By Jill Arnold
In 2010, a California-based reporting initiative called California Watch contacted me about sharing the analysis one of their reporters had conducted on practice variation, namely utilization of the cesarean section, in California. I e-mailed Nathanael Johnson, the reporter who analyzed the data for California Watch, last week about his new book, All Natural*: *A Skeptic's Quest to Discover If the Natural Approach to Diet, Childbirth, Healing, and the Environment Really Keeps Us Healthier and Happier, and asked him a few questions.
Nathanael, I was introduced to your work when you published the story for California Watch in 2010 on how for-profit hospitals in California perform more c-sections. Did any of that research prompt you to write the book?
I did a series of three stories for California Watch that year and I was already thinking about a book along those lines when I started. When I started my reporting on birth I learned the maternal mortality rate had actually started going up in California, and that was the clincher, I knew I had to write about that. It was so counter-intuitive: We live in this era of technological unbelievable promise, by the day after tomorrow your smartphone will be cooking you dinner, everything gets faster and better every day. So how does that square with women not doing as well in births? I wanted to find out. The result was the California Watch series, and the beginning of my book.
Tell me about some of the interesting birth professionals you came across in your research.
I got to talk to a lot of very sharp, very admirable people. Doctors like Elliott Main, Aaron Caughey, David Lagrew and Tracy Flanagan who are working to sort out the details of improving care in California. I visited Ina May Gaskin who is a legend and just whip smart and fascinating. And I did so many interviews with people who impressed me that I lost count. But maybe the most interesting person I met was someone I didn't end up putting in the book due to structural constraints - maybe because she deserves her own book. Her name is Faith Gibson. She was a L&D nurse in a segregated hospital in the South when she was young, and she got to see the difference between the white women, who got the benefit of all sorts of drugs, and the black women who were pretty much left to take care of each other. And Faith saw pretty quickly that the black moms and babies were doing considerably better. She went on to become a midwife in California and was actually arrested for practicing, handcuffed the whole nine yards. She's written voluminously about all of this and it would probably be a great book if you got an editor who could boil it down to one cohesive story.
My audience is a mix of consumers, midwives, doctors, childbirth educators and what seems to be a somewhat higher than average proportion of parents who want their pregnancy and their baby's birth and upbringing to be, well, "all natural." What do you think might surprise them about your book?
Well, that sounds like me, so I suppose it would be the things that I found surprising. I was surprised to learn how new this epidemic of asthma and allergies and autoimmune diseases is - these problems went from nearly non-existent to ubiquitous just in the last generation. I thought that there would be some blind spots in the medical orthodoxy regarding vaccinations, some kernel of truth behind that fear, so I was surprised by the strength of the evidence on vaccine safety. There were tons of cool bits of science that I found surprising, like the evidence that cholesterol in breast milk may tune the infant's internal production of cholesterol to a healthy level. And I suppose I was just surprised that in writing about nature I was left feeling, not depressed, but hopeful and excited about the future.
Nathanael Johnson can be found all over the country in the next few months talking about All Natural, including an event with his mentor, Michael Pollan, this Thursday in San Francisco.