Pushed: The Painful Truth About Childbirth and Modern Maternity Care

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Pushed: The Painful Truth About Childbirth and Modern Maternity Care

4.29 of 5 stars 4.29 · rating details · 1,340 ratings · 337 reviews

In the United States, more than half the women who give birth are given drugs to induce or speed up labor; for nearly a third of mothers, childbirth is major surgery - the cesarean section. For women who want an alternative, choice is often unavailable: Midwives are sometimes inaccessible; in eleven states they are illegal. In one of those states, even birthing centers are...more

Hardcover, 316 pages

Published June 4th 2007 by Da Capo Press (first published June 1st 2007)

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Feb 19, 2011 Meredith rated it 4 of 5 stars Recommends it for: women seeking natural childbirth

Shelves: nonfiction, pregnancy

Pushed is a shocking documentation of medically managed childbirth in the United States. The first four chapters detail the standard practices and current trends (a la 2007) and the effect these have upon the women giving birth. Jennifer Block challenges the sacred cow of an idea that the definition of a successful birth is simply a live baby and live mother. She makes the case that the trauma incurred during the birthing process through unnecessary medical intervention and surgery, artificial t...more Pushed is a shocking documentation of medically managed childbirth in the United States. The first four chapters detail the standard practices and current trends (a la 2007) and the effect these have upon the women giving birth. Jennifer Block challenges the sacred cow of an idea that the definition of a successful birth is simply a live baby and live mother. She makes the case that the trauma incurred during the birthing process through unnecessary medical intervention and surgery, artificial time limits, and practices that hinder and harm the natural working of a mother's body should be factors in declaring a birth "a success."

Block also delves into how procedures, instruments, and drugs that were developed to combat certain complications and particular potentially deadly situations suddenly became standard practice for all pregnancies regardless of whether they were low risk and showed no signs of complications. She also describes the potential side effects, increased risks for further interventions, and complications of common and standard practice medications, surgeries, and practices -- information that is usually omitted or downplayed because it might make women less likely to blindly submit to them.

Interestingly enough, the author doesn't take the opportunity to discuss the naive American mindset that everything a doctor does is in the patient's best interest rather than because it is in the best interest of a drug company or hospital or convenience-driven in general. Fun fact: a cesarean takes a doctor 45 minutes while a woman delivering vaginally can labor for over 24 hours creating over a day's worth of intermittent updates.

There is a lot of very good information about vaginal birth after cesarean sections, and the authors does include a defense of doctors who refuse to allow VBAC in that she explains the cost of malpractice insurance and hospitals' general unwillingness to take up the time and resources while risking a potential lawsuit to provide this option. Of course, she doesn't explain why hospitals don't simply allow women seeking VBAC to sign a waiver relinquishing their right to sue in the event of a negative outcome. There is also no suggestion of a nationwide initiative to push for at least one centralized hospital in each of the 50 states that would allow VBAC.

I wished that she would have gone into more detail about alternatives to the standard lithotomy (flat-on-back) birthing position. It's simply taken for granted that because this is the most convenient position for the doctor that there's no hope of changing hospital procedure even if it's the worst position for a woman's body and could end the practice of giving routine episiotomies.

I also wished that she would have spent more than half a page on the detrimental effects of "coached/directed pushing" in the lithotomy position. She explains that this practice originated with the advent of early pain medication when women were totally numbed from the waist down and had to be told when to push and for how long since they had been rendered medically helpless. And she mentions that it is now standard practice and can cause severe pelvic floor damage, but beyond adding that this is not insisted upon by hospitals considered "baby friendly" by UNICEF and that having a doula can help you avoid this, she lets the subject drop.
In just about every single, television, birth documentary filmed in hospital setting, the nurses have the woman begin directed pushing in the flat-on-back position as soon as she reaches 10 cm, but not once in all my TV viewing did I ever witness a member of the hospital staff ask the woman if she wanted to wait until she began to feel the urge to push as pushing before the baby was in a good position could result in lasting pelvic floor damage.

Pushed provided the statistical data to support my anecdotal evidence. From what I've witnessed, the norm for women in the United States is horrible impersonal care dominated by medical intervention as if birth were an emergency on par with a heart attack. Over the last 10 to 15 years, I have not known one woman among all my friends, acquaintances, and co-workers who has been allowed to go into labor naturally. Not one. Three had complications/high risk pregnancies that warranted inductions and scheduled cesarean sections, but the majority had the "big baby" card played on them. Now it is always possible that every pregnant woman of my acquaintance over the past decade fell into the 5 to 10% of all pregnancies that develop macrosomia (baby too large to deliver). But the statistical odds are against this.
These women were all told at or before 37 weeks that they needed to be induced in order to prevent complications such as shoulder dystocia, an event that the medical literature states is impossible predict and occurs 50% of the time in babies smaller than the macrosomic weight of 8 lbs, 13 oz. Their doctors also insisted on inductions out of fear for a big baby despite the fact that fetal macrosomia can only be diagnosed after the child is born and that the guidelines issued by the American Congress of Obstetricians and Gynecologists recommended against elective inductions in cases of suspected fetal macrosomia because labor inductions only raised the odds of having cesarean sections without changing the fetal or maternal outcomes.
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Dec 06, 2009 Karen rated it 5 of 5 stars Recommends it for: expectant parents, mothers, feminists, OBs, midwives

