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     Do Doctors Put Corporations
     Before Mothers And Babies?

         —A new book by Schuster Institute
            Senior Fellow Jennifer Margulis
            reviews the evidence

It's hard enough to challenge authority. But when that authority is a doctor or nurse, caregivers we often see when we are sick, hurt, pregnant, challenging them becomes even more difficult.

When she was a 29-year-old graduate student and pregnant for the first time, Schuster Institute Senior Fellow Jennifer Margulis, now an award-winning author of several books, had no reason not to trust her doctors. But time and again, Margulis left her prenatal checkups wracked with anxiety. Her doctors got defensive when she asked them questions. She and her husband felt bullied into doing tests and procedures she did not want and wondered if she needed. Why, she asked herself, when she had the privilege of receiving healthcare in the world’s finest medical and healthcare establishments, did it feel like so much was going wrong.

Then, just after Margulis had given birth, a nurse marched into her hospital room intent on vaccinating her hours-old newborn for hepatitis B. Hep B is a sexually transmitted disease which she and her husband had been tested for with negative results.  

“We told the nurse we wanted more information” Margulis writes in her new book “The Business of Baby.” The nurse unhappily obliged. Two weeks later, her pediatrician applauded her move, telling her that news had just been faxed to doctors warning them not to give that vaccine to newborns.

A journalist with an inquiring, wide-ranging mind, Margulis set out to uncover why the United States spends more money on health care than any other country in the world yet in spite of this, it is more dangerous to give birth in America than in other industrialized countries.

Considering all the money spent to ensure healthy pregnancies, the United States should be one of the safest countries in which to give birth. We would expect that harm to mothers and babies would be isolated events, so rare and shocking that they would make national news. Logically we should be among the industrialized countries with the best birth outcomes.

But we are not.

In fact, the statistics in our country related to maternal and infant mortality lag so far behind other countries that in 2010 Amnesty International called the situation for mothers, especially women of color and low-income women, a ‘crisis’.

Amnesty International’s report Deadly Delivery reveals that women in the United States have a greater lifetime risk of dying in pregnancy-related complications than women in forty other countries. There’s ample evidence that things are getting worse: Data collected by the UN shows that while the vast majority of countries reduced their maternal mortality rates (for a global decrease of 34 percent), the maternal mortality rate in the US doubled between 1990 and 2008, from 12 to 24 in 100,000 births.

While our maternal outcomes are much better than in war-torn countries like Afghanistan or impoverished countries like Niger, they are inexcusably high: More than two women die every day in the United States from pregnancy-related causes. (pp. 1165-1166, Kindle e-book)

Following ten years of research and three years of writing, Margulis has written “The Business of Baby” in which she investigates prenatal care, the cost of childbirth in America, cesarean sections, post-delivery care, breastfeeding, potty-training, and more.

Parents of all levels of experience are likely to learn something about baby-care they didn’t know, and will wish they’d learned it sooner.

Are Prenatal Ultrasound Scans Safe?

It’s fun to know the gender of your unborn baby—so much fun that commercial businesses offer non-medical (and unregulated by the U.S. Food and Drug Administration) ultrasound services to expectant parents. But there’s a potentially serious downside to all those prenatal ultrasound scans, says Margulis, citing the hypothesis of University of Louisville neurologist Manuel Casanova who suggests that ultrasound scans, common now since the late 1970s, may be triggering neurological disorders in the developing fetus’s brain.

Ultrasound waves, Casanova explains, are a form of energy known to deform cell membranes. In fact, in the early 1990s the FDA approved the use of ultrasound to treat bone fractures because ultrasound increases cell division. Some cells in the human body are more sensitive than others.

Among the most sensitive cells? Those stem cells in the brain that divide and migrate.

