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Summary
Summary
In the tradition of Jessica Mitford's The American Way of Death , an eye-opening work of investigative journalism that challenges our common wisdom about pregnancy, childbirth, and the first year of a baby's life, showing how the mother and child's wellbeing are often undermined by corporate profit margins and the private interests of the medical community.
Why, despite our state-of-the-art medical technology, does the United States have among the highest maternal and infant mortality rates in the industrialized world? Why do pregnant women who are planning to breastfeed receive "free" samples of infant formula from American obstetricians? Why are American newborns given a vaccine at birth against hepatitis B, a sexually transmitted disease? The Business of Baby, an eye-opening work of investigative journalism, exposes how our current cultural practices during pregnancy, childbirth, and the first year of a baby's life are not based on the best evidence or the most modern science, revealing how American moms and their babies are being undermined by corporate interests. An illuminating combination of meticulous research and in-depth interviews with parents, doctors, midwives, nurses, health care administrators, and scientists, Margulis's impassioned and eloquent critique is shocking, groundbreaking, and revelatory. The Business of Baby arms parents with the information they need to make informed decisions about their own health and the health of their infants.
Reviews (4)
Publisher's Weekly Review
Award-winning investigative journalist/mother of four Margulis comes to some startling conclusions in this comprehensively researched examination of the business of giving birth in America. Beginning with pregnancy and ending at baby's first birthday, the text follows in rough chronological order the issues that parents face, from prenatal care, labor and delivery, to potty training and well-baby pediatrician visits. Margulis raises the question of why the United States has the highest maternal mortality rate of any industrialized country. She interviews doctors, midwives, parents, scientists and others, hunting down the corporate profits and private interests that "trump mom and baby," relentlessly searching for evidence of why unnecessary and sometimes harmful medical interventions are practiced in American hospitals. In her search for answers, Margulis comes to some stunning realizations about practices that most parents believe to be safe, ranging from ultrasounds and C-sections to the baby's first-possibly "toxic"-bath in the hospital nursery (researchers, for instance, are studying a link between ultrasounds and autism; C-sections have become a dangerous "trend"). Many decisions, the author concludes, are not based upon "best evidence or best practices," but rather on medical industry profits and fear of litigation. Inspiring readers to follow her lead by trusting their instincts and questioning the status quo, Margulis delivers a compelling and thought-provoking work for every parent and parent-to-be. (Apr.) (c) Copyright PWxyz, LLC. All rights reserved.
Booklist Review
Readers who are skeptical about mainstream medicine will love this book. Margulis, a journalist with a PhD in English and four children, begins her story with some scary-sounding facts: Every year more than 700 U.S. women die in childbirth, more than 25,000 of 4.3 million U.S. babies born each year will die before they turn one, and eight out of 1,000 U.S. infants will not live to age five. Margulis raises many valid questions: Why do more than 1.4 million U.S. women each year give birth via cesarean section? Why do U.S. dads often get no time off from work after the birth of a baby when fathers in Norway get 12 weeks of parental leave at full pay? She also asks whether doctors make too many of their decisions based on the profit motive. Unfortunately, she may unnecessarily alarm some pregnant moms about everything from vaccines (she particularly dislikes giving the hepatitis B immunizationto newborns) to ultrasounds (she cites a hypothesis that they may trigger autism). It's not a balanced book, but it is a thought-provoking one that will motivate women to ask why before blindly agreeing to everything their doctor orders.--Springen, Karen Copyright 2010 Booklist
New York Review of Books Review
AMERICANS, you may have noticed, live in a capitalist society. In practical terms, this means someone is often trying to sell us something. John Updike saw a kind of glory in this: "America is a vast conspiracy to make you happy," he wrote. Jennifer Margulis sees a vast conspiracy too, only its purpose is to make you miserable, sick and quite possibly dead, especially if you are a pregnant woman or a new mother. In "The Business of Baby," Margulis, a journalist and a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University, recounts a range of horror stories, from expectant mothers "told to drink an unnaturally sweet and horrible-tasting syrupy beverage" as part of a test for gestational diabetes to women who die after a botched Caesarean section or from an embolism after