Finally! An expose of the birthing system in the United States. It's absolutely a fascinating read, tracing the history of managed birth and outlining the various factors that scare and push expectant moms into unnecessary interventions. Ms. Block points out numerous statistics that support how out of whack interventions are in North America. In the countries where there are the best birthing outcomes, the c-section rate hovers around 15%, which is also the rate set by the World Health Organizat...more Finally! An expose of the birthing system in the United States. It's absolutely a fascinating read, tracing the history of managed birth and outlining the various factors that scare and push expectant moms into unnecessary interventions. Ms. Block points out numerous statistics that support how out of whack interventions are in North America. In the countries where there are the best birthing outcomes, the c-section rate hovers around 15%, which is also the rate set by the World Health Organization where the risks of a section outweigh the benefits. The 2005 section rate in the US was 30.5% and in some states, topped 45%.

This is not a book that gives specific guidance in planning a non-interventionist hospital birth nor does the author promote a medication free birth. Instead, she is curious why a physiological birth is something that women have to fight for in the US. This book gives all the information necessary to understand what is going on with your doctor and your hospital when suddenly, in your most vulnerable moments, you find yourself sliding down the slippery path to a hospital managed birth and c-section. If you are planning a non-interventionist hospital birth, this background information is essential. Based on my own experiences (with both induced birth and 100% intervention/drug free hospital birth) Ms. Block's stated facts and observations are completely accurate. The book, which in general, is balanced in tone, seems to advocate midwife-assisted birth (but not unassisted birthing) over hospital birth. This is not surprising, given the level of vigilance one must have to achieve a low-intervention birth in the hospital. Also favorable are the outcomes achieved by midwives.

How is it, Ms. Block wonders, that such an overwhelming percentage of hospital births become an emergency instead of an emergence (when the true level of emergency births should be in the low single digits)? The protocols established by the medical staff are a huge factor, since so much of what they do and prescribe lead directly to more interventions and ultimately, either insanely medicalized/assisted vaginal birth or c-section.

Ms. Block has collected interesting data from a variety of sources. I particularly appreciated the anecdotes of a former L&D nurse in FL who became disenfranchised after observing the wonderfully low key, easy births that occurred during a hurricane when her hospital was conserving generated power and operating under different protocols. The emergency c-section rate was 6%.

The book has several chapters on midwives, some working illegally, devoted to bringing natural birth to their clients. Many frightening incidents are depicted involving the violation of women's rights when literally forced into c-sections and episiotomy without their consent, or indeed, against their express wishes. In particular peril are women attempting VBACs, which are rapidly growing out of favor.

She also notes the important contribution of American women to the growing trend of managed birth, many of whom are strikingly uneducated about the risks of intervention and c-section to both mother and baby or whose desire for a convenient birth outweigh common sense. Somewhere along the line, women have forgotten that a healthy mother and baby can achieve a remarkable, empowering, peaceful birth.

This book was fantastic - a must-read for the educated, thinking mother who refuses to be pushed around by a system set up for everyone's benefit except her own (and her baby).(less)

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Feb 22, 2008 Annie rated it 5 of 5 stars

After reading Pushed, you will never watch “A Baby Story” the same way again.

Block makes a convincing case that protocol on labor and delivery wards are driven not by what is best for individual women, but by fear of litigation. The stories that made me the saddest were those about women who expressly declined certain interventions and were given them anyway. The worst was a woman who showed up at the hospital with her baby crowning. Because she had had a previous cesarean, the hospital called i...more

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Aug 28, 2008 Jennifer rated it 2 of 5 stars

Shelves: pregnancy-childbirth-infant-paren

I've found fertility and childbirth were fascinating for a few years, but now I'm pregnant and obsessed. Luke calls it "girlie-parts science". This book isn't so much about the science but does present surveys on the state of childbirth in the US today (published 2007). It made me appreciate the tough situation obstetricians are in and want a health care system that treats low-risk, healthy pregnancies as life events, but not illnesses.

IF YOU'RE EXPECTING while you read this, please remind yours...more

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Jul 31, 2007 Lindsey rated it 4 of 5 stars Recommends it for: women

I felt "pushed" into being induced when I was pregnant with my second child. My doctors induced me and several other women who attended the same practice on the same morning--so the doctor's schedule wasn't affected. (We were told that by the nurse!) I have never felt good about my labor experience. As I started to read this book, I felt vindicated and realized I am not alone.

