Understanding the Dangers of Cesarean Birth
by Nicette Jukelevics

[2008, Westport, Connecticut: Praeger Publishers, 262 pages, hardcover.]

[Review first published in Midwifery Today Issue 88, Winter 2008, © 2008, Midwifery Today, Inc. Review by Cheryl K. Smith.]

This book could not be more timely, in light of the fact that the broken health care system in the US is on the radar screen of citizens and politicians alike. The cesarean rate in the US is fast approaching one-third of all births and is currently the most common major surgery performed. The financial costs (both present and future) of this surgery far outweigh those of midwife-assisted childbirth, yet it carries a mortality rate of two times that of vaginal birth, is a major cause of increasing preterm births that require more resources, and is used by obstetricians to justify future costly interventions. None of these bodes well for getting health care costs under control.

In addition to these adverse effects on the nation as a whole are the effects on individuals, including death, disability, posttraumatic stress disorder and problems with future pregnancies, among others. Understanding the Dangers of Cesarean Birth methodically lays out the case for slowing this epidemic, which will help to heal mothers, babies, health care providers and the system that is being so damaged.

This book should be read not only by people who plan to have babies, but by policymakers and providers as well, so that we can all work to change the system to one that values human beings and their informed choices, is humane and is cost-effective.

Reviewer Cheryl K. Smith is an editor and a writer who gave up lawyering to raise miniature dairy goats in the coast range of Oregon. She is currently working on a book on goat health care (www.goathealthcare.com).

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