Why We All Should Read The Business of Baby


The Business of Baby: What Doctors Don’t Tell You, What Corporations Try to Sell you, and How to put Your Pregnancy, Childbirth, and Baby Before Their Bottom Line (Scribner, 2013)

On a calm, early summer day, while away from home visiting family 13 years ago, I suddenly began hemorrhaging from a placental abruption. I  was just a few weeks into the last trimester of pregnancy with my first baby. I was terribly worried about my baby – as any expectant mother would be. 

But it turns out that our real ordeal – which lasted a month and involved bed rest at three different hospitals – didn’t have a whole lot to do with the complication itself. It had far more to do with the difficulty of sifting through completely differing medical opinions and conflicting information that didn’t always seem to be in our unborn child’s best interests. While everyone agreed that my baby was completely healthy and deserved every chance to remain in utero for as long as possible, I was shocked by how different the doctors’ approaches were. One doctor preferred to take him out (by scheduled c-section) as soon as possible. Another suggested inducing within a week; I cried when I visited the NICU. Only with the last doctor at the last hospital did we find a doctor who was not only willing to watch and wait; he was certain it was the best option for our baby.

These medical differences of opinion mattered to me; I did not want my baby to be born prematurely if it wasn’t necessary for him to be. I knew what the costs might be.  Our being thrust into the position of having to navigate such confusing medical advice gave me an inside peek at how pregnancy and birth are managed in America.

Or so I’d thought. Until I read Jennifer Margulis’s book, The Business of Baby (disclosure: Margulis is a friend of mine, and I was interviewed for her book), I hadn’t realized how little I knew about maternal care in America, and how poorly we do compared to other nations.

Here are some startling facts from her book (and this is just from the section on maternal care; her book covers many more issues, including circumcision, vaccines, baby formula, and the disposable diaper industry)

-The United States spends more on health care than any other country in the world, and yet we have the highest maternal mortality rate of any industrialized country.

-The likelihood of an American mom dying due to pregnancy or childbirth in the United States is more than four times higher than in Bosnia and Herzegovina and seven times higher than in Italy or Ireland; the likelihood of her dying as a result of childbirth is five times greater than in Germany or Spain, and fifteen times greater than in Greece.

Babies are at more risk too: As Margulis tells us:

-The countries with the highest premature birth rates are India, Nigeria, and the United States

-A child in the United States is more than twice as likely as a child in Finland, Iceland, Sweden, or Singapore to die before her fifth birthday.

-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.

-Of the some 4.3 million babies born in America each year, more than 25,000 will die in their first year.

The ending was a happy one for me. Eventually the bleeding subsided, we were able to return home, and my son was born peacefully, at term, in our birth center in Massachusetts. But as a nation we could do better. Not every parent has access to the support, information, and resources we had to cobble together that gave us the courage to seek out alternatives; no parent should have to do so. We should be able to trust that the medical advice and care we are being given is truly in the best interests of all our babies. 


The stats may sound scary. But The Business of Baby is not a book meant to scare people. It’s meant for opening our eyes and helping us in our decision-making. We tend to think doctors know everything, and to trust the system will work for us; my experience showed me that that’s not always true. Margulis’s book was written to empower parents: they cannot advocate for their families until they know what they are up against. Her book gives me hope that with greater awareness, things will change, and that a day will come when every expectant mother in America can trust that the care she is getting is in the best interests of her and her baby.


Christine Gross-Loh  is a freelance writer, mom of four, and author of The Diaper-Free Baby  as well as the forthcoming book Parenting Without Borders: Surprising Lessons Parents Around the World Can Teach Us.

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