The Business of Being Born

This documentary portrays well the reality in which doctors induce hospital deliveries for practicality and financial reasons. Very well directed and with a fascinating script, I had the honor of participating in the documentary with my wife, from images given from the birth of my first daughter.

Everyone in America should watch this film, especially fathers and mothers-to-be.

As a father of two babies delivered by Caesarean section, my real life experience reflects what this film presents. With a first pregnancy, men like me might trust a maternity and birthing health care system that obviously is accepted by everyone we know. As an engineer and technologist, I am attracted to statistics and procedures, I am attracted to managed systems and to logical decision-making. And I understand that giving birth involves a lot of money, and that doctors, hospitals and health care companies have a burden in how to run a successful enterprise.

But the American birthing system is missing something very important... our humanity, our sensitivity, our vulnerability. Ricki Lake and Abby Epstein reveal the vulnerability of father, mother and child during pregnancy, how easily we allow a managed system to make decisions in the name of our well-being. When faced with an overwhelming majority of our family and friends who know only one way to give birth, in a hospital, there is little room for anything else.

This film challenges what we assume works, and informs us that there are alternatives accepted everywhere else in the world but in the United States. I pray that other mothers and fathers-to-be, for the sake of their children's' psychological and emotional health, will step up to the plate, become informed consumers about what is happening, and consider a traditional birth, at home.

Your first step is to see this film.

This movie is terrific. I had my doubts when I learned it was produced by and starring Ricki Lake, I admit. But it is sensitive, interesting, intellectual, captivating, and incredibly moving. It was not manipulative, but by the end, the entire audience was in tears.

The most important thing about this film is that it shows the public what birth can be, for both the mother and baby. You see several homebirths, nothing too intimate (unless you consider the incredible post-birth high that somehow permeates the screen and affects the viewer, to be too close for comfort). No dilating vaginas or body fluids, sorry to disappoint. But what it does show is something that almost no one, especially not doctors (I am one), get to see. A natural birth with no intervention where things go right. Shocking! In my medical training, I attended hundreds of births. I probably saw one or two with no medical intervention in the hospital. My hospital birth was normal, with no problems, but I had interventions despite having told my OB (and mentor) that I didn't want any.

It does not idealize birth per se, except by showing how simple birth can be without medicalization. But the volunteers of this midwife to be filmed were not excluded if there is a problem; one of the births requires transfer so you see how that is handled as well.

The film educates people about the history of birth in this country, how things are done in other countries including Europe, and shows statistics about birth (there are more than they include in the medical literature) that will probably surprise a lot of people.

I wouldn't say that the film is about Ricki Lake. She shows up here and there, and yes, she gives birth, but there are so many women followed here, and so many experts in birth interviewed.

Dr. Michel Odent is one of them. He is a French OB/Gyn who attends homebirths. He has done considerable research on birthing, and has written multiple very intelligent books about it. He brings up the idea that when a rat or a monkey has an epidural or C/S, they will not bond with their babies. They will not breastfeed, they will not mother them, they do not care for them. There will be no natural hypothalamic oxytocin release, which causes a release of norepinephrine, dopamine, prolactin, serotonin, that prepares a woman not only to breastfeed but to bond. The oxytocin release in this situation will never be replicated, even if the women breastfeeds or does infant massage (which both do cause oxytocin release but not in the same amounts as if you start off with this kick-off). As breastfeeding lowers breast cancer rates in women in a dose related fashion, oxytocin release over time is associated with a certain calm, lower levels of stress, but actually is dose-related to lower levels of stroke and heart attack in the mothers. So it is a long-term benefit of natural birth. This is touched upon in the film, among many other interesting facts.

It is not surprising to discover that doing things the way women are created to do them benefits both the mother and baby in so many different ways. Part of why this movie is so important is that it challenges the notion that man-made is better than the intricate design of man from God or evolution or however you want to approach it. Many people may not subscribe to it when it is stated like that, but in the food we eat, the we feed our babies, the way we grow our food, the chemicals we use in the environment, and the way we birth our babies, we are saying that every single day.

Common sense says that man-made leaves a lot to be desired. Science is proving this every day, in research about omega-3 requirements in neurological and other conditions, in breastfeeding and oxytocin literature preventing cancer/heart attack and stroke, to the benefits of breastmilk for babies. This movie is a peek into how doing things as nature intended is BETTER.

