This book is a must read for anyone who works with birth, politicians concerned with public health, and especially all women who will ever give birth. Wagner is an obstetrician and a former Director of Women's and Children's Health for the WHO, and as such he gives a unique insight to the state of maternity care, how we came to be this way, comparison with the rest of the developed world, and clear recommendations for how to improve maternity care. Even though I have been studying this issue for a couple of years, this book was eye opening and even painful at times to read. I am especially grateful for the last two chapters which discuss where the US should be in maternity care and how to get there. ( )

Born in the USA discusses maternity care in the US from a policy perspective. Admittedly I read it because I am pregnant and looking for something a little more factual that the usual birth books. The author has served as both an obstetrician and an public health official, so he does bring multiple perspectives to the book. The chapter on the common off label use of an induction agent was excellent. As a scientist you can easily convince me to agree with his statements about inability of medical doctors to design experiments and interpret the results. In general, his conclusions are that only 10-20% of women (those who are "high risk") need an obstetrician and that the remainder are better served by midwives, a system that has been successful in most European countries. While he does put forward a compelling argument, he also ignores certain aspects of the data (i.e., how are mortality rates effected by the lack of universal health care and a national public health system as opposed to the obstetrician versus the midwife). I found many of his suggestions for change to be too dramatic to be considered realistic. His inter country comparisons were illuminating, but they also ignored factors that were different than maternity systems but that do affect health (i.e., levels of education, equality index). Worth reading for the information on policy that it contains - but not useful to a pregnant woman (which is not the author's point anyway). It worth noting, however, the reason I failed to find it not useful: with hind sight, it is easy to state that only 10-20% of all mothers are high risk and there for should use an obstetrician - however, the critical question at the time of care is how accurately can a midwife or an obstetrician define who is high risk. ( )

My jaw was dropped at the stuff I read in this book. I read it after I had heard the author on NPR. This is a must read if you or someone you know are planning on having a baby. ( )