Women need to take back their bodies and control of their births! Too many women are being "pushed" to be induced and hav...more

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Nov 10, 2007 Tom rated it 3 of 5 stars

Shelves: non-fiction

I read this book quickly and with interest. It is a rather alarming look at obstetrics--for that reason I don't know whether to strongly recommend it to other expectant couples or whether to dis-recommend it. Once you read the book, it is hard not to be suspicious of your doctors and to push back against their decisions -- this may be for the best, but it is not a comfortable position to be in. It is hard to judge exactly to what degree this is a reasonable book and to what degree it is an alarm...more I read this book quickly and with interest. It is a rather alarming look at obstetrics--for that reason I don't know whether to strongly recommend it to other expectant couples or whether to dis-recommend it. Once you read the book, it is hard not to be suspicious of your doctors and to push back against their decisions -- this may be for the best, but it is not a comfortable position to be in. It is hard to judge exactly to what degree this is a reasonable book and to what degree it is an alarmist book. After reading it (and doing a lot of research inspired by reading it), I think it is on the whole quite reasonable, which is quite frightening.

The book ends with a section on rights with a number of frightening cases -- cases of hospitals that got attorneys to represent the foetus of mothers who refused procedures and forced those procedures on women. The points the books make strike me as right on: that it is a violation of a woman's body to force a procedure on her without consent; that it is absurd to believe that women don't have the best interest of the foetus in mind when they make their decisions.

One of the most interesting points the book makes is that groups that push for "reproductive rights" have been slow to include among those rights women's right to choose how they have their babies. Which is to say, it seems strange that a woman's right to choose encompasses her right to abort a pregnancy but not her right to have her baby vaginally in any number of cases in which hospitals insist on C-Sections. In an absolute sense, it seems a woman should always have a right to refuse a C-Section, since it is a procedure which undoubtedly puts her at greater risk than a vaginal birth. In a more pressing sense, women have good reason to refuse many C-Sections, since there is compelling evidence that far too many are performed in the U.S.

The role of malpractice insurance is invoked as the main reason hospitals and obstetricians make decisions to operate or to induce when it is not in a woman's best interest (convenience is another, more cynical, reason, but one that I'm sure operates on a subconscious level--I can't imagine a doctor knowingly putting a patient at risk to free up a weekend). At first I was sceptical that malpractice insurers would push for something not backed up with data and would have such sway over hospitals, but conversations with our doctor seems to confirm that it is true: he confirms that malpractice insurers give "cut rates" to doctors or hospitals who won't do VBACs, for example (which our practice regularly "do").

I wonder in how many other places in the medical system malpractice insurance makes a big impact on care. If it does, it seems quite worrisome because it means that what plays well to a jury determines what is good care, and it's not hard for me to believe (or for me to believe that insurers believe) that juries don't think scientifically. My impression from taking classes with pre-med students in college was also that med students are not very good scientific thinkers, so the malpractice monster pushes things from bad to worse.

Thus, regardless of whether monitoring a baby's heartbeat is shown to help babies and mothers, monitoring is routine in hospitals so that doctors faced with a suit can say they did everything they can. And it goes similarly with other interventions.

Thus, a kind of hysteria sets in, and the results are decisions which individually may seem unassailable to jury and patient (we just want to make absolutely sure your baby is safe) but on a societal level clearly cause more harm than good (we have a 30%+ C-Section rate).(less)

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Aug 28, 2007 Amie Minken Merhege rated it 5 of 5 stars

Shelves: birthbreastfeedingbabies

This is the first book I have seen to tackle the issues of birth from a feminist perspective. It was a fascinating, gruesome, and eye-opening read that was extremely well researached and documented. Block's opinions on modern hospital birth come through loud and clear but are definitely evidence based. Especially interesting is the in-depth discussion of all aspects of the VBAC debate: emotional, public health, medical liability and legal ramifications are all covered. Also covered are the issue...more

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Aug 22, 2008 Elizabeth Abney rated it 4 of 5 stars

Shelves: health, nonfiction, pregnancy

While decidedly anti hospital and pro home-birth, this book is very well written and researched and has a lot of evidence to back up its position. It discusses in detail the ways in which augmentation can disrupt the physiological birth and what that can mean for mom and baby. It also details cesarean section and the many risks involved with such a major abdominal study. While the author’s bias may have led her to overstate some on the complications, I don’t think I fully understood the ramifica...more

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May 30, 2008 Sarah rated it 2 of 5 stars

This was the central text for a short course I took on the history and current practice of childbirth in the U.S. I think this book would scare any rational person into a celibate life. And that's my problem. Block's attitude is very clear: OB/GYN's & Hospitals= BAD, Midwives, home births and birth centers= THE ONLY OPTION AND YOU ARE A BRAINWASHED COW IF YOU DON'T RECOGNIZE THAT!!
The caps are deliberate. Because this is popular non-fiction, she can be less rigourous in her sourcing and citi...more

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Jan 10, 2008 Dayna rated it 4 of 5 stars Recommends it for: anti-intervention folks and people that can make a difference in this field.

