Block, Jennifer. Pushed: the Painful Truth about Childbirth and Modern Maternity Care. Cambridge, MA: Da Capo Lifelong, 2007. Print.
- Discusses C-sections much more in depth, both the surgical procedure and effects on the mother.
- Arranged birth and how it has changed the dynamics around the hospital.
- The science of each procedure i.e. episiotomy, c-section.
- How pitocin has developed throughout medical history and its role in the birthing process.
- Vaginal birth after cesarean and doctors’ attitudes around the subject.
In the next pages that I read, the topic switched from “arranged birth”, as in induction and planned cesarean, to women whom birth was denied at the hospital. A small percentage of women have breech babies, meaning the child is not positioned head down in the uterus. This can be extremely dangerous for the child, therefore causing doctors to plan cesareans. However Pushed discusses the risk of cesarean and tells stories of successful breech births performed by midwives. Lastly, Block writes about VBAC – vaginal birth after cesarean, and women’s battle with that. This I found a bit more interesting than before, because neither topics are very heavily discussed. It seems crazy that a doctor would not heed to his patient’s preference, but instead decides what would be most convenient for him or her. If a mother wants to take the risk of VBAC, then she should be allowed it. Pushed has clearly proven that she is just as much risk having a repeat cesarean. I believe that when the mother is comfortable with the choice, then the best outcome will result.
- “As obstetrics becomes more didactic, women who are determined to avoid unnecessary surgery are shunning the hospital altogether and planning to give birth at home. ‘It’s a matter of trust for most of these women,’ says Bennett. ‘The reason they’re having HBACs is because they don’t trust the hospital.’” (p. 95)
- “The women online are months, or even years, out from their cesareans, yet many are still coming to grips with them. And when they get pregnant again, they are often being told they must have another surgery; that their uterus could rupture and the baby could die.” (p. 92)
- “An unmedicated birth in an environment where a woman feels comfortable, where she’s adequately supported, where she has a degree of privacy that allows her brain and her uterus to do the dance that we understand very poorly called labor, is a physiological birth. And once you start messing with any one of those factors, put her in hospital with noise and light, take away her privacy, you down a slippery slope toward industrial birth.” (p. 105).
- “ ‘Our results show how a medical intervention or treatment that is effective when applied to sick individuals in emergency situations can do more harm that good when applied to healthy populations.’” (p.114).
- “The truth is however, that we don’t know what our true maternal morality rate is. The U.S. Centers for Disease Control and Prevention acknowledges that pregnancy-related deaths are underreported by as much as three times.” (p. 119)
I decided to check the fact that maternal mortality rates are underreported in the United States, as I found that surprising. I never really considered them to be that high, as we live in a first world country with such advanced technology. I would never have reflected on the fact that the US would try to cover up a number, because it never would have been significant enough to. However after researching a bit online, I came across a prenatal yoga studio that had written about it:
“In 1998, the CDC estimated that the US maternal death rate is actually between 1.3 and 3 times what is typically reported in vital statistics records because of under-reporting of such deaths. There are potentially many more pregnancy-related deaths than those reported and accounted for. Ina May Gaskin points out that: “Reporting of maternal deaths in the United States is done via an honor system. There are no statutes providing for penalties for misreporting or failing to report maternal deaths.” 1
I find it really interesting that there are no guidelines for reporting maternal deaths. Do they have less worth than other deaths in our society? Is it more important that the child survived, rather than the mother? It was very good of Block to bring this up, as I believe it clues us in to a lot of things. She exposes how secretive and manipulative the industrialized birth system actually is. By not reporting maternal deaths, it ultimately creates the image that the hospitals are succeeding in their tactics, and that it is therefore safe to access them. Women may see the birthrate and think, wow, the horror stories I have been hearing maybe are not so entirely true, or maybe they really are a rarity. Of course the hospital is important for when cesareans and induction are necessary, however they are performing these operations in unnecessary circumstances. A lot of these maternal deaths are probably covered up to avoid negative media about the practices of the hospital, which of course would lead to more home births and midwifery use.
The yoga site linked to a list prepared by Ina May that may also be interesting to read:
1 "The US Has One Of The Worst Maternal Mortality Rates In The World. Why?" - Prenatal Yoga Center. Web. 22 Mar. 2011. <http://prenatalyogacenter.com/blog/the-us-has-one-of-the-worst-maternal-mortality-rates-in-the-world-why/>.
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