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

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

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

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


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, scientists, insurance professionals, and anyone contemplating having a child, this passionate exposé documents how, in the most expensive maternity care system in the world, women have lost control over childbirth and what the disturbing results of this phenomenon have been. Born in the USA examines issues including midwifery and the safety of out-of-hospital birth, how the process of becoming a doctor can adversely affect both practitioners and their patients, and why there has been a rise in the use of risky but doctor-friendly interventions, including the use of Cytotec, a drug that has not been approved by the FDA for pregnant women. Most importantly, this gripping investigation, supported by many troubling personal stories, explores how women can reclaim the childbirth experience for the betterment of themselves and their children.

Born in the USA tells:

• Why women are 70% more likely to die in childbirth in America than in Europe

• What motivates obstetricians to use dangerous and unnecessary drugs and procedures

• How the present malpractice crisis has been aggravated by the fear of accountability

• Why procedures such as cesarean section and birth inductions are so readily used


To remain silent and indifferent is the greatest sin of all.

You can’t change the status quo by being appropriate.

Much of what is in this book will come as a shock to women and families in America. There are two reasons for this. The first is that accepting that our present maternity care system is as abusive as documented here is a hard pill to swallow. No society wants to believe itself capable of putting its most vulnerable members—pregnant women and babies—at such risk. The second reason is that the American obstetric profession has managed to keep a big secret from the public for fifty years.

When I was a medical student, decades ago, I was shocked when I first became aware that obstetricians don’t attend women during their labor but instead rush in at the last moment to catch the baby (and the money). I talked about the situation with other students, and we all thought it was a terrible scandal, particularly since the laboring women had never been told that their doctors were not going to be there. But at the same time we were learning to be doctors ourselves, and that meant we were learning that great power is available to doctors who are willing to play by the rules—and rule number one is never talk about medical mistakes or bad practices.

Think about it: How often have you heard of a medical whistle-blower? It is a rare occurrence in medicine, and it is a rare occurrence in maternity care, where medical students, obstetricians, midwives, nurses, and everyone else in the field is under pressure to keep their mouths shut or risk losing their ability to practice. For me, however, there came a time when it was no . . .

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