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Pushed: The Painful Truth About Childbirth and Modern Materinity Care (2007) is one of the most fascinating books I’ve read all year. Jennifer Block presents a convincing case against the over-medicalization of the natural process of birth and advocates that women with low-risk pregnancies stay as far from hospitals as possible.

Birth plans give mothers-to-be a sense of control over an essentially control-less event. Most pregnant mothers are not informed that hospitals will not honor their birth plans. Once the hospital has the laboring mother inside its walls, she is doomed. Doomed to an unnatural process of drugs and monitoring and medical intervention.

Choice is thrown out the door once you roll through the sliding entry doors:

“It’s a illusion, she says. “No matter what anybody tells you in prenatal classes, or what your friends say, or what you read in books, the bottom line is, you will follow the rules of the hospital, and you will do what your doctor wants you to do. No matter what you think going into it. Sometimes I say your choices are very limited, but in point of fact, I don’t think women have any choices.” (166)

Much of the book’s focus is on the increasing rates of cesareans births. Across the nation, hospital’s cesarean rates should be around 10%, but most are around 30% or 40%. Cesareans have increased since the 1990s for many reasons. Hospitals and physicians claim that they’re scheduled because their patients request it. But actually its because there is less risk and liability for obstetricians when they surgically remove the baby. Obstertiricians can have a more normal life when they schedule their patient’s L&D between 9 a.m. and 5 p.m. The only way obstetricians make a living is to deliver babies. Their malpractice insurance is the highest of any medical specialty.

Then, another great concern of the book is women who want VBAC (vaginal birth after cesarean). Most hospitals and obstetricians refuse to let VBAC occur. In fact, Block cites Amber Marlowe’s case. In 2001 Marlowe waited at home until she was in active labor, with her seventh child, then drove around to several hospitals in order to avoid a section and being hooked up to fetal monitors, etc.
But, the first hospital said no to vaginal birth and told them to go elsewhere. At the second hospital hospital attorneys and judges petitioned for custody of her fetus in order to force a cesarean birth, while Marlowe labored for 14 hours. But before the order was handed down, Marlowe and her husband escaped and found a third hospital where she pushed her baby out vaginally. Marlowe’s was not the only frightening case in which the mother’s rights were disregarded mentioned by Block.

Gosh, this was an excellent book on the state of maternity care in the United States. Eye-opening, really. Block points out how feminists and women’s rights groups like NOW don’t support mothers; they’re only interested in abortion/choice. But what about mothers? Do their choices suddenly dry up while they labor and deliver? Women are medically assaulted by their physicians and nurses when they are given unwanted episiotomies and sections.