THE AMERICAN WAY OF BIRTH

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 exposÇ 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 Mitford recommends—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.