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Pushed: The Painful Truth About Childbirth and Modern Maternity Care Kindle Edition

4.7 4.7 out of 5 stars 523 ratings

In the United States, more than half the women who give birth are given drugs to induce or speed up labor; for nearly a third of mothers, childbirth is major surgery -- the cesarean section. For women who want an alternative, choice is often unavailable: Midwives are sometimes inaccessible; in eleven states they are illegal. In one of those states, even birthing centers are outlawed.When did birth become an emergency instead of an emergence? Since when is normal, physiological birth a crime? A groundbreaking journalistic narrative, Pushed presents the complete picture of maternity care in America. Crisscrossing the country to report what women really experience during childbirth, Jennifer Block witnessed several births - from a planned cesarean to an underground home birth. Against this backdrop, Block investigates whether routine C-sections, inductions, and epidurals equal medical progress. She examines childbirth as a reproductive rights issue: Do women have the right to an optimal birth experience? If so, is that right being upheld? Block's research and experience reveal in vivid detail that while emergency obstetric care is essential, there is compelling evidence that we are overusing medical technology at the expense of maternal and infant health: Either women's bodies are failing, or the system is failing women.
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Editorial Reviews

From Publishers Weekly

According to writer and editor Block (Our Bodies, Ourselves), "the United States has the most intense and widespread medical management of birth" in the world, and yet "ranks near the bottom among industrialized countries in maternal and infant mortality." Block shows how, in transforming childbirth into a business, hospitals have turned "procedures and devices developed for the treatment of abnormality" into routine practice, performed for no reason than "speeding up and ordering an unpredictable...process"; for instance, the U.S. cesarean section rate tripled in the 1970s, and has doubled since then. Block looks into a growing contingent of parents-to-be exploring alternatives to the hospital-and the attendant likelihood of medical intervention-by seeking out birthing centers and options for home-birth. Unfortunately, obstacles to these alternatives remain considerable-laws across the U.S. criminalizing or severely restricting the practice of midwifery have led the trained care providers to practice underground in many states-while tort reform has done next to nothing to lower malpractice insurance rates or improve hospital birthing policies. This provocative, highly readable expose raises questions of great consequence for anyone planning to have a baby in U.S., as well as those interested or involved in women's health care.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Review

"A stirring discussion of reproductive rights, informed consent, and the rights of the mother vs. the fetus... Recommended." -- Library Journal, 5/15/07

"The book is loaded with interviews, statistics and...some quietly deft storytelling." --
Chicago Reader, 6/29/07

"A gripping expose... Provocative and hotly controversial analysis of a side of reproductive rights feminism seems to have forgot." --
Kirkus Reviews, (Starred Review) 5/15/07

"[Block] really gets that maternity care is a woman's issue that all people should care about, not just mothers, and she has no agenda through a birth experience or professional work in maternity care. Pushed shines a spotlight on maternity care and asks important questions about the standard practices in America." --
BOLD Book Club, October 2007

"This is a worthwhile book for anyone who cares about reforming our health-care system--right from the start." --
Kansas City Star, 10/02/07

Product details

  • ASIN ‏ : ‎ B00A4JNG3K
  • Publisher ‏ : ‎ Da Capo Press; 1st. Da Capo Press Ed edition (September 10, 2007)
  • Publication date ‏ : ‎ September 10, 2007
  • Language ‏ : ‎ English
  • File size ‏ : ‎ 1173 KB
  • Text-to-Speech ‏ : ‎ Enabled
  • Screen Reader ‏ : ‎ Supported
  • Enhanced typesetting ‏ : ‎ Enabled
  • X-Ray ‏ : ‎ Not Enabled
  • Word Wise ‏ : ‎ Enabled
  • Sticky notes ‏ : ‎ On Kindle Scribe
  • Print length ‏ : ‎ 345 pages
  • Page numbers source ISBN ‏ : ‎ 0738211664
  • Customer Reviews:
    4.7 4.7 out of 5 stars 523 ratings

About the author

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Jennifer Block
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Jennifer Block is an independent journalist focused on women and health. Her work has appeared in The Washington Post Magazine, Pacific Standard, The Cut, Newsweek, The Daily Beast, The Los Angeles Times, and many other publications. Her first book, "Pushed," led a wave of attention to the national crisis in maternity care and was named a "Best Book of 2007" by Kirkus Reviews. A reporter with Type Investigations, Block won several awards for her investigative reporting on the permanent contraceptive implant Essure, which has since been discontinued. For early chapters of "Everything Below the Waist," she won a Whiting Creative Nonfiction Grant. She lives in Brooklyn, New York, with her son.

