Pushed

By Jennifer Block, 2007, 336 pages, amazon

The Painful Truth About Childbirth and Modern Maternity Care

This book is not an easy reading. It brings tears and fear. Not of childbirth, but of US hospitals. Belongs to the same category as the movie The Business of Being Born. Why is it so scary? Because it tells stories of women who had perfect uncomplicated pregnancies and ended up pushed into unwanted Cesarian sections. Of women who wanted VBAC (Vaginal Birth After Cesarian) with their second (or later) babies and were not allowed to have them. Of midwives who should be taking care of majority of pregnancies, leaving the complicated cases to obstetricians, but instead they are being prosecuted in some states.

These are not just some stories collected during family reunion, Mrs Block is a journalist who has done her reaserch well. Yes, the book is one-sided and biased, but presents facts, cites resources and gives opinions of obstetricians. Her basic concern is  that

What’s best for women is best for babies. And what’s best for women and babies is minimally invasive births that are physically, emotionally, and socially supported. This is not the experience that most women have. In the age of evidence-based medicine, women need to know that standard American maternity care is not primarily driven by their health and well-being or by the health and well-being of their babies. Care is constrained and determined by liability and financial concerns, by a provider’s licensing regulations and malpractice insurer. The evidence often has nothing to do with it.

And continues on:

… less than 2% of American women received “optimal maternity care” that consists of these six basic aspects, all of which are well supported by the best evidence-based medicine:
1. Labor begins spontaneously
2. Women have freedom of movement during labor.
3. Interventions are medically justified rather than routine.
4. Women have continuous emotional and physical support.
5. Pushing occurs in any position but flat-on-back.
6. Mother and baby are not separated.
In other words, 98% of women received sub-optimal care.

Is this asking for too much? Isn’t it interesting that childbirth is the only hospital event (I intentionaly don’t write procedure) for which the women (I intentionally don’t write patients) bring their own lists of things (birth plans) that they do not want to have done to them? Scary!

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