Business of Birth

By Heather Shumaker

Baby coverAmerica has a knack for bullying.  It starts young – oh, so young – even before birth.  One of the most bullied groups of people in the US today is expectant mothers.  Book Review and GiveawayThe Business of Baby, by Jennifer Margulis (Scribner, 2013).

Jennifer Margulis’s new book The Business of Baby could really be titled Bullied at Birth.  She’s an investigative journalist and mother of four who’s written for The New York Times.  Even though I thought I was fairly educated about the Birth Profit Machine in the US, Jennifer’s book surprised me.

  • Did you know hospitals sell your baby’s foreskin if he’s circumcised?  The foreskin is prized for skin-care products.
  • A First Bath in the hospital is bad for baby. Newborns need their protective vernix coating.
  • Most US babies are now born Monday-Friday during convenient daytime hours.

My first-born was hospital born.  My second was a home birth.  What a difference in night and day!  I deeply understand the message in Jennifer’s book.

Unfortunately, many first-time parents – the ones who need this information the most – may not be ready to hear the message delivered by The Business of Baby.  That's why the cycle of bullying continues.

Sometimes – like me and the author herself – you have to experience childbirth before you understand the intense pressures pregnant women endure.  I know I never would have guessed that nurses would thrust free diaper bags at me emblazoned with infant formula company brands (even after I insisted I would breast-feed), or that my doctor would say, “My shift ends at 8pm, let’s just get things moving by breaking your waters.”

Author Jennifer Margulis - photo by  Bryon Devore of Ashland, OR.

Author Jennifer Margulis - photo by Bryon Devore

Luckily I said no. Once you say yes, the “Cascade of Intervention” begins, as Jennifer wisely points out.  Soon you’re strapped to a bed with tubes of Pitocin and talk of “emergency” Ceasareans.  I still remember what I said when my doctor suggested “speeding things up.”  It was September.  “I have nothing to do until January,” I told him.

Expecting a baby is a vulnerable time.  Parents-to-be are filled with hopes, fears and naiveté combined with authority figures hovering around.  The Business of Baby is a well-researched wake-up call to the business of US pregnancy, birth and infant care.  It’s an excellent resource for nurse practitioners, midwives, ob/gyns, doulas and grandparents as well as expecting parents.

In fact, I agree whole-heartedly with this review by Library Journal: “Not just for parents to ponder.”

I hope people who teach childbirth classes get their hands on this book.  Perhaps childbirth instructors are best positioned to be the ones who open the eyes of parents-to-be.

Did you ever feel bullied or pressured during pregnancy or labor?  What shocks you about modern birth?  Leave a comment, send me an email or sign up to subscribe to this blog and you’ll be entered to win a FREE copy of this beautiful hardback book fresh off the press.

Date for free book drawing: Wednesday, May 22, 2013, 5pm Eastern time.

31 responses to “Business of Birth”

  1. Alyxandria says:

    Modern birth insists upon itself - our culture has this image of a strained-faced, screaming woman in labor shouting obsenities at the father and demanding "MORE PAINKILLER!!!" in our television and movies, so there's little wonder that women feel pressured to make decisions to circumvent this painful, terrifying situation by being pumped full of pain medications or opting for elective Cescarean. The more doctors and medicine, the better - right?

    The first time I watched a natural water birth video, the environment was calm and nurturing and everything moved at the woman's pace. Lots of deep breathing, working through the contractions, and putting control back into the place of the mother to lean, squat, lay, stand, bend and contort in any way that felt natural and comfortable. There was no screaming, no panic, and certainly not the level of dramatized pain I've come to expect. Having a baby shouldn't be treated as a medical emergency.

    Gag - circumsized flesh in my skin-care regimen? No, thank you. Outside of religious observations (which are traditionally performed within the home and the tissue is discarded), I see little reason for circumcision in sons any more than I would circumsize a daughter. Circumcision can always be performed later in life if so desired, and the myths about cleanliness and loss of sexual pleasure/performance are just that - myths. I'd like to take my baby boy home in one piece, thank you.

