List Price: $26.00
Author: Jennifer Block
Official URL: http://www.jenniferblock.com/
Rating:

With stylish, riveting writing, an exciting first-hand account of
traveling “underground” with an illegal midwife, and tales from the
operating table, Block skillfully takes stock of the current state of
birth in America. Not to be missed.

I highly recommend PUSHED: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block

An eye-opening book for anyone who has not been directly involved in maternity care, and a great resource for birth activists, Pushed brings together all the important issues about maternity care, including the difficult and “grey” areas. Because it includes individual experiences and as well as facts and evidence, and is very readable, this would be an excellent book for any woman starting to think about maternity care (newly pregnant, or planning to get pregnant), and for family members who might not be supportive of midwifery care.

IF YOU GO to a hospital in the United States to deliver your child, you will probably do so flat on your back — thought by many to be the worst possible position in which to give birth short of being hung by the feet. You have a one-in-three chance of having major abdominal surgery. If you don’t, you’ve got another one-in-three chance of having your vagina slashed with a knife. And you will have a better chance of dying, or having your baby die, than do women in almost any other industrialized country.

All of these details and more are available in Jennifer Block’s new Pushed, an examination of American maternity care in general and the rising rate of cesarean births in particular. Block used to be an editor at Ms., and the book is loaded with interviews, statistics, and the kind of muckraking you’d expect from a veteran of the progressive media.

Block’s tone is dry, her prose full of scientific minutiae about cesarean rates, obstetrician attitudes, historical studies, and the legal status of midwifery. Those undaunted by the facts and figures are rewarded with some quietly deft storytelling. Block’s description of a typical C-section, for example, is neither overtly judgmental nor outraged. Instead she calmly piles on details — the surgeon struggling to work around old scar tissue, the blood, the nurses choosing a radio station, the mother seeing her child for the first time in a digital picture. Anybody who’s ever been in a hospital for a major procedure will recognize the studied depersonalization and the downplayed but lingering threat that something could go very wrong.

Surprisingly, this book gave me a greater sympathy towards obstetricians (well, some of them at least). Many of the physicians Block interviewed held great respect for the natural, physiological birth process; bemoaned the current state of malpractice litigation, VBAC bans, and the dogma of automatic surgery for breeches; and secretly supported home birth midwives–often facing censure from their peers for their views.

PUSHED shows a maternity care system that has gone malignant. Instead of being a tool to aid women when pathology arises, it is now our master. Obstetricians, nurses, midwives, birthing women and unborn babies are all slaves to the machines and the technologies that they have created. Birth, for most women, is managed by drugs, hormones, and clocks, rather than being a chaotic but gloriously intricate and rewarding physiological process. In this system, no one wins. Instead of being bathed in a complex “cocktail of love hormones,” as Dr. Michel Odent puts it, women are on morphine drips in post-operative wards. Their babies are intubated, suctioned, and injected. Mothers are separated from babies, vaginas are separated from birth, and birth is separated from labor.

I want to share two excerpts from the book, which illustrate so profoundly why a “natural birth” is so difficult to attain in a typical hospital setting:

The vast majority of American births involve a myriad of medical devices, all of which tie the woman to a obstetric bed and deprive her of the ability to move freely during labor: IV, automatic blood pressure cuff, pulse oximeter, electronic fetal monitor, epidural catheter, urinary catheter, intrauterine pressure catheter, and circulation stockings. The latest device, just approved by the FDA, consists of two electrodes inserted inside the vagina that automatically measure cervical dilation. Judith Lothian (PhD, board member of Lamaze International, and professor of nursing at Seton Hall University) explains: “If we put women in hospitals with restrictive policies–they’re hooked up to everything, they’re expected to be in bed–of course they’re going to go for the epidural, because they’re unable to work through their pain.”

British midwife Tricia Anderson eloquently writes:

“Let us bring them into harsh rooms with bright lights. Let us make them lie on their backs on hard narrow beds. Let us tether them to machines so they cannot move. Let us make them stay silent and make no noise with their pain. Let us expose their most private parts and threaten them with cold steel. Let us make them push their babies upwards, against the pull of the earth…In these conditions, labour swiftly becomes unbearable and pain relief becomes a woman’s only hope….This is not the natural cry of a woman in labour bringing a child to birth, although if you have only ever witnessed childbirth in a medicalized setting you might be forgiven for thinking so. This is the screaming plea of a tethered animal in pain.”

BOTTOM LINE

This book gives a much needed second-look at traditional maternity care in this country where clocks are more important than natural progression, where the c-section rate is twice the rate that is safe and necessary and where “managing labor” becomes more important than the health and safety of mother and child. Giving birth does not need to be the hectic, uncomfortable and humiliating medical procedure that it has become. In fact, it is far less safe for it to be treated this way. Jennifer Block’s PUSHED is a powerful reminder of what birth should be about and just how far we have strayed from this ideal.