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.