doctor-ordered bed rest. From start to finish, in ways small and large, the process of having a baby is portrayed as one of humiliation, helplessness and fear on the part of women, and mendacity, greed and contempt on the part of doctors, nurses and anyone employed by companies that make diapers, formula or vaccines. There are, of course, serious questions to be raised about women's health care in this country: Why are maternal mortality rates higher in America than in so many other industrialized countries? Why is the rate of C-sections, which are associated with a higher risk of complications than vaginal births, increasing (in 2011 it hit 33 percent)? A reader looking for a nuanced examination of the many factors behind these complex phenomena will not find it in this tendentious, one-sided book. Margulis sniffs the same motivation behind prenatal care, ultrasounds, neonatal intensive care units, well-baby visits, even circumcisions: profit. Hospitals have a lucrative sideline in selling foreskins to the biotechnical industry, Margulis reports, which uses them to make artificial skin, wound dressings and "high-end beauty products." She quotes Tora Spigner, a doula and registered nurse, on the real reason doctors circumcise: "All you have to do is follow the money trail." Margulis's travels on the money trail lead her to many sources like Spigner - health care professionals who often seem to have an ax to grind or a perspective to promote. The author acts as their uncritical and frequently credulous scribe. Margulis interviews Larry Palevsky, a pediatrician from Long Island, who tells her that he was taught in medical school that the hepatitis B vaccine is given to infants to protect them against the disease in case any of them grow up to be prostitutes or IV drug users. "If I'm a rational person and I listen to what you've said, the recommendation that we vaccinate a newborn against hepatitis B sounds absolutely insane," Margulis says. "Asinine," Palevsky agrees. Inaccurate or inflammatory statements are repeatedly reproduced without adequate substantiation or comment from the other side. "Formula is killing babies in the United States," a Norwegian obstetrician claims. The behavior of American OBs "is often arrogant, disrespectful, and sometimes even abusive," charges a retired physician from Washington State. Margulis's treatment of scientific evidence is similarly unbalanced. She chides doctors for ignoring "the existing scientific literature" on bed rest or toilet training, but resorts to anecdote to support her own positions: midwives in Iceland are "having a lot of success" with a rebozo, a "Mexican cloth" they wrap around the hips and buttocks of a woman in labor; ultrasound exams of pregnant women may be responsible for rising rates of autism among their children, according to "a commentator in an online article." This anonymous individual has "used ultrasonic cleaners to clean surgical instruments (and jewelry)" which apparently qualifies him or her to offer an opinion on how the vibration of ultrasound waves may be causing the developmental disorder: "Perhaps this vibration could knock little weak spots in myelin sheeting of nerves or such, I don't know." Margulis employs a simple heuristic in evaluating the practices and products associated with childbearing: anything used by mainstream doctors and hospitals = bad; anything used by midwives or alternative healers = good. (She also approves of anything used by Scandinavians; she spends many pages praising the health outcomes of women in Norway and Iceland, without delving deeply into the demographic and economic differences between America and such countries.) Her conviction that what is natural must be good leads her to romanticize not only other countries but also other eras: "In colonial times and during most of the 19th century, the majority of births in America took place at home," she writes approvingly. "Birthing women were usually attended by informally trained midwives who passed on their skills from generation to generation" - while a birth taking place in a hospital today involves "at least half a dozen medical professionals." What's the reason for this? Margulis allows a doula named MaryBeth to make the by now predictable point: "Are all those people needed at a normal birth? Absolutely not. All it does is drive up the cost of everything - after all, all these people need to have salaries. If we make it normal to have your baby at a birth center, too many people will be out of a job." While there are no stories of women or babies saved by medical advances made since "colonial times," Margulis's book includes many wrenching accounts of mothers and infants dying from the indifference or incompetence of doctors, and many bitter complaints about "sterile" and "hygienic" hospitals. "The Business of Baby" is dominated by an emotional dynamic that feels oddly dated: in Margulis's telling, doctors are supercilious, dismissive or hostile, and their female patients are naïve, cowed and submissive. She doesn't seem to be describing 21st-century America when she writes that "it's almost unthinkable in the United States to go against what is considered