As Karkowsky notes, rather than providing an exhaustive guide, she is sharing a collection of stories (with details changed to protect confidentiality) that are loosely organized to follow the chronology of a pregnancy. Just the same, she provides a great deal of helpful information, carefully explaining an alphabet soup of acronyms, such as VBAC (vaginal birth after cesarean) and TOLAC (trial of labor after cesarean). And in nonmedical terms, she spells out why some pre-existing conditions in pregnant moms can lead to problems ... It’s reassuring to know that maternal deaths are rare and that doctors try so hard to help at-risk moms and their babies beat the odds.
Karkowsky candidly acknowledges the ongoing problem of implicit bias and its harmful impact on black patients. This well-written narrative is moving and medically dense. Clearly not a simple pregnancy manual for the average patient, the book provides vivid insights into the more intense aspects of reproductive medicine ... Karkowsky raises important issues concerning patient autonomy and the treatment of women in the health care system. For those who enjoyed Perri Klass’s The Real Life of a Pediatrician and anyone interested in the challenges of modern health care.
In addition to graphic accounts of complications, Karkowsky also examines how pregnancy care is evolving—not always for the better ... A solid primer on pregnancy risks as well as a cogent plea for progress to make childbirth even less perilous.