I finally finished this book!!! I really struggled with how many stars to give it, because I liked it but not because I liked reading it ... does that make sense? It is packed with so much information that some of it was hard to sort through and digest, but it's information that I wanted all the same. The book is about the pros and cons of modern maternity care (specifically in the U.S.) and the book itself has some pros and cons. I did not like Jennifer Block's writing style. She wasn't very go...more

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Apr 15, 2009 Tierney rated it 5 of 5 stars

Shelves: nonfiction

This was a fascinating, meticulously researched, information-packed book that I thoroughly enjoyed. Block makes the case that modern maternity care in the U.S. is seriously flawed. The average woman laboring in a hospital can expect to be hooked up to a vast array of machines and to have her labor chemically induced if she's not progressing fast enough according to certain timelines - often resulting in a C-section. Block argues that most of this is unnecessary for women with otherwise uncomplic...more

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Dec 19, 2008 Amanda rated it 4 of 5 stars

Like one reviewer said, "Every page will surprise and outrage you." An impressive and absorbing review of childbirth-related research, as well as common obstetric practices - and the frequent inconsistencies between the two. Here are two of my favorite parts:

"As the sociologist Barbara Katz Rothman puts it, 'Have our uteri somehow lost the knack this generation? Or have our doctors speeded up the clocks on us?' Or is there a third possibility, that active management practices have inflicted comp...more

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Mar 26, 2009 Liz rated it 5 of 5 stars

Shelves: pregnancy-and-childbirth, 2009, favorites

Women deserve choice in pregnancy and delivery. If you are ever thinking about having a baby, I wholly recommend reading "Pushed", by Jennifer Block.

What's the difference between this book and the gazillion other books about childbirth out there? For one, it's the documentation. Jennifer Block meticulously references legitimate medical research and studies throughout her book. Instead of making an empassioned tug-at-your-heartstrings plea for her case, Ms. Block makes her case with statistics an...more

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Feb 23, 2008 sdw rated it 5 of 5 stars Recommends it for: Everyone.

Recommended to sdw by: Mindy

Shelves: notforschool, politics-of-reproduction

Pushed is a well-researched and stunning look at modern modernity care and women’s lack of control over the way they give birth. The introduction is stunning and beautiful. It is short and carries through the rest of the book. The first chapter looks at women in hospitals, the machines and the procedures enforced on them. The second chapter looks at the history of Cesarean births and how they work and when they are used. The third chapter looks particularly at the type of births forced to have...more Pushed is a well-researched and stunning look at modern modernity care and women’s lack of control over the way they give birth. The introduction is stunning and beautiful. It is short and carries through the rest of the book. The first chapter looks at women in hospitals, the machines and the procedures enforced on them. The second chapter looks at the history of Cesarean births and how they work and when they are used. The third chapter looks particularly at the type of births forced to have C-sections in hospitals – breech, twins, and after cesarean – vaginal birth after cesarean or VBAC is a big no-no to the hospitals. This leaves some women who don’t want a C-Section giving birth at home, unassisted. (Yep Mindy – this is the chapter where you appear). The book makes clear the role of malpractice insurance in dictating what procedures doctors were willing to attend. Yet as the extensive studies cited by Pushed show, these births are actual safer without the c-section in the majority of cases. The fourth chapter looks more at the dramatic rise in C-Sections (the current rate is more than double than what it should be). The fifth chapter looks at doulas, the demand for them and their role in the hospital. The sixth chapter looks at midwives and the question of licensing and unlicensed practice. Particularly she follows several unlicensed midwives in their work. The seventh chapter looks at the criminalization of midwives (so licensed midwives are legally forbidden from attending certain types of births in some areas, and in most places unlicensed midwives are forbidden from assisting with a birth at all). Midwives are on my list of heroes! The final chapter looks at women’s rights. In particular she talks about disturbing cases where c-sections and hospitalizations have been court ordered. The hospital finds out about a women giving birth at home and gets the court to put a protection order on her unborn fetus forcing her into the hospital.

