HW 40 - Insights from Book - Part 3

I seem to have found myself at a cocktail party, when in walks Marsden Wagner, the author of the book, Born In the USA, which coincidentally, I have just finished reading.

Elizabeth:

Hey there Dr. Wagner!

Marsden Wagner: 

Pardon me, but, do I know you?

Elizabeth:

No, but I just finished reading your book, Born in the USA, which I really enjoyed. Your main idea that the current system we use in America is more harmful than healthy made me think differently about the current status of our maternity system.

Wagner, surprised to be talking to someone who actually rephrased the main idea of the text instead of sharing their own birth story, replies curiously. 

 Wagner:

Really? Which parts were most effective or important for you?

Elizabeth:

Well, in the last third of the book you focused on methods to change the flaws in the maternity system, which further developed your thesis. You suggested many different solutions, but the three most realistic ones, in my opinion, were from pages 220, 240, and 242  where you mention educating the public, improving public health, and following the money.

At this point, Marsden has realized that he's having a unique conversation with a serious reader of his book.

Marsden:

But what could I have done to make this book so that it would more effectively fulfill its mission and to be all around better?

Elizabeth:

Well, your text sought to provide a system analysis from the perspective of what one would consider an expert in the subject, so the book-reading-public could better understand the maternity system in our culture. Given that aim, and your book, the best advice I would give for a 2nd edition of the text would be to rethink the solutions you provide in the book. While I do believe that you have created valid arguments as to why policies and standards need to change, I do think that some of your solutions contradict one another. 

Marsden:

How so?

Elizabeth:

Well, one of the solutions you mention is to create coalitions, but at the same time you mention that governmental standards need to be reformed. But they don't completely conflict one another.  I don't want you to feel like I'm criticizing, I genuinely appreciate the immense amount of labor you dedicated to this important issue. But most particularly for making me think more about the immense influence that money and politics have on the United States maternity system and the general safety- both physically and mentally- of mothers, children, midwives, and families has been heavily disregarded. In fact, as a result of reading your book, I'm likely to have a home birth of my own in the future, unless the system changes in favor of a more natural birth. 

Marsden:

Thanks! Talking to you gives me hope about our future as a society!

HW 39 - Insights from Book - Part 2

 Wagner, Marsden. Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First. Univ of California Pr, 2008. Print. 

While comparing The Business of Being Born and Born in the USA, I've found that the main difference between the two is the audience for which each medium is aimed. The Business of Being Born focuses heavily on the emotional aspect of pregnancy/birth whereas Born in the USA incorporates the emotional and business sides of the maternity system. The chapters I've most recently read were about midwives and legalities. This part of the book relates heavily to The Business of Being Born (TBBB) because they both fixate on midwives. The difference is that Born in the USA (BUSA) examines and gives examples of legal cases in which "the good guys" have been direct targets of the maternity care system. I personally enjoy watching TBBB more than reading BUSA because it's much more engaging. BUSA does have some really good information and touching stories to share, but I feel that the setup which they are given creates a strong unintrest for the reader. Example, on page 143 of the book, the reader is given a boatload of percentages and numbers and basically have to create an image in their head of how the data would be set up. I personally had to read over it 5 times to get the general idea of how the numbers would look next to one another, but I can hardly imagine that every single reader re-reads things they understand. In fact, normally I'd probably skim it and tell myself that the context would help me understand it. But the context didn't. And anything that came afterwords didn't really help to explain what the data meant. (Would put in quote but it takes up a full 1/2 page).

The second part of BUSA forces the idea that midwives are generally (not always, there was some counter-evidence) better birth-helpers due to emotional as well as health factors. I feel as though giving birth with a midwife would in fact be the best experience for giving birth. It seems much more emotional and not as sterile as hospital birth. Through my reading I've created a sort of mindset that doctors don't care about the patient, they simply care about the money, and how to make it fast.

HW 38 - Insights from book - part 1

Born In The USA

Marsden Wagner, M.D., M.S.

In Born In The USA, there are 9 chapters, each providing a new argument/reasoning behind the thesis. The first four chapters focus on the nightmarish aspects of maternity. I haven't read past chapter four, but from looking at the table of contents, it will most likely be another nightmarish chapter, but will also provide alternatives to the current system.

The major question the book is trying to answer is somewhere along the lines of "what is bad in the current US maternity system, and what can be done to change these things". So far, from what I've learned, I think a lot of what is wrong with the system are the doctors. They are so scared of a malpractice lawsuit that cesarean section is becoming the "easy way out". 

Chapter one is on the current state of maternity care, the second provides insight into the close-knit world of doctors, and the third is about surgery being incorporated into birth. The general thesis is most likely that the current maternity system is so heavily based around the hospital experience that people are losing sight into the process of giving birth.

One aspect of birth that deserves public recognition is that obstetrician aren't present during labor, but they rush in at the last moment, to help bring the baby out. They'll make money no matter what, but it shows that there is an impersonal connection between a pregnant woman and her doctor. 

Something else that disgusted me was that when a doctor is faced with a malpractice lawsuit, most doctors will not testify against them because it could mean losing referrals from other doctors, therefore losing money. 

Another thing that really riles up the author of this book, Marsden Wagner, is Cytotec. Cytotec is a drug that can be used to induce labor, but it's use has resulted in death. 

