I just finished reading a collection of true horror stories titled, Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First by Marsden Wagner. The first thing that the author, Dr. Wagner, is a man. Yes, a book by a male doctor who is fighting for women to have the kinds of births that they want and deserve. The kinds of births that medical professionals and our health care system often get in the way of. But, as I said, it's filled with horror stories...
A big focus of this book was Cytotec, a drug intended to be used on patients with stomach ulcers. Uterine contractions are a known side-effect of the drug in female patients, and some obstetricians have taken full advantage of this, despite the fact that Cytotec is clearly labeled that it is not to be given to pregnant women. Those doctors who use Cytotec for labor induction do so because the drug is cheaper than other induction drugs, such as Pitocin; and, unlike Pitocin, Cytotec does not have to be used continuously. Pitocin is administered intravenously, and once the IV is stopped, so are it's effects. Cytotec comes in capsule form and can be given orally, or placed inside of the vagina in order to stimulate contractions, and there is no stopping its effects until the drug has worn off. The problem is that Cytotec tends to bring on contractions that are too strong, and too close together (hyperstimulation), and again, there is not stopping or slowing the effects. This frequently leads to fetal distress, and there is an increased risk of uterine rupture, especially in those women with a previous c-section. This drug has costs many women and babies their lives, yet, it is still in use.
Of course there are plenty of stories of doctors who induced women's labor for their own convenience, and in some cases didn't even inform the woman that they were being induced. There is an account of a couple who intended to have a natural birth, the doctor was aware of this, and he still (unnecessarily) induced labor against the family's wishes. The baby went into fetal distress and the mother ended up having a c-section as a result. All of this could have been avoided had the mother been allowed to birth as she had intended.
Of course we're not talking about medically necessary inductions or c-sections here. While some births do require medical intervention, most pregnancies and births are low risk and require no intervention. Obstetricians are trained to find problems though, they're trained to use medical technology, to do surgeries. All too often an unnecessary medical intervention, be it induction, augmentation, epidural, whatever, can lead to further interventions, and sometimes to loss of life.
The practice of midwifery is another big topic in this book. Studies have shown that a low risk birth at home or in a birth center is just as safe (perhaps safer in some cases) as giving birth in a hospital. Obstetricians have done a good job of spreading fear about out-of-hospital births and about the use of midwives. Why would they do this? Because they lose business when women choose midwives. There are horror stories given here, too. Doctors accusing midwives of "practicing medicine without a license", but midwives ARE licensed. A midwife accused of botching a birth when a day old baby is found to have severe breathing problems; though it is later discovered that the respiratory problems were due to a genetic deformity and the doctors were too busy trying to throw the midwife under the bus to see what the real problem was.
I can't begin to even touch on all of the personal accounts and research contained in this book. It's a surprising read, one that infuriated me, saddened me, disheartened me, but also gave me hope, because there are people out there who are working hard to improve our maternity system.
I'll leave you with an interested tidbit of information to consider... The US spends 40% more on health care than Canada, 90% more than Germany, and 100% more than Japan. Yet, all 3 of these countries have a lower infant mortality rate. There are 22 countries that have lower mortality rates than the United States, all of them have universal prenatal care, while 25% of American women receive little or no prenatal care.
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