Baby Business

Where do you plan to give birth? It seems a strange question with an obvious answer for most women, who would never dream of going anywhere but a hospital.  The Business of Being Born addresses the growing numbers of women who are opting for home births attended by midwives. The film is a fascinating look at America’s perception of birth, and the misconceptions surrounding midwives and their practice. The inspiration for this documentary was based on co-creator Ricki Lake’s own experiences with both hospital and home births. After finding her first experience in the hospital overwhelmingly negative, she began doing more research into birth alternatives and ultimately deciding to have her second child at home with the help of a midwife. Lake enlisted her friend, director Abby Epstein, to help create this film and show women with low risk pregnancies that they have a choice.

The Business of Being Born presents a strong pro home birth perspective. Although it does not vilify hospital births, it does present several aspects as problematic. The overwhelming majority of women in the United States give birth in a hospital under the supervision of doctors, which they perceive to be the safest choice. While obviously this is the case for women with high-risk pregnancies, it is not clear that this is the best route for low-risk pregnant women. For instance, despite nearly all births taking place in hospitals, the US has the second worst newborn death rate in the developed world, with one of the highest maternal mortality rates among all industrialized countries. Once admitted to the hospital, 90% of mothers receive birth augmentations and currently 1 in 3 women will end up having a Caesarian section. The majority of these surgeries only become necessary due to the domino effect of the drugs, such as Pitocin, administered to labouring women. Although C-sections seem commonplace, there is no mistake that they are major surgery, leading to increased rates of infection and possible complications later in life. These statistics seem to fly in the face of the common assumption that births attended to by doctors in hospitals are “safer”.

The film features several pieces of footage from successful home births, including Lake’s own. Most importantly, several misconceptions regarding midwives are cleared up. There are two doctors interviewed in the film who express their doubts about midwives, particularly that they are not properly equipped to deal with emergencies, should they pop up. However, they admit that they have little first hand knowledge of midwife practices to back up their opinions. The midwives in the film contend that they put all prospective women through intense screening processes to determine if they are good candidates for home birth, are highly trained and well equipped, and keep an eye out for red flags so, if need be, they can decide to send their patient to a hospital for support.

Lake and Epstein have infused this film with their passion, providing both a wellspring of information, as well as equipping their film with an emotional core. The various birth stories were touching, and I often found myself smiling and laughing out loud. Sadly, it can’t all be sunshine and roses. The film presents many expert opinions from doctors, midwives and researchers in the medical field, the majority of whom are pro home birth. Many of their arguments are based in fact, though there are a few points that seemed a little off. For example, a portion of the film addresses the ‘authentic’ experience of all-natural birth. It sets me on edge any time the term ‘authentic’ is thrown around. Authenticity can mean a great many things to people. What does it mean to have an inauthentic birth? Does it mean that you are not a real mother, or less of one? The question of authenticity seems absurd in this context.

There was also a brief nature/nurture discussion towards the tail end of the film, in which a doctor seems to suggest that because fewer mothers are giving birth naturally, (and are subsequently missing out on the crazy chemical cocktail of love juice their brain would produce) they are somehow less attached to their infants. It’s a suggestion rather than a statement of fact, but I found it disturbing nonetheless. To suggest that women who miss out on this chemical boost, such as those who have Caesarian sections, or are adoptive mothers, are less attached to their children, or have to work harder to love them, is bizarre. Although The Business of Being Born stumbles during these rough patches, they are not big enough flaws to overcome the strengths of this documentary. In the end, this film accomplishes what it set out to do: educate its audience about birth alternatives, and clear the air of misconceptions that surround the practice of midwifery.