Laura Pemberton was giving birth in 1996 at home, making good progress when sheriffs stormed her house forcing her to the hospital for a c-section. She was dilated 9 cm when the forced c-section was performed, the baby inches from birth. It shows some of the dangerous consequences of giving fetus’ rights, but more importantly the legal and cultural way we privileged the “rights” of fetuses above the rights of mothers. It is truly scary to reach a point where women literally cannot choose to give birth at home. Obviously this is rare, but horrifying. And it is part of a larger challenge. She won the case on appeal, so this particular legal precedent is helpful, but there is another case on trial now for a woman who gave birth to a stillborn and is on trial for first degree murder. If a baby or mom dies in the hospital, and a c-section was attempted, no one is to blame, even if the c-section might be the reason. If a baby or a mom dies outside of the hospital, the consensus by the mainstream seems to be that someone is to blame – even if maternal and “fetal morbidity” still happens. This is to say “the campaign for fetal rights, led by those intent on re-criminalizing and stigmatizing abortion, has been a detriment to women who decide to carry their pregnancies to term.” As Lynn Paltrow, the attorney and ED for the National Advocates for Pregnant Women states, “the question is not when do fetuses have rights, but at what point in pregnancy do women’s civil rights end?”

This book is stock full of the most recent statistics and studies (scientific and legal). It is a barrage of information that at times can slow the book down (particularly around the middle). The stories of real people though, also fill the book. Without the studies the stories would loose their impact. But we hear from many women about their experiences giving birth, having C-Sections, having home births, being forbidden from attending home births, attending hospital births, attending home births, etc.

The author is attentive to race and class, although never as attentive as I would like. For example, the author puts the framework of the right to reproduce alongside the framework of the right to avoid reproduction. While I agree with this move, there is a long history of women of color and poor women denied the right to reproduce whose rights were violated. The lack of control over when and how women gives birth belongs with discussions of forced sterilizations and other derogatory treatment women received at the hands of medical institutions.

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Nov 03, 2007 LINDA rated it 4 of 5 stars Recommends it for: Women that may want to have kids

Shelves: medical

This book opened my eyes, and made me really think about the options (or lack of) presented to women in American Hospitals for birth.

It is too often that women's bodies are hijacked by doctors, nurses, and hospitals because they want the woman to give birth on their schedule, and also they want to make money, and protect themselves from law suits.

Don't get me wrong, I am not against any women that get epidurals, or c-sections, or get induced at their own election. I am against Doctors pushing t...more

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Apr 11, 2009 Abbie rated it 5 of 5 stars

4.5 stars. I would highly recommend it to any woman, whether she wants to go natural or not - this is important information that every woman should care about. This is the WHY I go natural and see a midwife. Jennifer Block does a great job documenting what maternity care is like in America and why things need to change. She sheds light on both sides, but definitely shows the remarkable benefits of letting the body do what it needs to do in childbirth whether you're at a hospital, birth center, o...more

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Oct 15, 2007 Susan rated it 4 of 5 stars Recommends it for: women and those who love them, obstetricians, policymakers

Shelves: parenting-kids-family

This is the book I wish I'd had when I was pregnant. I was interested in a drug-free birth, and read all the usual books. Most of them seemed to equate natural childbirth with some sort of moral stance or an ethereal connection to womanhood, and although I can't prove it statistically, they were shrill and biased.

Pushed is not a light read. It's not going to help you create a lilac-scented birthplan on pink paper. It's not going to help you do anything, except think. It's a fact-packed book, he...more

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Jan 17, 2008 Ruth rated it 4 of 5 stars

Basically this book made me happy to have had my kids outside the hospital system. But it was a good read. It really showed the contrast between the mindset that birth is inherently dangerous and needs medical attention and the view that birth is normal and a birthing mother needs to be supported and listened to. Interesting information. Was a bit depressing that the end of the book pretty much brought freedom to choose how we birth as the "last frontier" of feminism now that we have access to a...more

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Jun 24, 2008 melissa rated it 4 of 5 stars Recommends it for: anyone with a baby in your belly.

Shelves: nf-for-mamas

since having a child, i've become really interested in the rules of maternity care and how i think they fail women. truly, i'm a bit of a nazi about it. i read stuff like this so i can be more annoying when i'm on my soapbox.

okay so any book like this has an agenda...Block's agenda just happens to coincide with mine. i think it's a must read for any woman considering children, mostly because i think it's important to be informed about anything you do, but also because your OB/GYN won't tell you....more

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Nov 15, 2007 Caitlin rated it 5 of 5 stars Recommends it for: All women, and people interested in birth, civil rights and feminism

Jennifer Block has written an exhaustively researched book detailing not only current birth practices in US hospitals, but also the history, politics, and science that shape those practices. This book should be a must-read for anyone with a vagina. It explains what is happening to women's rights and how choice is being removed right out from under their noses. Early on in this book, Ms. Block asks a simple question that seems to radiate throughout: with so much argument in recent years over a wo...more

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Feb 25, 2013 Alanna rated it 5 of 5 stars

