The Business of Baby

1. The American birth system prioritizes profit over health

"The United States spends more money on health care than any other country in the world. Hospital charges related to pregnancy, delivery, and infant care are among the top five most expensive conditions requiring hospitalization."

Profit-driven healthcare. The American birth system has become a profit-generating machine, often at the expense of mothers and babies. Hospitals and insurance companies have financial incentives to promote interventions, regardless of medical necessity. This profit-driven approach leads to:

• Overuse of expensive technologies and procedures
• Rushed deliveries to maximize bed turnover
• Unnecessary C-sections, which cost twice as much as vaginal births
• Promotion of formula over breastfeeding due to industry influence

Poor outcomes despite high costs. Despite spending more on healthcare than any other country, the United States has:

• Higher maternal mortality rates than other developed nations
• Higher infant mortality rates than 48 other countries
• Increasing rates of pregnancy-related complications

2. Unnecessary medical interventions during pregnancy and birth can harm mothers and babies

"We credit doctors with saving lives, but the truth is that doctors in the recent past have also been directly responsible for untold numbers of fetal and maternal deaths."

Overuse of interventions. Many routine pregnancy and birth interventions lack scientific evidence of benefit and can actually cause harm:

• Frequent ultrasounds: Potential risks to fetal development
• Continuous fetal monitoring: Leads to more C-sections without improving outcomes
• Induced labor: Often unnecessary and increases the risk of C-section
• Epidurals: Can prolong labor and increase the need for further interventions

Cascade of interventions. One unnecessary intervention often leads to another, creating a domino effect that increases risks for both mother and baby. This cascade can turn a normal birth into a medical emergency, leading to:

• Higher rates of C-sections
• Increased risk of maternal and fetal complications
• Traumatic birth experiences for mothers
• Difficulty establishing breastfeeding

3. C-section rates in the US are alarmingly high and often unnecessary

"Cesarean sections were originally used during the Roman Empire to remove a living baby from a dead mother. Now they are used for convenience and money."

Skyrocketing C-section rates. The C-section rate in the US has risen dramatically:

• 1960s: About 5% of births
• Current: Nearly 33% of births
• WHO recommendation: No more than 10-15% of births

Reasons for high C-section rates:

• Convenience for doctors and hospitals
• Higher reimbursement rates compared to vaginal births
• Fear of malpractice lawsuits
• Lack of support for VBACs (vaginal birth after cesarean)

Risks of unnecessary C-sections:

• Increased maternal mortality and morbidity
• Longer recovery times for mothers
• Difficulty establishing breastfeeding
• Potential long-term health consequences for babies

4. Breastfeeding is best for babies, but formula companies undermine it

"Formula manufacturers have only one goal: to sell formula. In order to do so, they need to convince both health care professionals and parents that the products they sell are better than the cheaper natural human alternative, breast milk."

Benefits of breastfeeding. Overwhelming scientific evidence supports breastfeeding as the optimal nutrition for infants:

• Enhanced immune system development
• Lower risk of SIDS, infections, and chronic diseases
• Improved cognitive development
• Health benefits for mothers, including lower cancer risk

Formula industry tactics. Despite the clear benefits of breastfeeding, formula companies use aggressive marketing strategies to increase sales:

• Providing free samples and educational materials to hospitals
• Advertising directly to parents and healthcare providers
• Sponsoring medical associations and influencing their recommendations
• Creating doubt about mothers' ability to breastfeed successfully

Undermining breastfeeding. These tactics contribute to low breastfeeding rates in the US:

• Only 36% of babies exclusively breastfed at 3 months
• Lack of support for breastfeeding mothers in hospitals and workplaces
• Misinformation about the adequacy of breast milk

5. Routine infant procedures like circumcision and vaccinations require scrutiny

"Circumcision is an often painful and sometimes dangerous operation, performed without consent, which is medically unnecessary for a newborn."

Circumcision debate. Routine male circumcision in the US is controversial:

• No medical association recommends routine circumcision
• Potential risks include bleeding, infection, and long-term complications
• Ethical concerns about performing unnecessary surgery on infants
• Cultural and religious factors often drive the decision

Vaccination concerns. While vaccines have dramatically reduced infectious diseases, the current US vaccine schedule raises questions:

• More vaccines given at younger ages than in other developed countries
• Potential risks of multiple vaccines given simultaneously
• Lack of long-term safety studies on the current schedule
• Financial conflicts of interest in vaccine research and policy

Informed decision-making. Parents should be provided with unbiased information about these procedures to make informed choices based on their individual circumstances and values.

