Expecting Trouble - Thomas H., Jnr Strong
Book Description
Prenatal care in America does not work and much of it lacks a solid scientific
base. We spend more for it and provide more of it than any other nation on earth.
Yet in return our prematurity and low birthweight rates are among the worst in
the world.
So argues Thomas H. Strong, Jr., a second generation obstetrician whose entire
professional career has centered around prenatal care. Expecting Trouble calls
into question many of the prevailing assumptions which have driven our country's
maternity healthcare for decades.
While the general understanding of prenatal
care as crucial to the wellbeing of mothers and their babies is now enshrined
in American culture, Strong draws upon scientific research
to show that few procedures are actually as helpful as we
imagine. Much of what passes for prenatal care is unduly
expensive, unnecessarily high-tech, and surprisingly unsupported
by medical research. New--and unproven--technologies are
adopted by obstetricians seeking to appear "cutting-edge" in
order to attract patients while procedures which could potentially
detect problems, such as ultrasound, have taken on the status
of fads, becoming virtually ubiquitous in obstetricians'
offices rather than remaining in the hands of those specialists
who have extensive and proper training.
Strong dispels widespread
misconceptions about the effectiveness of prenatal care in
its current form and explains ways in which mothers themselves
can affect their pregnancy outcomes to a greater degree than
their obstetricians.
Expecting Trouble exposes the glaring deficiencies
of American prenatal care and outlines what can be done to
remedy it. In addition, it provides specific questions that
parents should be asking their health care providers to ensure
that they and their babies receive the best care possible.
About the Author
Thomas H. Strong, Jr., M.D. , an award-winning speaker and researcher,
is a board-certified Obstetrician-Gynecologist and Maternal Fetal Medicine Specialist
in Phoenix, Arizona. He is on the clinical faculty at the University of Arizona
and the University of California in San Francisco (Fresno) Departments of Obstetrics
and Gynecology.
Great reductions on this book from Amazon!
Editorial Reviews
From Library Journal
Drawing from the literature of medical and epidemiological
research, Strong"a
second-generation obstetrician"presents compelling evidence that prenatal care
in the United States does little to improve birth outcomes. The current trend
toward universal prenatal care is fueled not by evidence that it is effective,
he argues, but by unexamined assumptions as well as political expediency and
economic greed. While stressing that access to prenatal care should not be impeded,
Strong recommends that the technology and costs for uncomplicated pregnancies
be scaled down, noting that prenatal care for these pregnancies could be shifted
from obstetricians to midwives whose care is as effective but less costly. Obstetricians,
in turn, could then focus on what they do well"assisting pregnancies with medical
complications that respond to treatment"and the routine use of costly, high-tech
procedures that do not improve outcome could be halted. In support of his vision,
Strong explores a range of medical and public-policy issues currently under debate.
Provocative and stimulating, this book performs a valuable service by bringing
evidence on this vital issue out of the research literature and into public discourse
and providing the tools for a long-needed paradigm shift. Recommended for public
and academic libraries."Noemie Maxwell, Seattle Midwifery Sch.
Copyright 2000 Reed Business Information, Inc.
The New England Journal of Medicine, October 12th, 2000
"What makes this book important is its comprehensiveness, its general readability,
and the fact that it has been written by a practicing obstetrician."