I read this book for the first time back in 2008. At the time, I thought it was a bit incendiary (sort of like Fast Food Nation moves on to talking about birth and maternity care). Reading it again now, after two more miserable hospital experiences, I think it spoke a lot more to me than it did before. I did skim parts, but I was still impressed with all the research Block did and how hard she tries to find people in all professions who are on both sides of the fence. I think she also does a goo...more

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Feb 17, 2013 Leah Krauss rated it 4 of 5 stars

Shelves: birth, non-fiction

I finally finished this book, which I've read chapters of here or there, for months.
In spite of the protracted reading duration, this book is engaging and infuriating. A polemic, Pushed outlines the historical precedents which have spawned a management model of birth, moving it out of midwifery care and into the authority of obstetrics. Jennifer Block applies a precise lens to different modern technologies - observing the discourse behind each practice and the research that may or may not suppor...more

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Jan 15, 2013 Megan rated it 5 of 5 stars

A friend of mine, who's a midwife, actually recommended this book to me. At first, I was a bit apprehensive because I was skeptical of the writer's research and frankly, I thought it was another book ranting and raving about feminism issues and how women are "pushed" into motherhood forcibly by society and whatnot. I was pleasantly surprised that this book was a page turner. I was both astonished and appalled at some of the horror stories that some of these women have had to face during a time o...more

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Jan 06, 2013 Jackie rated it 4 of 5 stars

An amazing book about birth in the US.

While some of the facts presented can seem somewhat alarmist, the state of birth in the US is alarming. Women aren't being given the opportunity to actually experience the births of their children, instead they are forced to allow the medical world to dictate what happens to them in the name of safety.

I know that sounds like a ridiculous thing to say - after all, we're talking about babies and mamas here. But it is so much more than that. It is that in oth...more An amazing book about birth in the US.

While some of the facts presented can seem somewhat alarmist, the state of birth in the US is alarming. Women aren't being given the opportunity to actually experience the births of their children, instead they are forced to allow the medical world to dictate what happens to them in the name of safety.

I know that sounds like a ridiculous thing to say - after all, we're talking about babies and mamas here. But it is so much more than that. It is that in other countries they have different ways of caring for pregnant women and bringing babies into this world that include the mother's basic needs for good care.

One small example that has a huge impact on the how many babies are breastfed: In the US, our medical world expects babies to lose a certain amount of weight after birth - up to 10% is considered 'safe' and within the 'normal' range (or was, at the time I had my children). In Canada, they have the same expectation that babies can and do safely lose a certain amount of weight post-birth, however, that number is between 12-15%. So when babies lose more than 10%, they don't freak out, tell the mom she isn't making enough milk (don't even get me started on milk production, stress, how long it takes to 'come in,' the purpose of colostrum...)and demand that she give the baby formula supplements. Instead, they tell her "you're doing a great job feeding you baby." I've known too many women to stop nursing all together because they just couldn't make enough milk, which was determined my a nurse who had taken a one hour course on breastfeeding online. Don't get me wrong, nurses are great.

Don't get me wrong - nurses are great. In fact, I'm pretty sure they run the world - or at least the medical world (no tongue in cheek here - I have worked at several hospitals - I know who is in charge). But they too are falling victim to what our medical world believes. The beliefs just get perpetuated with every mom that is convinced her labor isn't progressing quickly enough so she is given pitocen. Only, who decides how quickly labor is supposed to move? Did anyone bother to remember that it is called labor for a reason? It is a process you move through, and rushing it along (except in emergencies -- true emergencies), isn't good for anyone, least of all babies and mamas.

This book isn't for everyone. Like mamas who have just had babies. And it probably will just be considered a bunch of bunk by people who think doctors always know best and as patients we should do as we're told. I know for a fact that this isn't always the case. Doctors are people too, and sometimes they make mistakes. And then sometimes that mistake gets continued on and taught in medical school and it becomes the right, proper and safe thing to do. But that doesn't make it so. (less)

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Jan 05, 2013 Ciara rated it 2 of 5 stars

Shelves: baby-pregnancy-infertility-parentin, read-in-2012

okay, my review of this is likely to be colored by my own experience of pregnancy & childbirth, & it is a very different review than i would have written like ten years ago, when i was in midwifery school & just 100% gung ho about natural birth.

this book is kind of an expose of the increasing medicalization of american maternity care. i am less than convinced that such an expose needs to happen, but i have probably read far more than my fair share of books on this topic. there was li...more okay, my review of this is likely to be colored by my own experience of pregnancy & childbirth, & it is a very different review than i would have written like ten years ago, when i was in midwifery school & just 100% gung ho about natural birth.

this book is kind of an expose of the increasing medicalization of american maternity care. i am less than convinced that such an expose needs to happen, but i have probably read far more than my fair share of books on this topic. there was literally nothing in this book that was news to me, but i guess that it could be a nice place to start for someone who has never read much about this topic before.