routine when it comes to pregnancy, childbirth and raising an infant. We defer to the person we believe is the expert, wearing a white coat with a stethoscope around her neck. We are conditioned to trust doctors, to accept that what they tell us is true and to believe that they only have our best interests in mind." Has she not heard of Dr. Google? Today it's easier than ever to educate ourselves about health and disease and to find communities of like-minded people online (many of whom are proudly going "against what is considered routine"). With her focus on a largely bygone 1950s dynamic between women and doctors, in fact, Margulis has missed the real problem for today's patients: too much information and too few reliable intermediaries who can sort fact from rumor. Margulis herself proves unfit for this role in a shockingly irresponsible chapter on vaccines. All of her favorite conceits are here: the money-hungry pharmaceutical companies; the pediatricians who schedule routine immunizations simply to collect insurance reimbursements; the health care workers who patronize and bully women who refuse vaccinations for their children; and the brave parents who "decide that they do not want to intramuscularly inject their child with something that is not part of the natural course of life." Just because something is for sale doesn't necessarily mean it's suspect. Caveat emptor has been good advice for a very long time; I advise you to apply it when considering whether to buy "The Business of Baby." Jennifer Margulis offers wrenching accounts of mothers and babies dying from doctors' indifference. Annie Murphy Paul is the author of "Origins: How the Nine Months Before Birth Shape the Rest of Our Lives."
Kirkus Review
Investigative journalist Margulis (co-author: The Baby Bonding Book for Dads, 2008, etc.) contends that corporate interests are putting the lives of mothers and children at risk in order to increase the bottom line. "Most hospitals have a financial incentive to do as many interventions as possible and deliver women as quickly as possible," writes the author. The American medical profession ranks so poorly when it comes to maternal and infant mortality that mothers are four times more likely to die during pregnancy or in childbirth than in Bosnia; compared to Irish or Italian women, the death rate is seven times higher. Similar shocking statistics hold for children. The U.S. ranks 49th among industrialized nations regarding infant death rates. While recognizing the importance of factors such as the higher number of older American women pregnant with their first child, the use of fertility drugs leading to multiple births and lack of universal health care, Margulis focuses on the one-size-fits-all, high-end medical care offered to middle- and upper-income women despite their age, their ability to pay or their expressed preferences. To substantiate her charge that the medical system puts the interests of "large companiesahead of the best interests of the mother and her baby," the author gives examples of women being warned off natural childbirth by obstetricians and urged instead to induce labor using hormones; or better yet, from the standpoint of doctors and hospitals, opt for a Caesarian section. Margulis also examines the claim that overuse of ultrasound to test fetal development and routine administration of megadose vaccinations may contribute to autism, and she finds fault with supplementary bottle-feeding and the overuse of diapers, which causes an unnecessary delay in potty training. Somewhat extreme views that are nonetheless worthy of close consideration by parents.]] Copyright Kirkus Reviews, used with permission.
Excerpts
Excerpts
The Business of Baby Introduction Twenty-nine years old and pregnant for the first time, Marijana Picton noticed her nausea only went away when she took long walks and ate stapci, Serbian-style salty pretzel sticks. It was 2009. Marijana and her husband, Richard, had been living in England but they moved back to Šipovo, the small town in Bosnia and Herzegovina where Marijana grew up, when she was seven months along. Šipovo's bars were filled with unemployed men and two of the town's four factories had not fully reopened for business--tangible signs of the war that once tore the former Yugoslavia apart. After taking a birthing class in England, Marijana and Richard had a long list of questions for the staff at the Mrkonjić Grad clinic where they would have their baby: Would her husband be allowed to stay with her? Most husbands in Serbia don't, they were told, but the staff could make an exception. What kind of pain medication would they provide? None, the doctor answered, unless you need a C-section. What about epidurals? "If you want it, you have to buy it yourself," the doctor responded. "Most people get them from Italy. And then you have to find the anesthesiologist to give you the injection." Marijana's water broke that November on her birthday. She called the clinic to tell them she and Richard were coming so they could turn on the heat in the labor room. Two years earlier in Oaklyn, New Jersey, twenty-eight-year-old Melissa Farah, a special education teacher