The whole process of the actual delivery is something a pregnant woman spends a lot of time thinking about. The unknown causes a lot of anxiety, and that fear can lead you to believe that birth is a very clinical experience. I admit, I was of that opinion and never considered a midwife for my own labour experience. This very graphic documentary, produced by Ricki Lake, did not change that. What it did do, is raise some very interesting questions about the way birth is portrayed in the media, and how science of the delivery is actually practice in the United States. The message began with tangible numbers, and personal anecdotes, but ended with a harsh and emotional-fuelled assault on hospital birth that I found distasteful. Here's my full account of "The Business of Being Born."
The film starts with some pretty staggering facts, including that 70% of births in Japan and in the United Kingdom employ a midwife, whereas the the number in the United States is less than 8%. In fact, the use of home birth in the US has seen a tremendous decline in just over 50 years. From 95% in 1900 to less than 1% in 1955. I find that difference remarkable, especially given the later stated math on cost. At the time of filming, a "spontaneous, vaginal birth" cost in excess of $13,000 done in hospital, while a mid-wife claimed her fees for the entire process, including pre-natal care and facility fees, would be around $4,000! The trouble of opting for the less expensive method is the ensuing insurance claim, which was made to look gruelling, if not practically impossible. I can see how these numbers would scare Americans, especially those in low income brackets, but as a Canadian viewing this film, the cost is all but irrelevant.
The thesis of the film seems to be that a midwife offers you a lot more control over your birth experience than a doctor (granted), and that should be something we all want for the natural bonding implications. I'm not sure they convinced me of the later part of that statement, but control is very lacking on a bed in a delivery ward. Some of the evidence they show of hospital births are damning. In one scene, a doctor told a woman in a rather cold fashion "Remember, no crying. You gotta breathe, okay?" Several clips of births with "interventions" by hospital staff certainly play into that traumatic, sensational, ER version of birth you see on television. Nurses giving women deadlines on how long they had to push, and dosing medication after medication for everything from contraction management to pain reduction. By comparison, the home water bath and birthing centre did seem more civilized and calm. This is one of the strongest points put forward; feeling scared, and being given "expert" opinion does make you question your body and your ability to deliver in the manner in which you want. So called "choices" in hospital are really just instructions while you are in such a compromised state of body and mind.
|An image of a restrained woman about to deliver used in the film|
That second part of the film's central premise - that we should desire to control our birth experience, and the essential emotions it produces - goes too far on too little in my opinion. While, as Ricki at one point says, childbirth is "not an illness," they overtly suggest that women that choose a doctor, medication, c-section, etc are not experiencing the natural chemical reaction necessary to create a loving bond. The pain/ pleasure euphoria that ensues after a natural (read: midwife assisted) birth supposedly generates an essential reaction crucial to attachment. I was shocked to the point of being a little offended. After nearly two hours of encouraging women to take charge of their own bodies and have the birth experience they want, they then back track telling you that the only kind they should want is natural, with a midwife. They insult women as "too posh to push" and bring up heinous examples of medical horrors such as thalidomide and 1920's birth restraints to really send home their point. It's cruel to women who have had medically necessary c-sections, and those who, after having done their research, chose an OB/GYN.
I did learn a lot about the options available to women in terms of the delivery process, and it did have moments of truly empowering information. While I was not convinced that they proved their point, I do agree that women should trust in their bodies and pursue a delivery that suits their individual needs, be that a home birth, a natural birthing centre, a hospital, or otherwise. You do not need to expect a traumatic birth experience, and you do have a choice as to your practitioner, your medications, and your limits. As graphic and hard to watch as this film can be, I highly recommend it for women unsure of what direction they would like to take - just take the message with a grain of salt.