i read this book while i was pregnant, which was probably mistake number one. there are A LOT of stories in here about pregnant women & their babies experiencing various adverse outcomes due to medical error or over-management. even though the author states upfront that pregnant women should take care of themselves emotionally while reading the book & not get too freaked out, that's easier said than done. especially in light of the fact that the author acknowledges that she has never had children, so she can't really know how terrifying it is to read about other people's pregnancies going south so suddenly, or to hear about the (generally rare, but horrifying nonetheless) negative outcomes that can accompany relatively routine procedures.

i also read this book right after being diagnosed with pre-eclampsia, which was mistake number two. for anyone who doesn't know, pre-eclampsia is a fairly uncommon but very serious pregnancy complication in which the pregnancy becomes toxic to the mother. her blood pressure can rise the the point that she is having seizures or even a stroke. her liver can begin to shut down & be damaged permanently. the placenta can suddenly detach from the uterine wall, causing the baby to die & the mother to hemorrhage. i could go on. the only cure for pre-eclampsia is to deliver the baby, & risks must be weighed between the dangers of the pre-eclampsia to baby & mother versus the trauma of prematurity for the baby.

i scanned the index of this book for references to pre-eclampsia, because it is one of a few major pregnancy conditions which really requires medical management in order for mother & baby to have the best chance of survival, & it's one of a few protocols that particularly demands cesarean (because labor & vaginal delivery can sometimes push a pre-eclamptic woman over the edge into strokes & seizures). it was mentioned a few times, but only in the context of, "cesareans are the worst thing ever & will destroy a mother's ability to bond with her baby & the baby will never be as smart as other babies as a result...but it's unavoidable with pre-eclampsia." at the time that i read this book, i was still hoping to have a vaginal, full-term birth, so this was both super-discouraging in that respect & also upsetting as far as me trying to make peace with the possibility of a pre-term &/or cesarean birth.

i wound up having my baby just shy of 33 weeks via emergency cesarean after a failed trial of labor which involved my blood pressure spiking all the way up to 200/130 (stroke zone, for sure). she spent over three weeks in the NICU, but we seem to have avoided the long-term issues that can impact premature babies (knock on wood--sometimes those issues aren't apparent until the child is older). so in light of all of that, this book seems even more like well-intentioned fear-mongering. there's not necessarily anything in this book that is untrue, but is anyone really served by hearing horror stories about women who contract infections from cesareans & die? maybe it will motivate a few people not to schedule elective cesareans for themselves, but statistics indicate that very few women do that anyway, so...? i won't argue for a second that the enormous rates of cesarean are all medically necessary, but some (like mine) are, & i know it really didn't help me out on that operating table to think about the possibility of the doctor, like, accidentally stitching me up with her car keys tucked inside, causing a massive systemic infection & death. & i stressed A LOT about how much i was missing out on by not having that "golden hour" where my baby is laid on my chest to experiment with breastfeeding & we have a magical bonding experience that forever cements my maternal love & sets my baby on course to someday attend swarthmore or whatever. in my case, i was so sick, i didn't even get to SEE my baby until she was 26 hours old, let alone hold her or try to breastfeed her.

block & other natural birth advocates might say, "oh, i'm not talking about YOU, of course there are cases where medical management is necessary & even life-saving." but there was barely even any lip service paid to that idea in this book. (less)

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Oct 14, 2012 Melissa Moorhead Wilde rated it 5 of 5 stars

Definitely a worthy read. Childbirth and maternity healthcare has never been very high on my list of personal interests, so it says a lot that I really enjoyed reading this book. It is extremely well researched and documented, and left me feeling informed and empowered, rather than freaking me out like a lot of other childbirth books tend to do to me. It reminded me to trust my body, my instincts, and my ability to actively and competently participate in my own care and decision making, and in t...more

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Sep 26, 2012 Shana rated it 3 of 5 stars

Though some may not agree, I believe that the issues surrounding birth choices are part of reproductive rights, and therefore it’s of interest to me. That and I’m just fascinated by the fact that women can be pregnant and give birth to babies. It’s hard to wrap my mind around the amazingness of it all. The miracle of birth, indeed!

Block did a great job of dissecting the history and research that exists around the topic of Cesareans. Because C-sections are becoming the norm in our society, she re...more

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Nov 12, 2011 Holly rated it 5 of 5 stars

This book blew my mind. The documentary "The Business of Being Born" first made me question the typical American childbirth experience and led me to choose a midwife (although, admittedly, one in a hospital setting). My aha moment: Most U.S. mothers today give birth on their back with their legs in the air -- which puts them at a convenient height and position for doctors, yet directly works against gravity and therefore impedes labor. Craziness.