at Avon Elementary School, was pregnant for the first time. Melissa and her husband, Dan, were planners: They had been married for almost two years and had begun trying to start a family on their first wedding anniversary. Melissa felt especially lucky because a close girlfriend, Valerie Scythes, was pregnant too. Both women planned to have their babies at the same hospital in Woodbury, New Jersey. Here's the question: Which young woman would be better off, the one in a small Balkan country still recovering from a brutal civil war, or the mom in the richest and most powerful country in the world with state-of-the-art medical equipment and know-how? The answer: Marijana. According to the most recent reports, the likelihood of a mom like Melissa dying due to pregnancy or childbirth in the United States is more than four times higher than in Bosnia and Herzegovina and seven times higher than in Italy or Ireland; the likelihood of her dying as a result of childbirth is five times greater than in Germany and Spain, and fifteen times greater than in Greece. The United States also lags behind most industrialized countries when it comes to the health and well-being of infants. Eight American children per 1,000 live births will not live to age five. Fact: A child in the United States is more than twice as likely as a child in Finland, Iceland, Sweden, or Singapore to die before her fifth birthday. We feel great sadness and shock when we hear about a baby dying: Avery Cornett of Lebanon, Missouri, who was ten days old when he died on December 18, 2011, of a bacterial infection thought to be contracted from contaminated infant formula; a two-week-old unnamed baby boy who died in September 2011 from complications due to an out-of-hospital circumcision; six-week-old Ian Larsen Gromowski, who died of a severe reaction to the birth dose of the hepatitis B shot on August 10, 2007. We stop in horror, our hearts in our throats for the grieving parents. But we consider these deaths isolated incidents, rare occurrences that garner our sympathy, sure, but that certainly won't happen to us. Fact: The United States has one of the highest infant death rates of the industrialized world. It is safer to be born in forty-eight countries than in the United States. Fact: Of the some 4.3 million babies born in America each year, more than 25,000 will die in their first year. Fact: The maternal mortality rate in the United States is among the highest in the industrialized world. After taking that birthing class in England, Marijana had been scared of giving birth and was sure she wanted an epidural. But the clinic in Mrkonjić Grad was the only hospital she and Richard could find in Bosnia and Herzegovina where Richard would be allowed to stay with her. So Marijana ended up having no pain medication and no fetal monitoring during labor. When she was fully dilated and climbed onto the ratty operating table, her contractions slowed. The doctor and midwife heaved her upright and told her to walk around the room some more. Her son was born vaginally about three hours after her water broke. The doctor joked you couldn't find another baby like him in all of Bosnia. Richard is half English and half Nepali and the baby, whom they named Stanley, looked to Marijana "like a little Chinaman." Twenty-eight years old and in good health when she went into the hospital, Melissa Farah gave birth to a healthy baby girl via C-section in April 2007. But the birth did not go as expected: Melissa was transferred to another hospital due to complications from the operation. Doctors were not able to stabilize her and Melissa bled to death the next day. She is not alone: More than seven hundred American women die in childbirth every year, though most of these deaths go unnoted. The vast majority of maternal deaths in the United States are never investigated in any true sense: In 2007 only slightly more than half the deaths related to pregnancy or childbirth were autopsied, and there's evidence that autopsy rates in hospitals are declining; a review of the death is almost always conducted behind closed doors by a committee comprised only of hospital staff, and the information garnered is not released either to the family or to the public; journalists and other outside investigators are often hindered from accessing information because (they are told) of patient privacy concerns. When there is obvious wrongdoing, hospital lawyers work tirelessly to cover it up, negotiating financial settlements that include gag orders so the details of what happened cannot legally be made public. Only twenty-four states require hospitals to report adverse maternal outcomes to the state government. And only a handful of these states-- including Ohio, New York, and California--require that this information be available to the public. But even when the reporting is mandatory and the numbers are submitted to the state (noncompliance is an issue), most states have no system in place to investigate maternal deaths. A 2010 investigation revealed that twenty-nine states and the District of Columbia have "no maternal mortality review process at all." Melissa's case became national news