One idea that is heavily pounded into the readers' heads is that surgeons are not scientists. Surgeons are trained to cut, remove, replace, etc. and can be more useful in situations not involving birth, which generally hasn't involved scalpels, scissors, and forceps.

The evidence in this book pulls from many sources; the writer's personal experience with medical training and practice, charts, statistics and real-life stories/examples. The entire book is basically composed using mainly evidence, mainly through stories and a a few tables thrown in here and there. I think that while some of the points that are being made in this book are interesting, a lot of it is repeated in different forms of evidence... not that it's bad to back up arguments with evidence, but sometimes the reader can get sick of hearing the same idea said over and over again but in different ways. 
A lot of the numerical evidence seems reliable because it is cited either in text or in the index. I've flipped through the index, which is actually a little helpful in telling the reader what is generally found in each source. 

HW 37 Comments on Birth & Pregnancy Stories

Comments I made:
Lucas:

I really enjoyed reading this post. Overall you did a great job. But I think you did best at keeping the stories informative yet short (a problem I faced in writing my assignment).

One of the only things I could think of changing would be the placement of this section, "Women who have miscarriages sometimes blame themselves for the event, wondering if every little event was the one that caused it. It can be psychologically devastating, and is hard to deal with without therapy. This link was somewhat informative on the topic". The reason for this is because that paragraph was a narrative, not research or response. I would have started off the next paragraph with a bit of rephrasing like, "Through research on (link here), I discovered that women who have miscarriages sometimes blame themselves for the event, wondering if every little event was the one that caused it. It can be psychologically devastating, and is hard to deal with without therapy".

Otherwise, good job!

P.S. I appreciate your sophisticated yet easy to read writing style.  

John:
Hey John,

I think that the first topic you'd like to explore further is a really interesting one (what are the reasons for marriage and birth to be so interconnected in our society?). Another thing that I liked was that in your response paragraph, you talked about society and then compared society's standards back to Tom and Jackie.

One thing I'd suggest is proofreading your work. There were a few minor grammar mistakes that you would have noticed i you'd combed through your work. Another benefit from proofreading is that you could probably see room for expansion and, by doing so, add some more "beauty" to your work.

Good Job! 

Comments on my Blog:
John:
Elizabeth!
Your interviews were interesting and you presented each one with something of a narrative arc, different from mine which is something i think i could work on. the details were the most nice spice, like how the doctor made threats and the nurse was incompetant. the one that struck me the most was the first interviewee only got offered a seat twice on the train in those 9 months, maybe my social obligations are more different than i thought than of others. im curious to know what neighborhood she would get off and on. another thing i also liked was how i could also very easily follow your thought process which almost made me feel im not alone at night looking at a computer reading someones blog. thanks for the stories,

John 

Lucas: 
Elizabeth,
Your interviews and their resulting analysis were very interesting to read; I found the part in which the doctor threatened your mother with a C-section particularly so, I wonder if doctors can legally perform such an operation under the given conditions (i.e. lack of consent). What do you think caused the 'superstitions' your grandmother had in relation to not buying baby items out of fear of essentially 'jinxing it'? Could it be a personal belief, or perhaps a cultural one?

I also kind of want to know the answer to the beer = milk question, it sounds worthy of investigation...

Nice post!

-Lucas  

Sara B (10th Grader @ different school):
Elizabeth -
I enjoyed very much reading what you wrote! It was interesting to read about different perspectives on pregnancy and birth stories, especially because the topic is so intimate and personal. I particularly was struck by when the first interviewee said she was only offered a seat on the subway twice throughout her whole pregnancy, despite riding it twice a day. You phrased it as this happened for 9 months, but women don't even start showing until later on in the pregnancy. Also, people can't always tell when someone's pregnant especially with coats on. Still, you'd think someone would notice, but maybe I just don't like the idea that our society is that inconsiderate. In terms of my own life, this post made me think about how I should find out about my own mother and grandmother's birth experience. You seem to have uncovered some funny details too, (like the myth beer = milk) and gained a better understanding of what it means to be pregnant. And of course it's interesting to think about what it means about society from way we treat pregnant people. Overall, I'm glad I read this post and heard all these interesting stories!

Sara B. :) 

 
Dad:
My reaction to your interviews, one of which was with me, is that I also found your grandmother’s comments most interesting. The most fascinating line was her comment about how drinking beer produces more breast milk. I had to laugh. I had never ever heard that before.

Given that your grandmother came from a different generation, it was interesting to see her perspective on pregnancy versus my point of view. I understood the superstitious aspect. I was surprised to learn that none of the pregnancies were planned. One thing that holds true even today is that people always want to touch the belly. To me it’s an invasion of one’s personal space. But people just seem to think it’s an accepted norm, as if they don’t even have to ask.

You indicate that it surprised you that I took such an interest in children, a notion I would guess that is normally associated with women. I think that comes from my father, who participated quite a lot in raising me, probably more than other fathers in the neighborhood. It was something I realized after I was well out of my teens; how lucky I had both a mother as well as a father who took an interest in my well being. I came to appreciate the experience I had with them. Some of my friends growing up were not as fortunate, coming from single parent homes and/or abusive environments. My parents set an example for me to follow. How well I carry on in the same tradition remains to be seen. As the saying goes, only time will tell.