This book provides the research to support the arg...more This book blew my mind. The documentary "The Business of Being Born" first made me question the typical American childbirth experience and led me to choose a midwife (although, admittedly, one in a hospital setting). My aha moment: Most U.S. mothers today give birth on their back with their legs in the air -- which puts them at a convenient height and position for doctors, yet directly works against gravity and therefore impedes labor. Craziness.

This book provides the research to support the argument that childbirth is a natural part of life that can usually happen without medical intervention (think about how many women around the world have given birth over the centuries without Western medicine). It points out that the advances in obstetrics were initially intended for the small percentage of births in which they are needed, yet now many of them (from continuous fetal monitoring to "elective" C-sections) are instead widely used for doctors' convenience and mounting malpractice concerns. It also describes the history of how we got here -- the patriarchal and medical takeover of childbirth from women, despite the measurably worse outcomes for mothers and babies (no, it is not a feminist rant -- it follows the general medicalization of health). Yep, the U.S. maternal and infant mortality rate is actually worse than in countries that do not routinely medicalize birth.

It explains the biology of childbirth and how each intervention affects that natural process, thus often leading to another intervention to correct the process. Example: hooking you to IVs and a continuous monitor keeps you immobile, which impedes natural labor, so then the doctors induce your labor, which then gives you such intense contractions that you need an epidural to relieve the pain, which then slows down labor (and hinders your abilty to know when to push), and then you "fail to progress" according to the hospital's timeline, and are wheeled into the operating room for a cesarean. (Today, one-third of American births are by c-section.) The book also tells compelling stories of the experience and knowledge of midwives, as well as the lengths to which women have gone to give birth naturally, despite the powerful lobby of the U.S. medical establishment and the criminalization in some states of midwives and home birth.

The book reads as investigative journalism (thanks to the author's background), not as an agenda or manifesto. It is somewhat dense but very readable, especially the personal stories, which are heavier in the last third/half.

I highly recommend this to any woman who wants to have a baby: no matter what conclusions you come to about the kind of birth you want to pursue (keeping in mind that sometimes things happen that you can't plan for or control), you should at least be fully informed about the consequences of each intervention you might face. As I now know first-hand, that information is NOT in "What to Expect When You're Expecting" or other pregnancy guides.(less)

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Oct 11, 2011 Christina Kessler rated it 5 of 5 stars · review of another edition

Shelves: pregnancy-and-birth

I really liked this book, but first let me say: if you are a pregnant mother and are only going to be able to read one book to help you make decisions about your birth, I recommend The Thinking Woman's Guide to a Better Birth. It has more information about your options and the impact of each on you and your baby. It has most of the information in Pushed, but is a little less sensationalist.

I did really like Pushed, though, once I realized her author's goal was not to guide pregnant women but to...more

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Nov 20, 2010 Carolina rated it 4 of 5 stars

I knew I wanted a natural childbirth before reading this book, but this book makes me want it even more. Obstetricians are so impatient and paranoid, they will augment your birth just as a "safety net" to protect themselves from lawsuits. I liked the idea of woman as pain-tolerating creatures back in the day of corset-wearing. But now, woman do to not distinguish the difference between good pain and bad pain, woman just associate pain as a symbol of oppression and sexism. Most woman see epidural...more

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“When ACOG (American College of Obstetricians and Gynecologists) claims that home birth and midwives are unsafe, they imply that the women who choose it and the midwives that provide it are acting irresponsibly and selfishly. They stigmatize normal birth just as the political right has stigmatized abortion. And they stigmatize women.
"Our country has created a mythology of women who are irresponsible and don't care," says Paltrow. "We talk about welfare queens, crack moms, and murderous women who have abortions." A culture that allows such language to permeate our national subconscious inevitably dehumanizes all women, including mothers. Lyon argues that this thinking perpetuates a phrase often invoked in exam rooms and delivery rooms: The goal is to have a healthy baby. "This phrase is used over and over and over to shut down women's requests," she says. "The context needs to be that the goal is a healthy mom. Because mothers never make decisions without thinking about that healthy baby. And to suggest otherwise is insulting and degrading and disrespectful."
What's best for women is best for babies.
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The goal is to have a healthy family. ” — 10 people liked it

“Today, what's normal is being redefined: from vaginal birth to surgical birth; from 'My water broke,' to 'Let's break your water;' from 'It's time' to 'It's time for the induction.' As medical anthropologist Robbie Davis-Floyd writes, 'in the early twenty-first century, we do not know what normal birth is.' Most practicing obstetricians have never witnessed an unplugged birth that wasn't an accident. Women are even beginning to deny normal birth to themselves: if 'normal' means being induced, immobilized by wires and tubes, sped up with drugs, all the while knowing that there's a good chance of surgery, well, might as well just cut to the chase, so to speak. 'Just give me a cesarean,' some are saying. And who can blame them? They want to avoid what they think of as normal birth.” — 4 people liked it

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