because it was the second death at Underwood-Memorial Hospital in Woodbury, New Jersey, in two weeks. Her good friend Valerie Scythes died two weeks earlier after having a planned C-section. Her husband told the BBC that doctors scheduled the operation because Valerie was thirty-five and had had ovarian cysts in college. How is it possible that a country as wealthy and medically advanced as the United States has a higher maternal mortality rate than a much less affluent country like Bosnia and Herzegovina? Are the high maternal and infant death rates in America really isolated events, or are they mounting evidence that something in our country is going terribly wrong? Many obstetricians in America throw up their hands and say that our high rates of maternal and infant deaths are either the patient's fault or "an act of God." They argue that our increasing infant mortality rates are due to the rising use of fertility drugs and a greater number of older women having first babies, both of which lead to an increase in twins and premature births. They also point out that more American women are overweight or obese when they get pregnant, making labor more dangerous. While maternal age, obesity, and multiple births can contribute to higher maternal mortality, these factors are only a small piece of the puzzle. If we look at the best evidence, and if we compare American practices to countries where moms and babies enjoy safer outcomes, we find that the science tells a different story. This book is about how what happened to Melissa points to a larger problem with the way we are treating women and their babies in the United States. "Obstetrics is an ugly business and it's our most primitive medicine," says Stefan Topolski, M.D., assistant professor of Family and Community Medicine at the University of Massachusetts in Worcester. "We say it in meetings in our department all the time. It's the least evidence-based discipline." As this book will show you, time and time again corporate profits and private interests trump what is best for moms and babies. The science is consistently ignored, and practices proven to be harmful are continued. Doctors--even though most have the best possible intentions--often unwittingly go along with a broken and sometimes dangerous system. Few American parents could imagine deciding what car to buy just based on the ads they see during the Super Bowl or on the first package the car dealer offers. Instead, we do our homework, talk to friends about options, research safety history and gas mileage on the Internet, and read Consumer Reports. Ultimately we choose the car that's best for our family after carefully weighing (and usually declining) all the little things the salesman tries to slip in. But most of us are much more naïve when it comes to parenthood. While it is acceptable to haggle over cars, it's almost unthinkable in the United States to go against what is considered routine when it comes to pregnancy, childbirth, and raising an infant. We defer to the person we believe is the expert, wearing a white coat with a stethoscope around her neck. We are conditioned to trust doctors, to accept that what they tell us is true, and to believe that they only have our best interests in mind. Like most American children in the 1970s and 1980s, my brothers and I grew up eating Froot Loops, Apple Jacks, and Count Chocula for breakfast. Zach and I sprinted home from school every day to watch ABC After School specials and sing along to Jell-O commercials while our teenage brothers blared Janis Joplin upstairs. We attended public school and received the recommended vaccinations on the recommended schedule. My parents may have been unusual in that they both had Ph.D.s (my mother was a microbiologist, my father a chemist), but our family was conventional. My parents basically did what everybody else did, fed their children what everybody else fed theirs, and conformed to the values and standards around them. I never thought to question American culture. I always assumed that Wisk could solve ring around the collar, that doctors knew better than I what would keep me healthy, and that government officials always had my best interests in mind. But during my first pregnancy, when I was twenty-nine years old, I found myself sobbing in the car in the parking lot after every prenatal visit. I felt I was being bullied rather than cared for. My husband, who accompanied me on these prenatal visits, would let me cry in his arms and try to hide his worry from me. We were both graduate students and we felt we couldn't change providers because the one we were using was the only practice in Atlanta, Georgia, that our insurance company would pay for. We knew we would not choose to abort, so my husband and I tried to forgo some routine prenatal testing. We weren't trying to be difficult or rebellious--we were just seeking to avoid unnecessary stress. But our health providers did their best to scare us into compliance. One hospital midwife in Atlanta told me I would "buy" myself a C-section if I refused the test she insisted on. We switched from the hospital midwives to the doctors because, ironically, they seemed less