Congratulations! You are about to embark on a journey that is both intensely personal and yet connects you to all mothers since time immemorial. Bringing a child into the world is a life-changing experience, and this book will help you to have a safe and happy pregnancy and postpartum year. No one goes into a pregnancy thinking they are going to have problems, but sometimes you’re suddenly faced with unexpected issues and decisions which you feel unprepared to make. The information in this book helps you understand your choices so you can work with your obstetrician to have the kind of pregnancy you want for yourself. After delivering 6,000 babies with no maternal mortalities, I want to share what I have learned with women and their families. I developed my methods by listening to my patients and learned that while there are universal traits to pregnancy and childbirth, each experience is as unique as the woman having it. In this book, I share with you my perspective on how you can make choices which can increase your safety and happiness in your own pregnancy. In this book, I share with you how and why to create your own unique “flight plan,” which includes your own personalized prenatal, birth, and postpartum plan. With this information, you will gain the confidence to participate with your doctor in making the best choices for you in your pregnancy, your birth, and the first year of your baby’s life. You are in charge of your safe pregnancy. Let’s make sure it’s the best experience it can be.

I saw what was happening to the practice of medicine when managed care corporations started replacing clinics some 30 years ago. Physician decisions were being denied by the recently graduated MBAs who were more interested in cutting costs than providing good patient care. I wrote Modern Medicine to tell the story of how hospitals, health maintenance organizations, insurance companies, and lawyers were forcing physicians and nurses to change the way they delivered health care. Doctors and nurses knew how these corporate bean counters were destroying health care. We wanted patients to know too. What we wrote about 30 years ago has come to pass in spades. Whether health care is a right or a privilege is irrelevant. We are the only developed country which does not provide basic health care to each and every one of its residents. Think about it. At that time, I thought that with some discussion of what was going on in health care, consumers would be able to take back control of their health care system. I concentrated on three main players in the takeover of the healthcare system: corporately controlled medical facilities, health insurance companies, and lawyers and the malpractice industry. Unfortunately, consumers have been unable to stop the flow of the control of physician decision-making largely because physicians have increasingly become employees of these organizations instead of independent practitioners. Today there are many, many books available on the high cost of health care in the U.S. and many proposed solutions. This book provides both history and story about how physicians were pushed aside in the takeover of their profession. The only solution is for physicians to take back their practice of medicine. This book is a reprint of the original, before Direct Primary Care offered physicians an opportunity to take back their ability to make health care decisions with their patients. Although first published in 1992, this book provides the history and background which explains why Direct Primary Care is so critical to any health care reform today.

In my 40 years of delivering 6000 babies, my patients have had no eclampsia, no strokes—and no maternal deaths. The information in this book won’t be found in medical school, in medical association recommendations, or in committee reports studying how to reduce maternal deaths. What I learned about safe pregnancies I learned by listening to my patients over my many years of delivering their babies. I offer this information and the stories in this book to help you find your voice in creating the kind of pregnancy and delivery you want.