the benefits and shortcomings of our US maternal/neonatal care system, and prepared me better for the birth of my first. One of the doctors I had to deal with had a very archaic viewpoint on childbirth and was extremely pushy (a nurse actually yelled at him in the hallway after one interaction he had with us). Reading this let me see the truth behind his scare words and pressure tactics and ask the relevant questions, such as "Do you think my health or the health of my child would be at risk if we don't agree to this intervention?"

He waffled a lot in answering my questions, and if I hadn't understood well the reasons why he might be pushing for unnecessary intervention so well, I think he would have managed to scare me into agreeing to things that wouldn't have been beneficial to either my son or myself.

If she's pretty healthy, it's ultimately up to momma. VBAC is generally a lot safer and better for mom and baby than repeat cesareans. If she wants to attempt trial of labor, she needs to find an OB or midwife that will support her decision. Sometimes the Dr might say they don't recommend a vbac, but the Dr has a high cesarean rate. Most times when Dr's recommend cesareans, it's out of convenience (for the Dr) and fear of litigation, not what's best for mom and baby. Look up hospitals' cesarean rates in your area. Meet with different doctors/midwives until you find the one the supports your decisions and won't "bait and switch." Do your research and ask questions. Lots and lots of questions. Houston, TX has the largest medical center in the world and there's only one hospital that will allow vbacs after 2+ cesareans, and even though vbac is proven to be safer, Houston still has a high cesarean rate (33%), but also the highest maternal mortality rate in the country🤦🏽‍. So depending on your area, it may be hard (or easy) to find a hospital that will allow mom to attempt a vbac. A cesarean should never be an elective option and should only be reserved for emergencies. It's a major abdominal surgery that takes 6wks to heal from. The "postpartum period" is generally 6wks as well (as far as maternity leave goes, but postpartum can be as long as 2yrs). Do your research and make your own informed decisions, and find a Dr/midwife that supports your decisions. You have a choice in EVERYTHING when it comes to the birth of your child. Here are some links for more info and a few good books on the U.S. maternity system and the industrialization of birth. Also, finding a doula would be beneficial as well. Look up evidence based birth, and maternity care.

Source: I'm a doula, and have doula'd for multiple successful vbacs

https://vbacfacts.com
https://m.acog.org/Patients/FAQs/Vaginal-Birth-After-Cesarean-Delivery
https://www.amazon.com/Pushed-Painful-Childbirth-Modern-Maternity/dp/0738211664
https://www.amazon.com/Born-USA-Broken-Maternity-Children/dp/0520256336
https://www.amazon.com/Farmer-Obstetrician-Michel-Odent/dp/1853432040

I haven't seen Jennifer Block's book mentioned yet- it's a great jumping off point for studies, statistics, opinions of obs who are pro-natural birth.

Pushed: The Painful Truth About Childbirth and Modern Maternity Care

I really recommend reading [Pushed: The painful truth about childbirth and modern maternity care by Jennifer Block] (http://www.amazon.com/Pushed-Painful-Childbirth-Modern-Maternity/dp/0738211664) before getting pregnant. It very important information that I think every American should know, but I can't even begin to imagine how horrifying it would be to read while pregnant.

I've also heard that its pretty hard to remember all of the information you need to if you start reading pregnancy books after you get pregnant because of pregnancy brain. So its a good idea to start reading books like [Our Bodies, Ourselves: pregnancy and birth] (http://www.amazon.com/Our-Bodies-Ourselves-Pregnancy-Birth/dp/0743274865/ref=sr_1_1?s=books&ie=UTF8&qid=1382042400&sr=1-1&keywords=our+bodies+ourselves+pregnancy+and+birth) and [Pregnancy Childbirth and the Newborn] (http://www.amazon.com/Pregnancy-Childbirth-Newborn-4th-Complete/dp/143917511X/ref=sr_1_1?s=books&ie=UTF8&qid=1382042460&sr=1-1&keywords=pregnancy+childbirth+and+the+newborn+the+complete+guide) so that you have a lot of foundational knowledge about what is going to happen. Then spend pregnancy reading positive birth stories so you can keep learning, but feel confident and happy.