Customer reviews

4.7 out of 5 stars
4.7 out of 5
523 global ratings

Top reviews from the United States

Reviewed in the United States on March 28, 2014
Really, this book is the truth, unmasked for everyone to see-this is a book which will be adjusting your perception on maternity care, insurance, Physicians and Midwives.
I was so offended at my first birth and delivery of my son 2 years ago...I filled out a birth plan and was bull-dozed and I was laughed at for it and manipulated by the nurses...I had no idea I was going to be induced when they asked me to come in after my water broke-even though I had not had any contractions I could feel. I thought I was going to get checked and sent home until labor progressed. Thats what you see in movies-women waiting to check in until they are having regular contractions...and thats about the most accessible information the average woman probably gets prior to delivery...films.
I thought I had prepared-I asked my OB questions (I really had no idea what to ask-and no additional info was ever offered by her or the office) I had attended a few classes at the hospital-pointless-none of it helped with reality-it was all theoretical and best case scenariol-like college is in preparing you to go out and get a job-pretty impractical and naive.

Anyways, I had no idea that pretty much everyone gets put on pitocin in the hospital which then requires and epidural because of the abject misery when contractions have no beginning or end. You just can't relax to dilate. I had a ton of people checking my dilation-gross, painful, and embarrassing...I had threats of c-section less than 8 hours after I arrived-less than 14 hours after my water broke...I was given some unheard of terminology scare tactic phraseology they called "a sticky baby" to justify such an insane intervention in a labor as simple and as healthy as mine. My delivery made me tear thanks to the coached pushing-2 pushes as hard as I could...not ideal. At least the hospital had a no episiotomy standard. ANyway-I felt totally let down, I had no idea of what would happen-I naively thought I could go there, labor naturally and deliver a baby without meds.
The experience was so life altering for me, I became obsessed with avoiding medical intervention and people associated with those fields...I changed my diet and lifestyle, committed myself to researching everything myself instead of blindly accepting pharmaceutical or physician offered drugs...I became the most unexpected version of myself-almost some kind of hippy. I'm a much happier person now, being able to beat and treat prettymuch any ailment or issues my family has naturally-especially things that had been misdiagnosed for years by medical professionals...so midwifery was a logical choice for my future pregnancies.
Reading this book was so necessary for me-so needed, so validating and empowering. As I am pregnant with my second-I know that a hospital birth is totally out of the question for me. I am so embittered to modern healthcare and the plain ignorance, arrogance and defiance of medical people I won't step foot in a hospital again unless my hand gets chopped off or my kids lose fingers or limbs. I picked this book up on a whim from the library at my midwife's office-I then purchased it and wrote notes and underlined everything amazing-which was a lot. I am willingly paying 1500 out of pocket to be delivered by and be seen by a midwife as opposed to hospital and obgyn care...and that is with my insurance covering the other 4500 in fees.
If in the future I can't afford a midwife (where I live you can't get one for under 5 grand) I feel I am prepared to deal with a few alternative scenarios to avoid any hospital madness. I purchased this for my sister who is TTC and will purchase it again for anyone who I know who gets pregnant.
I only wish the author would release another edition with more recent information and statistics as I am sure there is more to be learned and more changes since 2006. This book should be revised every 5 years or so for the posterity of the avg american woman.
I am also very grateful that my State-California-has some very midwife friendly policies that have influenced my insurance group positively-enabling me to get appropriate care for my low risk pregnancy.
Thank you Ms. Block for all your work and for giving mothers and mothers-to-be full disclosure-without which there is no freedom of choice.

Update:
I have since given birth to my second son...I went all natural, with a birthing center delivery and all my prenatal care was done by midwives...contrasting the two pregnancies and birth experiences I've had- I can see one big element the second birth lacked...this was the medical attitude of pregnancy as a scary, major medical intervention that required expert care. From the veteran midwives and staff I was given dependable, understanding support instead... I felt so calm, natural and confident receiving midwife provided care, I had support in my choices and empathy... I never got that from any care provider during my first pregnancy.

Chiropractics and My diet played a huge roll in making my second pregnancy almost symptom free, and the symptoms I had were higher energy, better mood, less weight gain and a few leg cramps...

my labor was only 4&1/2 hours from the first sense of contraction to delivery, was natural and calm...and felt so easy and exciting. This book gave me peace of mind that I was choosing a safe, natural method....it gave me confidence that my labor would be instinctual and that my body would know what to do. I labored without fear, with relaxation and calm serenity until the three pushes my body instigated on its own... I was so full of energy and excitement immediately after delivery and this lasted for days. It's been over two months and the excitement over the happy labor and delivery is still very present. The aftercare post delivery was calm, non invasive and simple. my new baby and I were left alone by the staff to nurse and relax. They brought me my food, poured me drinks and took my blood pressure later. I was mobile in a few hours and doing my regular activities in two days...making n g food, washing diaper laundry, taking care of my toddler...Though I did have help at home. Basically, I didn't feel exhausted or weak like before. I healed incredibly fast and was happy and bonded to my baby. I am so thankful for this book. I've bought another copy for another pregnant mom...I just can't recommend it enough.
99 people found this helpful
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Reviewed in the United States on December 23, 2008
I am the least crunchy person on the planet, but this book (among other things) convinced me to do what I could to go natural.

