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The American Way of Birth by Jessica Mitford

By fff | Books | September 8, 2010 |

By fff | Books | September 8, 2010 |


Jessica Mitford was a muck-raking journalist most famous for her book The American Way of Death, an expose of the funeral home industry and ways in which it exploits grieving families. In The American Way of Birth, she turned to the history of birthing in the United States, finding much to critique in the ways that doctors currently treat both pregnant women and non-doctor caregivers such as midwives.

Mitford begins Birth by relating her own experiences giving birth, showing through personal experience how medical standards have gradually evolved to allow the birthing woman less autonomy. She then moves on to a historical perspective, from barber surgeons of England in the 1500s to “granny midwives” in the south in the early 1900s, on to the highly medicalized births that are common today. The bulk of the book looks at current practices — including doctor vs. midwife care, how doctors and hospitals deal with midwives, and income and class disparities in care.

Mitford ends up on the side of the midwives, but her position is balanced and measured. She is not an advocate for at-home, natural births for everyone, but she appreciates the training and knowledge of midwives, and documents, then critiques, the ways in which midwives’ practice is restricted and devalued, and medical interventions planned when they are unnecessary. Mitford ultimately advocates for unrestricted choice for birthing women, and finds that our current system funnels almost everyone into the same type of care — care that uses medical interventions frequently, more often than is necessary and to aid the convenience of the doctor rather than serve the health of the mother and the child.

Mitford’s writing is a joy to read. She writes in a journalistic style — mostly relaying facts in a neutral manner, but she readily admits her biases when they come up. She is alternately funny, sarcastic, and skeptical, and builds a powerful argument within an enjoyable personal style. While her ultimate thesis — that medical providers should allow the maximum freedom for pregnant women to choose their plan of care, and simply treat them as autonomous human beings — is not so radical in and of itself, it is a proposition that seems radical in the current system. Mitford’s common sense journalism is simply a rational voice against a large and dominant bureaucracy.

This review is part of the Cannonball Read series. For more of fff’s reviews, check out the blog.