The American Way of Birth

Overview

Three decades ago, Jessica Mitford became famous when she introduced us to the idiosyncracies of American funeral rites in The American Way of Death. Now in a book as fresh, provocative, and fearless as anything else she has written, she shows us how and in what circumstances Americans give birth. At the start, she knew no more of the subject, and not less, than any mother does. Recalling her experiences in the 1930s and 1940s of giving birth - in London, in Washington, D.C., and in Oakland, California - she ...
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Overview

Three decades ago, Jessica Mitford became famous when she introduced us to the idiosyncracies of American funeral rites in The American Way of Death. Now in a book as fresh, provocative, and fearless as anything else she has written, she shows us how and in what circumstances Americans give birth. At the start, she knew no more of the subject, and not less, than any mother does. Recalling her experiences in the 1930s and 1940s of giving birth - in London, in Washington, D.C., and in Oakland, California - she observes, "A curious amnesia takes over in which all memory of the discomforts you have endured is wiped out, and your determination never, ever to do that again fast fades." But then, years later in 1989 - when her own children were adults, and birth a subject of no special interest to her - she meet a young woman, a midwife in Northern California who was being harassed by government agents and the medical establishment. Her sympathies, along with her reportorial instincts, were immediately stirred. There was a story there that needed to be explored and revealed. Far more than she anticipated then, she was at the beginning of an investigation that would lead her over the next three years to the writing of this extraordinary book. This is not a book about the miracle of life. It is about the role of money and politics in a lucrative industry; a saga of champagne birthing suites for the rich and desperate measures for the poor. It is a colorful history - from the torture and burning of midwives in medieval times, through the absurd pretensions of the modest Victorian age, to this century's vast succession of anaesthetic, technological, and "natural" birthing fashions. And it is a comprehensive indictment of the politics of birth and national health. Jessica Mitford explores conventional and alternative methods, and the costs of having a child. She gives flesh-and-blood meaning to the cold statistics. Daring to ask hard questions and skeptical of soft answers
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Editorial Reviews

Publishers Weekly - Publisher's Weekly
Mitford ( The American Way of Death ) interviewed obstetricians, midwives and antenatal and postnatal mothers for this journalistic probe of how Americans are born. In graceful prose she relates our appalling infant mortality rate to the obstacles poor women face in finding prenatal care and decent hospital treatment. After reviewing the potential hazards of obstetrical forceps, electronic fetal monitoring and diagnostic ultrasound, Mitford discusses the complications mothers often face after having a cesarean section and examines the financial and legal motives behind doctors' widespread performance of these largely unnecessary procedures. She takes readers on a grand tour of the midwifery scene, from a Bronx center for low-risk women to a Californian context in which the medical establishment harasses home-birth midwives with police break-ins. In an epilogue Mitford documents hospital routines and deceptive overbilling, criticizes the American Medical Association's powerful lobby, which squelches healthcare reform, and reviews efforts to pass a Canadian-style national health insurance bill that would eliminate the profiteering of U.S. hospitals and doctors. First serial to Good Housekeeping. (Nov.)
Library Journal
Mitford's probe into American obstetrics as well as the hospitals, clinics, and welfare agencies that supervise the prenatal care and births of American babies results in an indictment of the medical practices surrounding something that should not make us sick--giving birth. She also broaches the broader subject of the healthcare system or lack thereof, which governs much of American behavior surrounding the individual's own healthcare practices or failure to seek it out. Although her book is mostly anecdotal and meant to be read as if she were speaking to us directly, her attempt to be witty is annoying. Furthermore, much of the content lacks focus and will have difficulty holding the reader's attention from beginning to end. For a more engaging analysis of American birth practices, see Robbie E. Davis-Floyd's Birth as an American Rite of Passage ( LJ 8/92). For public libraries only. Previewed in Prepub Alert, LJ 7/92.-- Patricia Sarles, Mt. Sinai Medical Ctr. Lib., New York
Kirkus Reviews
From the author who 29 years ago roasted the funeral industry in The American Way of Death: a witty, pungent, comprehensive look at the frequently unfortunate practices that guide how American babies are born. The struggle over abortion has overshadowed many other issues that affect American women. Twenty years ago, giving birth was high on the list of women's concerns. Natural childbirth, Lamaze, midwives, birthing clinics for normal deliveries, even home births were widely discussed and practiced by many pioneering women. Surgical techniques, including Cesareans and episiotomies, were questioned, and often scorned. Mitford's telling investigation of American birthing practices today reveals that little has changed, and that in some cases things are worse. For instance, the infant mortality rate in the US puts it 24th among industrialized Western nations—a rate that could quickly be reduced if out-of-control hospital and doctor costs were reallocated to prenatal care. If this book doesn't pack the surprises that Mitford's expos‚ of funeral homes did, it's only because the issues have been in the air for so long. What Mitford brings to them are hard numbers, revealing interviews, and astute observations, pointing the finger at practices like speeding up normal labor to accommodate the doctors, not the mothers. Or at midwives who are driven out of practice because doctors and hospitals refuse them backup (a throwback, Mitford wonders, to the medieval view of midwives as witches?). And, of course, poor and uninsured women, often most in need of superb medical care, who are treated at best offhandedly, at worst with actual cruelty. Informed choice is the course Mitfordrecommends—but the choices must be available. An epilogue reviews the rocky history and problematic future of some form of universal health insurance for the US. Indispensable for prospective parents who may discover that they can just say no to doctor-dictated birth practices and can prescribe their own terms for having a baby.
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Product Details

  • ISBN-13: 9780452270688
  • Publisher: Penguin Group (USA) Incorporated
  • Publication date: 11/1/1993
  • Pages: 352
  • Product dimensions: 7.00 (w) x 5.00 (h) x 1.00 (d)

Table of Contents

Pt. 1 In the Beginning
1 Introduction 3
2 A Glance Backward 19
Pt. 2 Modern Times
3 Fashions in Childbirth 51
4 The Impoverished Way 75
Pt. 3 Doctors and Hospitals
5 Obstetricians 95
6 Electronic Fetal Monitors and Ultrasound 109
7 Forceps 119
8 Cesareans 129
Pt. 4 Midwives
9 In Search of Midwives 165
10 Grannies 173
11 Certified Nurse-Midwives 181
12 The Farm 197
13 The Childbearing Center of Morris Heights 209
14 Midwives Under the Gun 221
Pt. 5 Epilogue
15 Money and Politics 243
Appendix 273
Acknowledgments 283
Source Notes 289
Index 301
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