PROS:
1) The book accurately describes the infantilization of women in the OB office. I had a hard time believing this was accurate when I was reading the book, but meeting with the doctors was totally humiliating and horrible. MANY if not most treat you like a) an idiot with no reasoning facilities, b) a vessel for your baby and c) an obstacle. Be prepared. The book will prepare you to expect this and give you information necessary to be strong.

2) The book is fairly well-researched, and gives lots of facts, statistics, and best- and worst-case scenarios.

3) The book is relatively fair in terms of presenting some situations in which home birth turns gruesome.

4) The history section really gives you a sense for how things got this way. The author presents the information in a way that grounds the present in the past, which makes it pretty convincing. It doesn't sound all "I'm a hippie and doctors are the male establishment!" hysterical, it simply shows how at certain times in history it was in the best interest of different parties to change the birthing process in a way that led to how things are done now.

What I most liked about this was how it pointed up the dearth of actual scientific analysis backing up the current hospital MO.

CONS:
1) The writing style is a little sensationalistic and heavily anecdotal. This personalizes the information, but at the same time undermines the starkness of the data. Which is not to say the facts aren't there, but the anecdotes take up more room, so it's easy to lose data in the anecdotes. A more skeptical reader may be put off by the pages of emotional stories and thus not really SEE the facts also there.

2) I agree that the stuff at the end about abortion is extraneous. On the good side, I think it was useful to point out the failure of the women's movement to embrace mothers' and babies' rights, but on the down side, it might offend some friends of mom and baby rights. I'm totally pro-choice myself, but I didn't think it necessary to the main point of the book.

3) What could have replaced some of the anecdotes and pro-choice stuff? I would have prefered to see more suggestions for how to handle the facts on the ground. Most moms cannot afford to pay out of pocket, so I'd have liked to see suggestions of how to have a hospital birth and work around the system. All hospital births come with the posibility of being delivered by someone not amenable to your way of thinking (as the book states). So then what? How do you avoid getting on the clock? How do you talk to your doctor at your last OB appointment when they start talking about induction? How can you encourage your baby to come sooner so that induction is less likely? Etc.

For various reasons, I did not know until my third month that I was pg. I read this book right away, but when I finished, I was at my fourth month, and no other OB would take me, though I had DEFINITELY figured out that the OB I initially chose was a bad choice. So I had to manage the doctor. And it ended up having a happy ending, but with a lot more sturm und drang on the way than there needed to be. I figured out how to avoid making apointments and checkups by walking out without talking to the apointment desk, by rescheduling appointments at the last minute, by not answering the phone. Seriously. And just FYI, check around for the home remedy induction methods, e.g., oils, teas, etc. It really helped me to ripen so that, though genetically predisposed to long labors, my whole process lasted 3.5 hours. Much easier to have uninvasive delivery when it goes fast.

I figured out my own ways of avoiding intervention, but I would have really liked some information from the author on avoiding intervention when you have an invasive doctor.

End of the story though: this is a book that needed to be written, and is basically a necessity for any woman considering pg. Take the anecdotes for what they are, but make sure you read the facts and figures carefully, and pay particular attention to the history section. It will make you stronger.
33 people found this helpful
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Top reviews from other countries

Kayla Jacobs
5.0 out of 5 stars Incredible book
Reviewed in Canada on January 21, 2020
This book is so well written and so informative. Its very humorous too.
I recommend this book to everyone!
Myrto Kalle
3.0 out of 5 stars Very US focused
Reviewed in Spain on May 19, 2017
I found this book useful and eye-opening but it pretty much outlines the current practice in the US. I don't think it is that useful if you live outside the US. I enjoyed the first half of the book and learned a lot from it but the second half - especially the part with real midwife stories who have to work illegally- was particularly boring and shocking at the same time. I can't believe that midwifes suffer so much in some states and also that some pregnant women choose to give birth at home employing a midwife illegally (one of them actually died which would probably wouldn't have happened at a hospital). The book reveals a lot about insurance policies and the pressures OBs have.
Renee
2.0 out of 5 stars Dumped after first couple months of chapters
Reviewed in the United Kingdom on August 21, 2018
Boring and repetitive
Amazon Customer
5.0 out of 5 stars Amazing and informative!
Reviewed in Canada on December 10, 2016
Absolutely love this book and couldn't recommend it more!!!! VERY eye opening and these are facts every mother (or soon to be mother) should be aware of.
One person found this helpful
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CAM
5.0 out of 5 stars Need to read!
Reviewed in Canada on September 21, 2019
Great book
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