REVIEW: Pregnant In America (Documentary)

Overview

I was recently able to watch Pregnant In America and I cannot say enough positive things about this documentary. I honestly wish every expectant mother and father in the U.S. could watch it. It exposes some very interesting pieces to the American maternity care puzzle.

I love that this film was directed, filmed, and produced by a father-to-be simply seeking out the truth. On his wedding day, he vowed to protect his wife. When she became pregnant, they began a journey to know their options for childbirth. The result is a very powerful disclosure of what is going wrong with the maternity system in the U.S. Below you will find direct quotes from the movie, which pretty much sum up everything I wish the general public knew.

I think the worst thing we are doing to women is not telling them the truth. -Barbara Harper, RN

There are 4 million births each year in the U.S and 98% of them occur in hospitals. Yet, our country is 28th on the list of infant mortality rate.

We aren't saving any more babies with all this technology.

We have, for 50 years, been brainwashing American women about childbirth, about how dangerous it is, how all the terrible things that can go wrong, and how you need to be in the hospital where all the doctors are, where all the machines are, and all the operating tables so that we can take care of those horrendous emergencies when they occur. It is absoletely not true. - Dr. Marsden Wagoner

Induction

In my opinion, induction is the #1 barrier to a healthy, happy delivery for mom and baby. An induction commonly leads to one intervention after another. In fact, 50% of inductions end in a C-section. The main reason for induction is convenience, for parents, for doctors, for hospitals, which I think is absolutely absurd.

The pharmacological induction of labor is one of the most serious, drastic and dangerous interventions that you can make. - Dr. Marsden Wagoner

The main drug to facilitate an induction is Pitocin, which is basically man-made oxytocin, the chemical your body releases to start and maintain contractions. The problem with Pitocin is that it can make labor more painful by causing overly strong contractions. This also may be detrimental to the baby.

We don't know the long-term effects of Pitocin. - Barbara Harper, RN

Another popular drug used for induction is Cytotec, which is not indicated for this purpose. In fact, the literature clearly states that this drug should NOT be used on pregnant womenbecause of a huge potential for uterine rupture leading to maternal and fetal death. Yet, hospitals across the country continue to use it regularly.

This drug is not approved by the FDA for this purpose.

This is a humongous obstetric emergency.

The hospital pays a lot of money [lawsuit] but the women pay the price.

- Dr. Marsden Wagoner

Epidural

For some reason, in America, we think we are entitled to avoid experiencing pain in childbirth. Yet, this is just another intervention that can cause long-term side effects. Still, 80% of women in labor receive an epidural. Did you know that there are 58 (yes, FIFTY EIGHT) risks to having an epidural? Because the medication crosses the placental barrier, there are even studies which are linking epidurals to behavior problems, obesity, suicide, drug addiction, cardiovascular disease, and cancer. The effect is seeded as an infant only to manifest itself as an adult.

Mother and baby are both designed to work together in labor and, when drugs are used, they are both drug impaired so they are not working together.

Interventions

In the United States, childbirth is not seen as a normal event at all and women are not allowed to let it take its natural course. Pregnancy is closely monitored and labor & delivery are scrutinized and micromanaged. In turn, the interventions make more of a mess than what they aim to fix not that the process needs to be "fixed" to begin with.

In countries where they do not use [interventions] just as a normal management of labor technique or protocol, they have much better statistics, much better outcomes, and we can learn from that. - Kerry Tuschhoff

Doctors use the intervention and then have to save the baby because they have used the intervention. - Barbara Harper, RN

Cesarean Section

In 1975 the C-section rate in the United States was 7%. It is now well above 30% and continuing to rise. The World Health Organization recommends a maximum rate of 15%.

FYI: All OB/GYNs receive surgical training.

It's kind of a no brainer to say how come the U.S. has a high Cesarean section rate. Well, it has a high surgical rate because the people you ask to take care of it are surgeons. - Barbara Katz Rothman, PhD

To a surgeon, every problem looks like a surgical problem.

There are more than 42 risks of Cesarean section. Most of these risks are not discussed with patients. One doctor in the film goes as far as to say this nondisclosure is ethically inappropriate. I would whole-heartedly agree.

It's MAJOR abdominal surgery. - Dr. Marsden Wagoner {emphasis mine because I know first hand}

From the mother's point of view, if she didn't want the Cesarean, she has just been robbed of the chance to have the kind of empowering birth that she wanted. She may have been robbed of her change to bond with the baby and she may have been robbed of the chance to successfully breastfeed. - Robbie Davis Floyd, PhD

Vaginal Birth after Cesarean (VBAC)

This is where things get even more complicated. Most Cesareans are unnecessary to begin with and it is becoming increasingly more difficult be given a chance for a VBAC. Many hospitals forbid VBACs and some insurance policies refuse to pay for them. In some states it is even illegal.

There are women right now in this state [Washington] that are getting cut open because everybody around them is telling them that is their only option. - Betsy Chasse.

The above quote is from a mother whose insurance company refused to pay for her VBAC so she chose to cross the border and deliver her baby in Canada instead.

We are victims of our insurance.

Less patients are taking an active role in what they want. Some are even requesting surgery when it doesn't need to be done. - Dr. Sancetta (Miami, FL)

Homebirth

The filmmakers traveled to other countries to examine how maternity care and childbirth are handled in those areas. I was most intrigued by Holland, where 87% of women deliver at home. In fact, if a low-risk woman shows up to a hospital to deliver her baby, then send her right back home. In Holland, home births are covered by insurance and are drastically less expensive. Plus, contrary to popular belief, there is less bacteria at home compared to the hospital.

Women continue to be disappointed in hospital births.

Midwives

Here are some statistics on a very well-known Tennessee midwife, Ina May Gaskin. She has a mere 1.5% C-section rate in over 2000 deliveries where 95% of women delivered outside of a hospital. Impressive!

It is interesting to note that women using midwives in other countries may receive daily visits for up to three weeks post partum.

We don't say patients, we say clients, because they are not ill. - Dr. Tom Kreuning (Holland midwife)

Conclusion

There were many more topics covered in this movie and several topics not covered that I think are important. The film also includes the story of Steve & Mandy and you follow them throughout the pregnancy and through delivery. However, this movie is great for getting your brain thinking about the current state of affairs regarding childbirth in the U.S. The bottom line is that we need to take control of our own births, do the research, and determine what options are appropriate for us.

Doctors in America do not want any significant change in the present system. They have all the power, they have all the control, and they are making the big bucks. - Dr. Marsden Wagoner

It's so sad what women are missing and they don't even know that they are missing it.

We skip the sense of empowerment.

There are really only two ways to improve obstetrics; 0ne is litigation and the other one iseducation. - Dr. Marsden Wagoner

The goal of Steve Buonaugurio (director) was to inspire families to reclaim control of their birth experience. I want to encourage you to do the same.