The Business Of Being Born

2008, Movie, NR, 87 mins


Resist the urge to dismiss, sight unseen, this documentary about childbirth in the U.S. as executive producer Ricki Lake's vanity project. Directed by documentarian Abby Epstein — whose own pregnancy shapes the film's dramatic conclusion — it's a serious and well-researched consideration of natural childbearing vs. hospital delivery that explores the larger social conditions and assumptions that shape women's choices.

Lake, the mother of two, became interested in the maternity industry after bearing her first child, a disappointing experience that left her feeling bulldozed by a medical system that treats pregnancy and labor as ticking time-bombs of potential medical catastrophe. Epstein's film delivers alarming facts and figures: Midwives attend nearly three-fourths of births in Europe and Japan, but fewer than eight percent in the U.S., which spends twice as much per birth than any other country in the world yet has the second-worst newborn mortality rate and one of the highest of maternal death during childbirth. Insurance companies resist paying for certified midwives (most of whom are also registered nurses) — whether they provide in-home or birthing-center services — even though they're less expensive and at least as effective as hospital-based OB/GYNs. Epstein attributes the American way of birth to a combination of technology worship, for-profit health care, paternalistic medical attitudes stemming from a "public awareness" campaign launched in the early 1900s (it branded home birth as primitive and dirty, hospital birth as modern and progressive) and the cover-your-assets mentality fostered by malpractice suits. Female OB/GYN Dr. Eden Fromberg recalls being advised that cesarean sections are a hedge against lawsuits, because "[Patients] can never fault you if you just section them," which goes a long way to explaining why, by 2005, one American woman in four underwent a cesarean birth.

Much of the history of American obstetrical care, the film contends, is the history of making labor easy for doctors: Gurneys that placed women flat on their backs were bad for birthing, but convenient for medical personnel; drugs that hastened labor (but necessitated powerful painkillers) spared doctors the tedium of waiting out lengthy deliveries. The film's most horrifying archival material involves the "twilight sleep" of Scopolamine, a drug introduced in 1902 with the promise of childbirth without pain. In fact, it just left women (and their newborns) groggy and prevented the formation of memories; women who flailed in helpless agony were restrained and blindfolded. By contrast, extensive footage of women — including Lake herself — giving birth at home with midwife Cara Muhlhaun, a former obstetrical nurse, depicts a process that's clearly painful and exhausting, but driven by the mother's desires and biological rhythms. Throughout, Epstein interviews a range of doctors and midwives, and refrains from painting either in black and white: Muhlhaun admits to drug-craving panic during her own difficult delivery, while two OB/GYNs who reject home birth also deplore the rising cesarean rate and pop-culture factors — terrifying labor scenes on TV and in movies, the celebrity culture of "too posh to push" — that make women dread giving birth. In all, the film provides a great deal of food for thought. leave a comment --Maitland McDonagh

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The Business Of Being Born
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