rigid. But toward the end of my pregnancy a doctor ordered an "emergency" ultrasound because she believed I was measuring small. She turned to go to her next client before I could talk to her about it, muttering that she suspected "intrauterine growth retardation." We sat in the waiting room, flooded with anxiety. The scan showed the baby was fine. It wasn't until years later when I started researching and writing about pregnancy that I learned that ultrasound scans have not been shown to be any more effective in predicting intrauterine growth restriction (doctors these days try to avoid using the word retardation) than palpation of the pregnant woman's abdomen by an experienced clinician. The same summer my daughter was born, Marsden Wagner, an obstetrician and scientist, and former director of Women's and Children's Health at the World Health Organization, wrote: "There is no justification for clinicians using routine ultrasound during pregnancy for the management of IUGR." Mine was a low-risk pregnancy. I was young, strong, and healthy. When six months of nausea finally abated it was like someone washed the windows. I exercised daily, zooming past other cyclists on the bike path on Atlanta's East Side. I had been heavy when I first got pregnant, so I only gained a total of twenty pounds. I should have had a straightforward labor and delivery. But my husband and I knew very little about birth; we did not have a great relationship with our health care providers; and we did not have the support we needed in the delivery room. After hours of being left alone while in active painful labor, I was accosted by a brusque nurse who burst through the door, put on a glove, ordered me on my back, and stuck her fingers roughly in my vagina to assess the dilation of my cervix. "Nothing! Not even a dimple," she scolded before rushing out again. When I vomited during labor and my husband started panicking, nobody reassured us that vomiting was a good sign, an indication that my hormones were kicking into gear and that my body was cleaning itself out to make room for the baby. Instead, the staff acted disgusted that they had to clean it up. I have a family history of low blood sugar, and as the contractions continued hour after hour I felt myself getting weaker. I begged for something healthy to eat. The nurses refused. The doctor on call when our daughter was born was a floater in the practice, the only man, and the only one we had never met before. Knowing I didn't want an epidural or Pitocin (a synthetic hormone that stimulates the uterus to contract), he chastised me for selfishly putting my family through "so much waiting," and told me, while I was having an intense contraction, that I should stop thinking only about myself. I ended up giving birth on my back with Pitocin and an epidural, needing stitches for a badly torn perineum, and having side effects from the anesthesia (one of my legs went numb) that lasted for months. After our baby was born the nurse bustled into the room with a tray. "Time for the hep B vaccine!" she announced. I knew enough to know that hepatitis B is a sexually transmitted disease; I felt totally protective of the skinny frog-legged baby whose life was my responsibility. We told the nurse we wanted more information. Instead of explaining the rationale behind vaccinating an hours-old baby for a sexually transmitted disease my husband and I had both tested negative for, the nurse slit her eyes in anger. Two weeks later a pediatrician applauded our decision and told us that a fax on her desk warned that hepatitis B should not be given to newborns. I would find out ten years after that what happened: Since vaccines are tested individually and not in combination, scientists at the CDC had rather shockingly and embarrassingly discovered that they had overlooked the fact that the mercury load in the infant vaccine schedule might be damagingly high. In July 1999, the American Academy of Pediatrics (AAP) and the U.S. Public Health Service issued a joint statement asking for the mercury-based preservative thimerosal to be removed from infant vaccinations, and that the birth dose of hepatitis B be withheld from newborns whose mothers tested negative. Our stand against the hepatitis B vaccine had been more than warranted. It was a pivotal moment of disillusionment; suddenly I knew that it was up to me to educate myself in order to make the best-informed health decisions for my baby. In the weeks after my daughter was born, a slim envelope arrived in the mail. It was a hospital bill for more than $6,000. The insurance company denied the claim because they considered the pregnancy a preexisting condition, even though they had been my insurer for more than four years. As graduate students, my husband and I each made an annual stipend of about $11,000. I sat down to nurse my newborn, gazing at her tiny ears that stuck straight out like my husband's, inhaling the warm smell of her scalp, and fretted about the unpaid bills. Though the insurance company eventually acknowledged their mistake, my confidence was shaken. I felt like a trapped gerbil: I used an OB practice that I did not like because it was the