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The Polarizing Message Behind "The Business of Baby"

The topic of childbirth has this magical ability to divide and conquer parents.

Childbirth, child rearing, child development and any topic that addresses how to raise a child seem to have this magical ability to divide and conquer, even when both sides want what is best for the baby. But wanting what’s best is clearly different for different people, as a new book brings out in readers, reviewers, parents, and the pros who care for and deliver babies.

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 (Scribner) is a new book that has fueled such polarization, from the pages of the New York Times Book Review to the San Francisco Chronicle to Facebook. The book has won cheers and criticism parents, doctors and public health specialists, and, for any parent who is adopting a baby, will be sure to raise questions and pique interests.

Jennifer Margulis is the author of The Business of Baby. She is a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University, and an award-winning writer and Fulbright fellow. She is a former contributing editor at Mothering magazine and her writing has appeared in many of the nation’s most respected and credible publications, including the New York Times, the Washington Post, and on the cover of Smithsonian Magazine.

Meredith: For the parent who has adopted a young child, who has not had contact with the woman who gave birth to the baby or with the baby until he or she was, say, one year old, what would you like them to think about in relation to when they read your book?

JENNIFER MARGULIS: This book is about the systemic failure of our health care system. Though it concentrates on pregnancy, childbirth, and the first year of life, there is a lot of important information for parents of adopted children who are  already toddlers or beyond -- about gentle potty training (and how diaper companies do everything they can to make parents afraid to teach their children to use the toilet), well baby visits (and the overprescription of unnecessary medication), and the pros and cons of vaccines.

Meredith: The label “natural childbirth” is oddly (and confusingly) polarizing. Can you explain why?

JENNIFER MARGULIS: Good question. Several obstetricians and midwives I interviewed think the reason why mainstream obstetricians spend so much time and energy bashing home birth and natural childbirth is to avoid taking a hard look at how hospital birth is harming so many women and what they themselves are doing wrong. Only about 2 percent of births take place outside the hospital (at home and at birthing centers) yet 32.8 percent of births in America are via C-section. Some 34,000 American women nearly die every year from birth-related causes. We need to all be talking together and to each other about these horrifying and often avoidable near-misses and about why America has the highest maternal mortality rate in the industrialized world. That conversation is the urgent one that mainstream medicine ignores. Those who do talk about it blame women -- as if somehow American women have inferior bodies than women in Scandinavia and Europe.

At the same time, so many women in America have had been told by their health care providers that modern medicine saved their lives and that the bad birth experiences they had were unavoidable. I think that's why some women get so angry when they see people championing natural birth: it's easier to believe what the doctor told you than to realize that what happened to you might have been avoided.

Meredith: Home births may not be for everyone, even when the delivery is expected to be what we might call routine. But some parents-to-be may choose to have the baby in the hospital because they are more comfortable with that setting. In this case, what would you tell them to be aware of, to ask for, to do?

JENNIFER MARGULIS: Women who choose to birth in the hospital need to have support beyond the hospital staff. The doctor you've spent nearly nine months developing a relationship with won't be with you for your labor -- not unless something goes awry or until you're ready to push. Rather than rely on support from labor and delivery nurses you've never met before, assemble a birthing team. Hiring a doula and asking an experienced friend to be at your side makes a huge difference. The other thing is to empower yourself by reading the right books. (See THE BUSINESS OF BABY for recommendations.) My book doesn't really talk about home birth but it does go into detail about hospital birth. It can arm women having hospital births with the information they need to know to have the safest most enjoyable birth possible.

Meredith: What else would you like readers to know?

JENNIFER MARGULIS: Babies and small children are not a biohazard. Having a baby in your life--however he got there--is such a joy. The first years go by so quickly and children teach us so much. Trust yourself and listen to your baby.

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Note correction: Margulis originally said that "some 68,000 American women nearly die every year from birth-related causes." The correct number, according to Margulis, is 34,000.

Read Jennifer's blog by clicking here.

Meredith Resnick, L.C.S.W., is a health writer and licensed social worker. She is also the mother of two adopted daughters.

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