    I watched a wonderful documentary available on Netflix that seems similar to this study - "The Business of Being Born" produced by Ricki Lake and Abby Epstein. (Looks like there is a sequel now). In any case, I fully support a woman's decision to handle her birth in any way that makes her more comfortable so long as it doesn't pose a threat to the life of the baby, but I do believe that first-time parents should be particularly informed of their options and how the health care industry has falsely advertised birth. Perhaps with more educated families, this cycle of misinformation, intimidation, and loss of freedom can finally be broken.

    • Heather Shumaker says:

      All the books and movies do show women screaming in pain. How different birth can be! I was surprised not to feel any pain during labor. Just deep pressure and hard work. The images our brains are full of...

  2. Amy Rosenberg says:

    This book was eye-opening. These stories need to be told! Your review expressed very clearly that people get bullied and pressured into things that are not good for them or their children. I have not given birth, but I have heard these stories, and know they are true, and have myself undergone bullying and unethical coercion in many other areas of medical care. It is so important for pregnant women to be aware of what they are walking in to, in order to protect themselves and their babies.

  3. Why is it so threatening when women say they deserve better? Our maternal mortality rate ranks 39th out of 39 developed countries. Our infant mortality rate ranks 50th. What's shocking is not that we are seeking positive change... it's that it's met with such resistance. Buy this book for someone you love, and ask your library to get several copies. Knowledge is empowering. As Maya Angelou said: When you know better, you do better.

  4. bonnie roi says:

    I am so happy you have seen fit to write wholeheartedly upon this subject which I feel so passionate about. I pray many blessings and good success to follow you and all those who take the honest advice to heart and can then raise healthy happy offspring.

  5. Dana Read says:

    "I have until September"....LOVE IT!

  6. Kelly Peters says:

    I wish this book was out ten years ago.....knowledge is power. I would have done things so different. "Trust the doctors...." My biggest mistake. Would love to own a copy.

  7. Hilary says:

    I had a very much bullying experience with my first and have encountered to a lesser extent but again in my later pregnancies. With my first I was in my last semester of university and used the campus Maternal-Fetal Medicine specialist for routine care till 20 weeks because she was nice, helpful, easy to get to. She transferred my care at 20 weeks to an OB as she didn't do deliveries herself. The first OB... oh my goodness. There was a sign outside the door stating (in shouty caps!) that "NO SHOES WERE TO BE WORN IN THE OFFICE- THIS INCLUDES INDOOR SHOES!" Then when we got in the office, I was the only one with a significant other with me and there was another note posted that babies were to be left with the receptionist. It was not a good start. My husband and I entered the office and she looked unimpressed that I'd brought someone along and told him where he could stand and then ignored him the rest of the appt. I had a few questions for her- was she supportive of natural (med-free) birth, her stance on episiotomies, her c-section rate. She told me frankly, she does everything exactly often as necessary and where did I get my medical degree. Then she told me to stay the heck off the internet. We left, made an appt with the MFM specialist the next day and asked for another referral. This OB was NOT for us. Instead we found a very laid back OB who was MUCH more to my liking and, for an OB, was very supportive of my natural childbirth plans. I've thought so many times how differently my first birth and indeed perhaps my family planning entirely (had I had a c/s with the first... I might not have gone for 4 kids) could have been different all because of that one OB.

    I'm REALLY glad I didn't put up with the bully OB and found myself someone better suited to my care. From reviews I've read about her over the years the bully OB sounds VERY competent in surgical births which makes her practically an angel to parents with high risk pregnancies and in scary situations... but I and others have left reviews too letting other moms know that if they're low risk and have ideas about informed choice etc, this is NOT the doc for you!