I don't feel I am exaggerating when I say that this is one of the most important films of these times for both men and women. Everyone should see it. You may not decide to have a homebirth afterwards, but you will walk out better educated about birth and what is happening in the hospital when you give birth.

Informative? Sure. Gives a new perspective on a broken system? Definitely. Entertaining? Er ...not really.

After talk-show host Ricki Lake experienced a bad childbirth in-hospital, she decided to try a midwife, and thus THE BUSINESS OF BEING BORN was ...um ...birthed. I can't help but think that some of this (not all) was a ploy by Lake to put herself back in the public eye; specifically, the movie industry. Although this is strictly a documentary, and other actors support various causes (from freeing Darfur to Tibetan independence), this one felt a bit more forced.

The reason I say this is that the entire documentary was exceptionally boring and exceptionally lopsided. I work in the medical field (as an RN) but not in an Obstetrics setting. I can, however, vouch for the terrible cost of healthcare and some of the impersonalness of those giving it (as this documentary pointed out). I've heard doctors talking about "tee times" on the golf course and the need to "get home by dinner," so time is a big factor for physicians (the film pointed out that C-section deliveries peek at 4pm — just prior to dinnertime — and again at 10pm — so doctors can get home to bed). Be damned whether the patient needs a C-section or not, doctors force the decision so that they can "get on with their lives." Cut and run! Even with its interesting take on the care of OB/Gyn patients in the U.S., the film never delves outside of the States even though certain statistics are presented (including telling us that the infant mortality rate in the U.S. is one of the highest amongst developed countries). I would've liked to have seen at least one interview with a Japanese midwife or a European midwife, and have them show us how their system works. But we're never give the opportunity to see this for ourselves.

The boring nature of the film is that it never really finds its focus. Although the title of it is The Business of Being Born, it focused more on the plight of midwives and their care of expectant mothers at home or in midwife clinics. We drive around with midwives, trot down the road with midwives, listen to midwives talk on the phone to patients, and get to watch a couple of in-home births. Then we start the entire process over again.

And there's also a brief and confusing stint in which we learn one of the film's producers is pregnant and trying to decide on prenatal care.

All-in-all it's an informative story, but one that might cause a few too many yawns.

Like any good piece of propaganda, this movie starts by demonizing the OB/GYN profession (the enemy). The viewer is bombarded with images of early-20th century birthing practices as if they were still in use today. Having hospitals (and of course, insurance companies) set up as the "bad guy", the movie portrays the alternative (midwives) as the "natural" solution. Moreover, home delivery is portrayed as the only real choice for a woman to express her femininity and individual power.

A few hand-picked critics of hospital births are chosen, who promptly spew out some convenient statistics in support of home delivery. Correlations (like infant mortality rates) are presented as causality without even discussing other potential factors. For example, the movie likes to recite the infant mortality rates in the US as being higher along with the higher rates of hospital vs. home births in other industrialized countries. However, at no time do these "experts" note factors like the relative experience levels of midwives in Europe vs. the US. Nor is a qualitative assessment provided that compares the level of care offered. Further, factors like miscarriages are not even discussed (if there are higher rates in Europe then these babies would not be reaching full term, thus diminishing infant mortality at birth), nor are other elements like obesity discussed (the US is the fattest nation of fatties in the world).

One of the things that stood out to me was the frequent use of absolutes in their arguments: "There's no scientific evidence" to support hospital delivery as better than home deliver, etc. etc. Nothing even close to resembling counter-arguments were presented, making this documentary Michael Moore worthy in its biased presentation of its content.

It's a shame something so delicate has been treated with such utter disregard for good science and disinterested research. The movie maker had a clear agenda and presented a completely one-sided argument. If you disagreed with home birth, you simply are a brainwashed fool ready to submit to fake doctors posing as OB/GYNs.

Perhaps the most hilarious part of the movie came at the end, as the filmmaker went into labor one month early with a 3.5 lb baby who was in the breached position, umbilical cord wrapped tightly around its neck, as her water broke in a taxi cab as she was rushed to the ER. In spite of this, the filmmaker mused a month later "I think I would have been OK at home." Wow.