On Surgeons and Normal Birth

"In [European] countries, obstetricians serve as specialists. They are essential members of the maternity care team, but they play a role only in the 10 to 15 percent of cases where there are serious complications. Most women have babies without ever setting eyes on a doctor.

In the United States, the numbers are reversed. Obstetricians "attend" 90% of births and have a great deal of control, essentially a monopoly, over the maternity care system. Obstetricians are taught to view birth in a medical framework rather than to understand it as a natural process. In a medical model, pregnancy and birth are an illness that requires diagnoses and treatment. It is an obstetrician's job to figure out what is wrong (diagnoses) and do something about it (treatment) - even though, with childbirth, the right thing in most cases is to do nothing.

To put it another way, having an obstetrical surgeon manage a normal birth is like having a pediatric surgeon babysit a normal two-year-old. Both will find medical solutions to normal situations -- drugs to stimulate normal labor and narcotics for a fussy toddler. Its a paradigm that doesn't work."

Marsden Wagner, M.D., M.S.

Born In the USA,
How a Broken Maternity Care System Must Be Fixed
to Put Women and Children First,
University of California Press, 2006

US ranking in maternal mortality

TIME magazine recently reported that the United States ranks 41rst out of 171 countries, of women who die from complications in pregnancy or childbirth. The death rate in America - one in 4,800 - far surpasses other developed countries where they average one in 16,400. 1
The notable difference between these outcomes is the extent to which other developing countries provide access to midwifery care for their citizens. In those nations where midwives attend a significant portion of births, their intervention rates are lower and maternal outcomes prove
safer. 2

1. TIME, October 29, 2007, p18
2. Marsden Wagner, MD, MSPH; Fish Can't See Water: The Need to Humanize Birth;
International Journal of Gynecology and Obstetrics, 75, supplement s25-37, 2001