A muck-raking expose of what happens in labor and delivery wards across America.
Pushed upset me–so much so, that I considered not finishing the book. I have an innate mistrust of doctors and hospitals after some rough treatment I received during a miscarriage last year. where I was not informed of all my options and wound up in the ER with an infection. My quest to find a new care provider ultimately led me to choose home birth with a midwife for my low-risk, healthy pregnancy. It was a wonderful, peaceful experience.
Reading Pushed, you’d think that almost every hospital birth is rife with drama and that almost every OB would rather do a C-section than “allow” a woman to deliver vaginally. Since I don’t have a hospital experience of my own to draw upon, I can’t add to the conversation. However, among my friends, I have heard some horror stories. One woman I know delivered in a closet that was commonly used as a passage, so while she was pushing on her hands and knees there were hospital personnel constantly walking past. Another friend of mine was told at 39 weeks that her baby was “too small” and offered the choice of induction or a C-section–right then and there. Having heard horror stories about Pitocin, and because she had not even begun to dilate, she chose C-section. Her baby was 6lbs and she was unable to breastfeed (she chose to pump for 7 months and is my hero for that). On the flip side, I have several friends who chose the conventional epidural birth and had wonderful, easy experiences with no drama or chaos.
Block makes a convincing case that protocol on labor and delivery wards are driven not by what is best for individual women, but by fear of litigation. The stories that made me the saddest were those about women who expressly declined certain interventions and were given them anyway. The worst was a woman who showed up at the hospital with her baby crowning. Because she had had a previous cesarean, the hospital called in a judge who granted custody of the baby to the hospital and she was forced to have a repeat c-section. The concept of “informed consent” is being eroded day after day by hospitals who view vaginal delivery as a “procedure” to be granted or withheld, rather than as a natural, normal, biological process. Block writes:
What’s best for women is best for babies. And what’s best for women and babies is minimally invasive births that are physically, emotionally, and socially supported. This is not the experience that most women have. In the age of evidence-based medicine, women need to know that standard American maternity care is not primarily driven by their health and well-being or by the health and well-being of their babies. Care is constrained and determined by liability and financial concerns, by a provider’s licensing regulations and malpractice insurer. The evidence often has nothing to do with it.
Today women have unprecedented access to the information they need to make the best decisions for themselves–and therefore the best decisions for their babies. They are in fact in a far better position to make evidence-based decisions than their doctors. They have a right to make those decisions, and they should make those decisions.
The goal is to have a healthy family.
The must-read chapters in this book concern the role of midwifery care in the US, care that is illegal in many states. Whenever I think about a midwife being prosecuted for assisting a birth, the image of a woman being tried as a witch comes to my mind. I love the concept that a midwife doesn’t deliver a baby, she assists at the birth of a family. I really felt that my midwife (and my chiropractor, but that’s another story) shepherded me into motherhood, because the care I got was so personal and intimate.
I am the first to say that I am glad that we have modern medical technology. The friend of mine who was issued the c-section ultimatum was a c-section herself. Her mother’s placenta peeled off, which is a genuine life-or-death situation for the baby. I am beyond glad that my friend is here today, thanks to the doctors who intervened. However, I believe it’s just as important that women who choose to refuse interventions are supported in their decisions, because most births are simply not emergencies.
After reading Pushed, you will never watch “A Baby Story” the same way again.