    The thing that amazes me most in modern birth care is that lack of education women have regarding the power of their own choices. The whole "my doctor won't LET me go past 40weeks" or "my doctor LET me travel in the third tri". Doctors are not decision makers- they are there to give patients the information and medical advice based on their knowledge but the choice comes down to the woman. There's a rather shocking power differential evident in most doctor-patient relationships. Personally I used to be more that way too but having worked with midwives in the informed choice model, I now demand that of my interaction with all medical professionals. It's really put the onus for my health more on me which I think is so important.

    Would LOVE to read the book!

  8. This is a FANTASTIC, eye-opening post! I agree wholeheartedly with another reader, Louise, who said:

    "What’s shocking is not that we are seeking positive change… it’s that it’s met with such resistance."

  9. HeatherB says:

    I'm actually working on a book now, of women's traumatic birth stories. It's sad how many of the women contributing to this project were bullied at some point during their pregnancy/labor/birth/postpartum. Not all, but most or the birth trauma I see is caused by this bullying and deception. The positive thing is in every case I've found so far, these ladies have transformed a negative experience into positive intentions for improving maternity care.

    After all, if it hadn't been for the incompetent OB who didn't know "arrest of descent" could be resolved through position changes, and the d-bag doctor who pulled a "bait and switch" on me for a VBAC, I wouldn't have met all the amazing women committed to improving maternity care, including a number of fantastic midwives, doulas, childbirth educators, and authors.

    Here's to finding the silver lining and making it brighter.

    Heather,
    HBA2C mama

  10. Osiris Legates says:

    Can't wait to get my hands on this book having been bullied into a c sec with my second which lead to the c secs of my third and fourth i want all new moms to open their eyes to what is going on in america

  11. As a doula I see a lot of pressure put on families. It's so hard to see because most of the time when they get to the end of the pregnancy the "healthy baby" card washes away everything they've researched and believed in their 9 months of planning. There is so much potential for beautiful healthy birth that is being sabotaged by medical procedure and protocol. I have been really looking forward to reading this book and learning more about "The Business of Baby."

  12. Thomas H says:

    Our first child was born on a Friday and the hospital was packed, our second on a Sunday, and I think only two or three newborns were on the floor.

  13. Elizabeth says:

    As a Childbirth Educator and Doula... I can not wait to read this book!

  14. Kim W. says:

    This whole topic brings up so much angst for me...I was bullied in this very manner with my first baby, who I ended up having via emergency c-section at 24 weeks. Long story short, and three c-sections later...I look back and see that not only was I bullied, but treated like a "liability", like a cow in a cattle drive...and to make matters even more complicated, we were uninsured at the time. They see THAT on your paperwork and the reigns on your choices tighten even more.

    After three c-sections, I'm stuck...but for new moms out there that still have a choice, I hope this book strengthens their resolve and gives them tools to understand the "system" they're entering. Motherhood should leave a woman with something beautiful, (and pain can be beautiful!) not the kinds of "trauma center" imagery that I've got in my head. My babies are worth all of it...just wish I could have had a better experience. Thanks for writing this book.

  15. Meredith says:

    So glad I had all three of my boys at home! I want to read this and add it to my list of shower gifts I give to people.

  16. Susie Pellum says:

    I went through a very traumatic birth and believed at the time that it was unavoidable. I've learned so much since then and love that my daughter is becoming aware of the bullying tactics of modern medicine and how the business of having a baby outweighs common sense and nature in the eyes of many doctors.

  17. carrie says:

    Looking forward to reading.. 🙂

  18. Sarah says:

    This book looks so awesome! My first was born in a hospital 11 years ago. Even though I thought I stood firm on what I wanted and didn't want during labor and birth, it's amazing how fast that goes out the window when you're in pain and someone in scrubs is telling you "what's best for the baby". Ugh! My second, born a year ago, was born peacefully at home. My midwives were loving, caring, and supportive. It was amazing! <3

  19. Accalia says:

    Thank you for reviewing this book! The word needs to spread from multiple sources about the state of maternity care in the U.S. I truly wish more women, and men, would recognize that WE are in charge of our health care decisions, not administrators of a hospital, or a doctor you've known for five minutes, etc. It's sad that most people don't see the actual business side that is driving our maternity system...