only one my insurance would pay for; I was frightened into having a birth with expensive intervention that I did not want or need; and then I ended up with a bill for procedures I had not wanted that I could not afford to pay. Unfortunately, the experiences I had during the birth of my first child are not unique. The difficulties that started with prenatal care and continued well into my daughter's childhood are part of a larger system that I expose in this book, a system that puts large companies and corporate interests ahead of the best interests of the mother and her baby. You may be surprised to read that the baby wash used in American hospitals contains formaldehyde, and that the same company that makes it changed their formula for the European Union. You may be dismayed to learn that the pediatric "expert" who promoted what we now know is a mistaken idea of delayed potty training was a paid spokesperson for Pampers. Though some are no longer even American owned, the businesses that are hurting babies in order to increase profits--like Gerber and Pampers and Johnson & Johnson--are such an ingrained part of American culture and so aggressively promote their public image that many of their unconscionable practices are not questioned even by the most educated and savvy caregivers. When we were little my brother Zach, just eighteen months older than I, and I used to ask our father which of us he loved best. "The one who likes ice cream," my father would invariably answer. Zach and I would throw our heads back and laugh. I knew my dad loved me best because I liked ice cream. My brother knew my dad loved him best because he liked ice cream. My father never said, "I love you both the same," because he, in fact, didn't love us the same. None of us loves our children equally, we love them specially, according to their needs and our needs, their age and our age, their temperament and our temperament, and a host of other factors. This book is not an advice book and it does not offer One Right Way to parent. Because every baby is different, every parent is different, and every circumstance is unique, each triad of parents and baby comes to figure out their own way in their own time. What it does offer, however, is valuable information to help all of us in America stop blindly following the status quo and start doing our own research. In order to most effectively protect and raise our children we have to figure out the best way to do things ourselves. Parents, not for-profit companies or health care professionals, are actually the real experts when it comes to gestating, birthing, and raising our babies. Though we need support and advice, we do not need to be bullied or intimidated. We know more about what works best for our families and for our children than anyone else. As Benjamin Spock famously told the generation of nervous parents at the beginning of the baby boom in 1946, we can trust our own instincts; we know more than we think. Still, it's not easy to tell a well-intentioned doctor, who acts like he knows better than you, that you question his reasoning, or that you want a second opinion before proceeding. What if you're wrong? What if they're wrong? The Business of Baby will show why the practice of self-education, standing up to the system, voicing your concerns, and acting on them is more crucial than ever to the well-being of our babies. It is my hope that the stories of the men and women who kindly agreed to be included in this book, as well as the testimony from doctors, nurses, and other health care practitioners who are deeply concerned about the failings in our system, combined with a more detailed knowledge of both the science and of who is benefiting from the ways things are being done today, will inspire readers to seek out their own path and find a healthier and happier way to raise America's children. Excerpted from The Business of Baby: What Doctors Don't Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby Before Their Bottom Line by Jennifer Margulis All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
Table of Contents
Introduction | p. ix |
Author's Note | p. xix |
Chapter 1 Gestation Matters: The Problem with Prenatal Care | p. 1 |
Chapter 2 Sonic Boom: The Downside of Ultrasound | p. 24 |
Chapter 3 Emerging Expenses: The Real Cost of Childbirth | p. 45 |
Chapter 4 Cutting Costs: The Business of Cesarean Birth | p. 75 |
Chapter 5 Perinatal Prices: Profit-Mongering After the Baby Is Born | p. 96 |
Chapter 6 Foreskins for Sale: The Business of Circumcision | p. 118 |
Chapter 7 Bottled Profits: How Formula Manufacturers, Manipulate Moms | p. 137 |
Chapter 8 Diaper Deals: How Corporate Profits Shape the Way We Potty | p. 166 |
Chapter 9 Boost Your Bottom Line: Vaccinating for Health or Profit? | p. 191 |
Chapter 10 Sick is the New Well: The Business of Well-Baby Care | p. 226 |
Chapter 11 So Where Do We Go from Here? | p. 246 |
Abbreviations | p. 253 |
Glossary of Terms | p. 254 |
Appendix | p. 261 |
Resources | p. 261 |
Recommended Reading | p. 263 |
Vaccine Schedules in Norway and America | p. 264 |
Photo Credits | p. 265 |
Notes | p. 266 |
Acknowledgments | p. 329 |
Index | p. 333 |