Born in the USA by Dr. Marsden Wagner is organized in such a way that is reminiscent of Fast Food Nation. Now maybe I’m just saying that because the color scheme, size and font are the same, but each of the nine chapters focuses on an aspect that connects to the major theme that pregnancy is designed for the ease of the doctor and not for the care of the child and mother. About every time Dr. Wagner makes a claim or refutes one he has a superscript to back up his claim that when done with the chapter one could check the source of evidence for if one was so inclined.
The question Dr. Wagner tries to answer is: how is the maternity system in the USA broken and how are we to fix it? Dr. Wagner clearly states his views on the maternity system and what safer alternatives are available. I don’t think “fixing” is the best word however, I think Americans need an entirely new outlook on how birth is dealt with, and our maternity system shouldn’t be fixed it should be burned and from the ashes of sonographs and lithotomies rises a new system dominated by midwives and doulas.
The major insight Dr. Wagner establishes in Born in the USA is that there has been a curtain pulled, it separates the large population of the US from the procedures performed by obstetricians. It separates the truth from the reason, the logic from science, the nature from life and most importantly the options from the mother. This is not any individuals fault but a fault on the development into what is now the USA’s maternity system. The book is a clear example to me the dangers of hierarchy and absolute power. A reminder that education is not always preventing ignorance but can actually breed an I’m the expert consciousness that will result in closed minded followers. And most profoundly it criticizes society as it accepts knowledge; that once a group of experts in a given field reach a consensus on anything that may pertain to that field, whether it be right or wrong, everyone else will follow blindly.
Both Dr. Wagner and I agree that the structure of power within maternity care must be reshaped as it encourages pregnant women to yield to their doctor’s will. The ease of performing certain pregnancy procedures such as cesarean sections should be restricted because of the health risks and contingent nature of the procedures. People should also be aware doctors make mistakes, and often don’t see that they made a mistake because the procedure they are following has not been criticized. People should know that pregnancy and pain aren’t synonymous. The most important thing that should be put under public eye is the options available to pregnant woman, the alternatives to having birth in a hospital and the probable sequence of events of their decision.
Dr. Wagner’s use of evidence is very strong. Much of the evidence is firsthand accounts as he is well experienced in the workings of medical practice because he is (or was at some point) a doctor. Because of his direct experience he shares rare insight and has irrefutable testimony to the maternal system. That which he can’t support by pure firsthand account he supports with statistics and historical context. He does not cite the evidence in text, but he does make superscripts so if one were to doubt a claim one could flip over and see where its source is.
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