  20. Rene Kratz says:

    I never felt bullied or pressured, but looking back I think I wasn't critical enough or questioning enough of some interventions. Both of my labors were induced -- the first because my amniotic sac had torn but labor didn't start, the second because I was really close to having the baby (huge and due) and I wanted to have him when my mother was in town. But now, research is coming out about possible harmful effects of pitocin, so I'm definitely questioning my decision in the second birth. I'd like to see a wider perspective on birth and birth options become mainstream so that women make more informed choices.

  21. Becca says:

    The typical hospital stuff for my hospital births, then I educated myself and found a midwife and home birth...no bullying there, I run this show! The biggest case of bullying that comes to my mind was not during pregnancy but soon after my first was born....we were a military family coming back from overseas when he was 2 months old and because we had a two month old, I went to my parents while his dad went on to the duty station to get housing and stuff set up for us. During the two months I stayed with my parents, my own mother harrassed and bullied me to stop nursing. She said it was disgusting, making him sick, every little bit of spit up she blamed on breast milk....she would buy formula and try to sneak it to him, etc. I was so glad to get the heck out of there and back on my own so I could raise my kiddo as I saw fit.

  22. Wendy says:

    I was bullied into pitocin when my water broke and there had been no change for 4 hours in my contractions. This lead to the horrible labor ever. When I started throwing up my husband had to leave te room and I felt pressured into an epidural. Due to pregnancy complications we have decided not to have more children. And it makes me sad to not have the chance to experience a natural (possibly home) birth. Would love to read this book!

  23. Michelle says:

    I cannot wait to read this book. So much of the information I have been reading all over the internet in one place-what a find!

  24. It is so important to be informed. I would love to add a copy of this book to my lending library, which I share with my clients. I feel as a doula part of my job is to make sure that the mothers I serve are aware of their choices. Living in NJ, where we have an extremely high cesarean rate, and many mothers are told that they aren't "allowed" to go post-dates makes this even more important. All women should be informed & we need to start talking to kids about this, so they are aware that they have choices & shouldn't take everything they hear at face value.

  25. I've been wanting to read this since I heard about it!

  26. Linda says:

    I have been teaching prenatal yoga since 1997. Mamas come to me with all manner of questions, many that they have asked their OB and get the reply "Oh, that's normal." The lack of respect in the answer increases their anxiety and stress levels. I became curious about "normal" and went in search if my own answers. I became a doula, took prenatal massage trainings (already an MT) and several childbirth education trainings (teaching Hypnobabies for 10 yrs!) Being able to describe the reason they may feel the round ligament more one day than another has a powerful calming effect for them. How the mamas experience pregnancy and birth prepares the foundation for their emotions in parenting. If the medical community were to trust mamas and let them trust their bodies, they would trust their choices as a patent as well. If we are to create a calmer healthier society we must begin at the beginning. How these previous ones enter their lives affects all of us.
    Thank you for sharing your message! Lets keep the conversation going!
    Namaste,
    Linda

  27. Lindsay Wilson says:

    Oh I would love to read this book. It infuriates me how women are so bullied during their childbearing years. Knowledge is power!

  28. As an attorney practicing in the field of assisted reproductive technologies, I can't recommend this book highly enough. Parents who are forming their families using egg donation and surrogacy are dedicated and devoted parents who will make independent decisions on behalf of their babies, I they have the information upon which to make those decisions. The problem is finding that information. Propaganda and marketing plans are multitudinous. Sources if unbiased information are scarce. This book is an important step in meeting that need. I will be suggesting this book to future clients on a regular basis!

  29. Michelle says:

    I would really like to read this book. The more I learn about birth and mothering in our modern Western culture, the less the corruption and deception shock me! Great giveaway!!

  30. Kelly says:

    I have been looking forward to reading this book.

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Heather
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