From The Practising Midwife Volume 11 No 5 May 2008
The Business of Being Born (DVD)
2007, Ricki Lake (Executive Producer), Abby Epstein (Director)
www. thebusinessof beingborn.com
Ricki Lake, well known as an American talk-show host, started this project after a high-intervention first birth and deciding on midwifery care and a home birth the second time around. She approached filmmaker Abby Epstein, who also became pregnant over the process of the filming. The result is an honest look into the state of birth for American women in New York at this time.
The documentary addresses the contrast between birth in hospital, controlled by obstetricians and insurance companies, and midwifery care provided by midwives in birth units and home settings. The film follows a New York-based home birth midwife as she goes from birth to birth. This is profoundly in contrast to the stark realities of the hospitals' induced labours, epidurals and caesareans. Ricki's second birth in water is seen, as well as the labour of the home birth midwife.
The footage is interspersed with discussion with various midwives, activists and academics including Michel Odent, Robbie Davis-Floyd, Marsden Wagner, Ina May Gaskin and Patricia Burkhardt. What they say highlights the tragedy of what has happened to American birth over 50 years and what could be done to make it better. As I watched the film I couldn't help 'feeling' distressed for the women as I listened to their stories of their birth experiences and wondered how prevalent this really is in the UK. The historical reminder of how women were treated during the period when 'twilight sleep' was the norm is particularly disturbing. The high induction rate is discussed but it struck me how the women themselves describe the 'snowball' effect of intervention. How many times has this been written about since the 1970s? How many more times before we take notice? And then you have the pictures of women trying to give birth flat on their backs.
Incidentally, I watched part of this with my 15-year-old daughter who periodically shouted at the screen! She commented: "I am so glad I was born at home and I want to have my babies at home!" Significantly, she also shouted at the doctors and said they ought to be better trained - how right she is!
I would recommend midwives to try and get to see this film. There are some showings taking place in the UK now and the DVD will soon be available to buy from the website. It will hopefully make you think about where birth is going here in the UK and inspire us all to take steps to stop the intervention rate. The irony is not lost that the film maker ended up needing some assistance to give birth. In this situation there were no 'heroics' on the part of the home birth midwife but a definite decision to admit to hospital. In this situation it clearly shows that midwives are skilled to know when help is really needed and when CS can save lives. Let's not lose skills and regain others to ensure the best for women.