Casanova’s hypothesis: Prolonged or inappropriate ultrasound exposure may actually trigger these cells to divide, migrate, and form too many minicolumns [vertically oriented groups of neurons that work together]. [Cells] divide when they’re not supposed to and there are no inhibitory cells to contain them. (p. 847, Kindle e-book)

While the healthcare industry and researchers scramble to understand the cause of autism and why its rates are rising in developed countries, expectant mothers continue to receive numerous ultrasound scans. But a study of 15,151 pregnant women published in the New England Journal of Medicine in 1993 “showed that an ultrasound scan does not improve fetal outcome” though it did add “more than $1 billion to the cost of caring for pregnant women in America each year.”

Initially celebrated as a harmless new medical technology, X-rays were once championed for routine obstetric care.

As use of obstetric X-rays became more widespread, an industry grew up around it. Obstetric X-ray equipment was needed, as well as training for specialized radiologists or radiographers. Although concern continued to mount, for almost fifty years, X-ray technology was used to estimate fetal head size, calculate a pregnant woman’s projected due date, and screen for fetal abnormalities. A pregnant woman would be strapped to a table and an enormous machine, beaming X-rays at her abdomen, would take images of her pregnant belly for doctors to analyze. The routine use of prenatal X-rays was justified because the information gathered was thought to help ensure a safe pregnancy outcome.”

“We now know that obstetricians were terribly mistaken. (p. 904, Kindle e-book)

The Business of Circumcision

Globally, routine infant circumcision is not the norm. Yet in America, even though the numbers of newborn boys being circumcised continue to drop, (rates in the U.S. were 58.4 percent in 2001 and are now estimated at 54.7 percent according to the Centers for Disease Control and Prevention [CDC]) male circumcision is commonly performed. In “The Business of Baby,” Margulis devotes a chapter to the practice of circumcision in America, describing the circumcision procedure, the prevalent but not well-known use of glucose water as a substitute for anesthesia, reasons parents choose to circumcise or not, and medical reasons (to prevent penile cancer and urinary track infections) that might justify its practice.

Yet while the American Academy of Pediatrics contends that the medical benefits to circumcision outweigh the harms, “they do not recommend routine male circumcision,” writes Margulis. Moreover she says that “none of the equivalent medical associations in Europe recommends routine male circumcision, and some actively oppose it.” The Royal Dutch Medical Association has recommended a “ban on the procedure in Holland, both because it endangers an infant’s health and because it is ethically questionable.”

Margulis reports that in America, parents often decide to circumcise their infant sons if the father was also circumcised, and because they worry that if they don’t circumcise their sons they will be teased for looking different.

Margulis’ research has led her to believe that most parents seem unaware of the dangers a baby faces during the circumcision operation. Dangers include botched procedures that one medical liability attorney Margulis interviewed believes are more common than people think; and death by bleeding.

Canadian-born Ryleigh McWillis died in 2002 from blood loss after a circumcision: “‘I didn’t realize a baby can die from losing as little as one ounce of blood,’” his father Brent McWillis, a medical professional, told a reporter.

Perhaps the most surprising revelation about circumcision Margulis presents is the commercial value of newborn baby foreskins to hospitals that sell them and manufacturers and biomedical tech companies that buy them.

What American parents do not realize, when they decide to remove a part of their son’s penis at birth, is that the foreskin is tremendously valuable. Hospitals provide foreskins donated by parents at a cost (masking the fact that they are selling them by only charging shipping and handling fees) to the biotechnical industry, which uses them to create medical products that are then resold to the consumer. Infant foreskins are used to make high-end beauty products like injectable beauty treatments; artificial skin for burn victims, diabetics, and plastic surgery; wound dressings; hair regrowth products; and spa products. (p. 2739, Kindle e-book)

Vaccinating for Health of Profit?

Margulis begins her chapter on vaccines lauding their efficacy in preventing disease and saving lives. She reviews the current vaccine schedule for babies in America, compares it to schedules earlier in American history and to those in other industrialized countries. By the time an American child is 18 months old, if a parent has followed the CDC recommended vaccination timetable, she will have received 26 injections to prevent 14 different diseases, double the number of injections given in Norway and some European countries, and four times more than the number American children received in the 1970s.