6. The business of prenatal and postnatal care often ignores evidence-based practices

"As new mom, she had to get the hang of doing something with two intimate, private body parts that she had never done before. And she's not the only one learning. Her newborn too has to learn to extract sustenance from a breast that is probably much larger than his small, wrinkled head."

Outdated practices. Many routine prenatal and postnatal practices are not supported by current scientific evidence:

• Immediate cord clamping after birth
• Separating mothers and babies after birth
• Routine use of artificial infant formula
• Rigid feeding schedules instead of on-demand breastfeeding

Profit-driven care. The business model of prenatal and postnatal care often prioritizes efficiency and profit over evidence-based practices:

• Short prenatal appointments focused on tests rather than education
• Lack of support for breastfeeding in hospitals
• Promotion of unnecessary products and interventions

Consequences of ignoring evidence. Failure to implement evidence-based practices leads to:

• Higher rates of breastfeeding difficulties and early weaning
• Increased risk of postpartum depression and anxiety
• Missed opportunities for early bonding and attachment
• Unnecessary medical interventions and their associated risks

7. Alternative birth models and informed choices lead to better outcomes

"We credit doctors with saving lives, but the truth is that doctors in the recent past have also been directly responsible for untold numbers of fetal and maternal deaths."

Midwifery model of care. Countries with better maternal and infant outcomes often rely heavily on midwives:

• Focus on pregnancy and birth as normal, healthy processes
• Emphasis on prevention and non-invasive interventions
• Continuity of care throughout pregnancy, birth, and postpartum
• Lower rates of unnecessary interventions and C-sections

Homebirth and birth centers. Alternative birth settings can provide excellent outcomes for low-risk pregnancies:

• Lower rates of interventions and C-sections
• Higher rates of successful breastfeeding
• Greater maternal satisfaction with the birth experience
• Cost-effective care with lower rates of complications

Informed choice. Empowering parents with unbiased information leads to better decision-making:

• Understanding risks and benefits of various interventions
• Feeling confident to question healthcare providers
• Choosing care providers and birth settings that align with their values
• Taking an active role in their pregnancy, birth, and postpartum care

8. Corporate interests heavily influence prenatal care, childbirth, and infant health practices

"Procter & Gamble is such a giant that it describes itself as 'a force in the world,' selling products to 4.4 billion of the world's 7 billion people."

Pervasive influence. Large corporations have a significant impact on pregnancy and childbirth practices:

• Formula companies donate millions to medical associations
• Pharmaceutical companies fund research and influence guidelines
• Medical device manufacturers promote their products to hospitals

Marketing tactics. Companies use various strategies to reach parents and healthcare providers:

• Free samples and educational materials in hospitals and doctors' offices
• Sponsorship of medical conferences and continuing education
• Direct-to-consumer advertising of infant products

Conflict of interest. Corporate influence can lead to:

• Biased medical recommendations
• Overuse of unnecessary products and interventions
• Undermining of natural processes like breastfeeding
• Prioritization of profit over health outcomes

9. The US lags behind other developed nations in maternal and infant health outcomes

"The United States has one of the highest infant death rates of the industrialized world. It is safer to be born in forty-eight countries than in the United States."

Poor maternal outcomes. Despite high healthcare spending, US maternal health lags:

• Maternal mortality rate doubled between 1990 and 2008
• Higher rates of pregnancy-related complications than other developed nations
• Significant racial disparities in maternal health outcomes

Infant health concerns. US infant health outcomes are also concerning:

• Higher infant mortality rates than many developed countries
• Increasing rates of preterm birth and low birth weight
• Higher rates of NICU admissions and associated complications

Factors contributing to poor outcomes:

• Lack of universal healthcare access
• Overuse of medical interventions
• Inadequate support for breastfeeding and postpartum care
• Social determinants of health, including poverty and racial disparities

10. Empowering parents with knowledge can lead to healthier pregnancies, births, and babies

"Parents, not for-profit companies or health care professionals, are actually the real experts when it comes to gestating, birthing, and raising our babies."

Informed decision-making. Educating parents about evidence-based practices empowers them to:

• Question unnecessary interventions and procedures
• Make choices aligned with their values and preferences
• Advocate for themselves and their babies in medical settings
• Seek out providers who support their birth preferences

Natural birth advocacy. Supporting natural birth processes can lead to better outcomes:

• Promoting physiological birth when possible
• Encouraging skin-to-skin contact and early breastfeeding
• Minimizing unnecessary interventions and separations
• Respecting the mother-baby dyad as a unit

Systemic change. Informed parents can drive change in the birth system:

• Demanding more transparent healthcare practices
• Supporting midwifery care and out-of-hospital birth options
• Advocating for evidence-based policies and guidelines
• Sharing information with other parents to create a ripple effect

Last updated: July 20, 2024