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Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First
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Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First

4.27  ·  Rating details ·  590 ratings  ·  82 reviews
In this rare, behind-the-scenes look at what goes on in hospitals across the country, a longtime medical insider and international authority on childbirth assesses the flawed American maternity care system, powerfully demonstrating how it fails to deliver safe, effective care for both mothers and babies. Written for mothers and fathers, obstetricians, nurses, midwives, sci ...more
Hardcover, 305 pages
Published November 1st 2006 by University of California Press (first published 2006)
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4.27  · 
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 ·  590 ratings  ·  82 reviews

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Liz Deren
Mar 11, 2008 rated it it was amazing
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 an ...more
Jul 26, 2011 rated it liked it
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 ...more
Jun 13, 2011 rated it liked it
Shelves: nonfiction, pregnancy

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
Dec 06, 2009 rated it liked it
Shelves: 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 M
Laura Vogt
Feb 24, 2015 rated it it was amazing
Shelves: birth
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 i ...more
Jul 12, 2007 rated it it was amazing
Recommends it for: people having a baby
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 ...more
Dec 28, 2008 rated it liked it
Shelves: non-fiction
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 docto ...more
May 26, 2014 rated it did not like it
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.
Jul 25, 2012 rated it it was amazing
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.
Molly Morgan
Mar 27, 2018 rated it liked it
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 unravel ...more
Feb 07, 2018 rated it really liked it
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.
Jean Panek
Dec 04, 2018 rated it really liked it
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 19, 2017 rated it it was amazing
Shelves: pleasure-to-read
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.
May 03, 2018 rated it it was amazing
This is a very well done scientifically based book on the maternity system in America. Every pregnant woman, OB, Midwife, Doula should read.
p roper
Apr 17, 2019 rated it it was amazing
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.
Aug 03, 2018 rated it really liked it
This book provided great insight of our very broken maternity system.
Nicole Greer
Jan 24, 2009 rated it it was amazing  ·  review of another edition
Recommends it for: Women, fathers, obstetrcians
Shelves: i-own-these
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 vio ...more
Jennifer Margulis
Jun 02, 2015 rated it it was amazing
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 manu
Apr 01, 2011 rated it really liked it
"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 m
Sep 26, 2012 rated it really liked it
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 ...more
Aug 21, 2009 rated it really liked it
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. ...more
Mar 31, 2008 rated it it was amazing
Recommends it for: Everyone and especially all women between 18 and 50
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 ...more
Aug 29, 2008 rated it it was amazing
If I could give this a 5+ I could, just because I think it contains such important information and EVERYONE should read it.
The take home message of the book is this:
-Current obstetrical practices in the US are simply not based on science.
-Midwives should be taking care of most women giving birth, with obstetricians taking care of the high risk pregnancies.
-Scientific studies have proven that this has better results for mothers and children.
-Birth is a normal, natural event, and obstetrics has
Oct 06, 2009 rated it really liked it
Shelves: doulas
I really love this book. The only thing I don't love is that I kind of think that Dr. Wagner is overly optimistic about what maternity care improvement coalitions can actually achieve in this country. But there is a lot of great insidery info on how the maternity care system works with ideas on how consumers in the system (pregnant/childbearing women and their families) can advocate for themselves and better care over all. Great info on the legal status of midwives in the US and the difficulties ...more
Tommy Estlund
Jan 22, 2012 rated it it was amazing
A fantastic book about a fundamental part of the human experience: the birth process. Dr. Wagner breaks down in clear, compelling and well-organized arguments the reasons why our maternity care in the US is so screwed up, and most importantly the things we can do as a people, as individuals, and as parents to fix things.

In the interest of full disclosure, we had our second baby, Ava, at home, using the services of a phenomenal midwife. So, Dr. Wagner necessarily needing to convince me of anythi
Feb 08, 2009 rated it it was amazing
can i give this more than 5 stars? if every insurance company in this country reviewed this book, i guarantee midwives would be primary prenatal caregivers, and OBs would be relegated to what they are there for-- speciality and high risk cases. every womam would do well to inform themselves by reading this.... i swear, he finds EVERY scientific study in every country about birth, pregnancy, labor.... it's a treasure chest of information. a little academic-y, but that's what is needed for some pe ...more
I'm not in the mood to write a long review, so I'll just say that this is a book I really think everyone ought to read. Everyone. There are things here that we the public need to demand be changed. It was well cited and written (except that it tended toward being a bit repetitious at times). It made me glad I'm using a midwife with this pregnancy and delivering in a birth center. Having also delivered in a hospital, I've had first hand experience with how the current system makes you believe and ...more
As an ally for midwives everywhere, Wagner makes some excellent points and uses his privilege (as both a man and a doctor) for good. However, his combative tone in places renders the book as almost sounding petulant. The arguments are sound but the tone ruins them sometimes. This book is also far longer than I expected. Wagner spends a good deal of time repeating himself and referencing other chapters. While that sort of reiteration might be good for some readers, it annoys the hell out of me. S ...more
Lisa R.
Jun 15, 2008 rated it it was amazing
Recommends it for: Expectant parents or those who plan to be
This book, which I actually began reading for work and then found out I was pregnant while in the middle of it (!), changed my view of modern-day obstetrics and gynecology, and is what convinced me to have a natural birth.

The author's statistics are compelling and much of what he writes is backed up by professionals such as Ina May Gaskin. If you are pregnant or planning to be, I STRONGLY recommend you read this book - it will really change your view of our maternity system and the way we treat
Dec 10, 2009 rated it it was amazing
A terrifying and persuasive criticism of maternity care in the U.S. I generally read more practical texts about birth and don't follow the politics so much, but this was a required reading for a doula certification course I'm taking next month. The author seems to be a quite reliable source, very focused on the ways the current standards of OB practice in our country fly in the face of scientific evidence. This grounding in the scientific method is what won me over (and scared the hell out of me ...more
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Marsden began his career in public health as a neonatologist and epidemiologist, firstly in California then Denmark. He retired from a distinguished career as head of Maternal and Child Health for the European Office of the World Health Organisation (WHO) after 15 years during which time he chaired the three consensus conferences convened by WHO on appropriate technology around the time of birth. ...more
“One way to measure a particular doctor's openness and attitude toward women in general is simply to ask about the doctor's opinion of midwifery.” 13 likes
“...the total number of pregnancies in which powerful and dangerous drugs are used is 60 percent, or nearly two-thirds of all births. It is rediculous to think that two-thirds of American women have such lousy uteruses that they must be whipped into shape with drugs in order to have babies.” 7 likes
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