According to Margulis, there is a growing number of healthcare professionals who are questioning the safety of vaccines, some of whom publicly defend the vaccine schedule while privately questioning its efficacy:  

It’s a well-kept secret that doctors, nurses, physician’s assistants, government officials, vaccine developers, and others who work in the health care industry, and whose job it is to publicly urge parents to vaccinate, often delay vaccines for their own babies, pick and choose vaccines, or decide not to vaccinate at all. (p. 4003, Kindle e-book)

Margulis writes that administering multiple vaccines at one time to young children seems particularly problematic:

The fact is, large-scale vaccine safety studies have never compared the immune systems of completely unvaccinated children to vaccinated children, nor have we studied the possible long-term damage that may be done to the immune system by multiple vaccines. We simply don’t know what the effect of giving so many vaccines at once is on the immediate or long-term health of a child. (pp. 4279-4280, Kindle e-book)

Margulis also writes that we can’t expect the pharmaceutical manufacturers, which are almost entirely protected against liability by the National Childhood Vaccine Injury Act of 1986, law that was further bolstered in the 2011 federal case Bruesewitz v. Wyeth, to do these studies.

Big pharmaceutical companies earn more than $13 billion in yearly profits through convincing parents in the United States and around the world that vaccinating (as opposed to exclusive breastfeeding and eating healthy whole foods) is the most essential component to ensure their children’s health. (p. 4434, Kindle e-book)

These are only a few of the topics Margulis addresses in “The Business of Baby.”

She says she wrote the book hoping to inspire readers to do their own research about best obstetric and parenting practices, to encourage them to stand up to the system when they think it is wrong, to voice their concerns, and to act on them.

Each chapter in “The Business of Baby” could be expanded to book length, Margulis says, and many readers may well wish she had, as book reviewer Devon Barta did in her review for the Paperhouse, where she expresses a need for all the research, or at least more, that addresses opposing viewpoints to the positions Margulis has taken about controversial issues.

Selected Reviews

Award-winning investigative journalist/mother of four Margulis comes to some startling conclusions in this comprehensively researched examination of the business of giving birth in America. Beginning with pregnancy and ending at baby’s first birthday, the text follows in rough chronological order the issues that parents face, from prenatal care, labor and delivery, to potty training and well-baby pediatrician visits. Margulis raises the question of why the United States has the highest maternal mortality rate of any industrialized country. She interviews doctors, midwives, parents, scientists and others, hunting down the corporate profits and private interests that “trump mom and baby,” relentlessly searching for evidence of why unnecessary and sometimes harmful medical interventions are practiced in American hospitals. In her search for answers, Margulis comes to some stunning realizations about practices that most parents believe to be safe, ranging from ultrasounds and C-sections to the baby’s first—possibly “toxic”—bath in the hospital nursery (researchers, for instance, are studying a link between ultrasounds and autism; C-sections have become a dangerous “trend”). Many decisions, the author concludes, are not based upon “best evidence or best practices,” but rather on medical industry profits and fear of litigation. Inspiring readers to follow her lead by trusting their instincts and questioning the status quo, Margulis delivers a compelling and thought-provoking work for every parent and parent-to-be. (Apr.)

Ina May Gaskin

“Jennifer Margulis's searing and well-researched exposé is a must-read for expectant mothers. Whether she is discussing common obstetric practices, circumcision, vaccination, breastfeeding, bottlefeeding, diapering, or choosing a pediatrician, she points the way to rational, health-based decision-making.” 

More Book Reviews & Interviews>

Upcoming Events: Jennifer Margulis talks about "The Baby Business"

Visit Jennifer Margulis' website for additional appearances and more about her work.

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Healthcare costs around the world are compared with life expectancy rates in this line chart created using 2007 Organization for Economic Co-operation and Development data by Oliver Liberti, National Geographic.