Last night I went to see this film, The Business of Being Born, at a women’s showing sponsored in the community.  I was ambivalent about attending, since I saw it would be followed by a panel discussion of an ob, nurse midwife, and lactation consultant, and was very skeptical about the value of that discussion.  But yesterday was an emotionally hard day (not because of dealing with my children, but dealing with an adult who acted like a child – not a family member!), and I finally in the afternoon decided I’d like to get out.

I very much enjoyed the film, which was made by producer (?) Rikki Lake.  She had a typical medicalized hospital birth with her first, which was very unsatisfactory, and led her to explore birthing, to learn lots more about it.  That was followed by a wonderful home birth, following her exploration of various aspects of current birth technology and how it affects women.  She shared some of those perspectives and information in this film.  But it’s not an intellectual movie; it doesn’t promote a specific agenda but does give a nice picture of home birth as being a viable and good alternative.  Which I of course like and feel is important, since women need to know that there are other options than hospitals, and that home births aren’t just for hippies or those who have no regard for the safety of their unborn children (roll eyes).

But the discussion after the film – oh, so not worthwhile and very frustrating to sit through.  The ob, though very nice and clearly much more openminded than most, gave a very good medicalized point of view, one that I think was very comfortable in its familiarness to most of the women there and reinforced some unhealthy attitudes rampant in society that birthing women have bought into and don’t serve them well.  I was really trying not to grimace or outwardly show my disgust.  It was such a perfect venue for an open discussion of options that women may not have considered before, and the presence of the ob, in my opinion, shifted the focus away from that to dismissing the film as nice but unrealistic and overly negative about medicalized birth. 

I was so glad that the lactation consultant was there, because she added a very necessary balance to the discussion – like when the ob said she used to back up a birthing center, but they stopped doing it because by the time women who needed it were transferred to the hospital, they were ‘train wrecks’.  To which I was thinking that there was a major assumption being made, that no one in the hospital is a train wreck, when in fact perhaps the majority are.  And bless her heart, the l.c. said, the hospital she worked in has a c-section rate of 45% and serves an affluent and highly educated population – and to imply that hospitalized birth avoids that is simply false.  I later thanked her and said that she added some necessary balance and she told me she found it very frustrating to participate in the discussion.  But at least she could say something – I really, really wanted to jump onto almost every point made by the ob and ob resident in the audience to supplement the missing info.  I only one time interjected a comment, when the ob said that based on studies done in Ireland, they ‘know’ that active birth management improves the birth outcomes, and used that to justify current birthing practices (specifically, to justify inducing labor at 38 weeks for ‘high risk’ mothers).  To which I had to add that a critical part of those studies was that every woman was provided with a doula to support and encourage her from the time she entered the hospital throughout the entire birth – to ignore that factor negates the value of the information gathered in that study.  (Unfortunately, I forgot to mention that another very crucial factor in that study was that the active management of labor began only after a laboring mother reached 4 cm – very different from inducing two weeks early with no signs of labor being imminent.)  The ob nodded to admit that what I said was correct.  Oh, the challenges of being highly educated about birth, and having the personal experience of being a doula for many women, and a childbirth educator for others, and seeing the difference information and empowerment can make – and then having to sit there silent listening to people being sold a bill of goods.  Sigh.

I started reading The Unborn Life of a Child recently, something I haven’t read for years, and I was struck by how outdated the statistics are.  The book was written in the 70s, and the author wrote with concern about rising intervention rates (eg 15% c-section rates), increasing use of technology, and I keep thinking how we’re actually moving backwards into the dark ages of birthing, while thinking we’re so advanced.  Because thirty years later, our statistics are drastically worse than when this book was written, but we’re under the impression that we’re moving forward because we do it with the help of so many bells and whistles, and women really think they are doing the utmost to keep their babies safe, not realizing how many of those ‘improvements’ and ‘advancements’ have decreased maternal and infant mortality in the US (and how many are about money, convenience, and avoiding lawsuits).  Even the ob last night said it’s an embarrassment to the medical community that the US  ranks last among industrialized countries in these crucial statistics.

Anyway, I think the film was just released on dvd, and don’t know about general availability to the public, but if you have the chance to watch it, I think it’s a nice balance to the typical of picture of birth that is presented just about everywhere – on tv, in the movies, when you listen to conversations in waiting rooms…..  I’ve had eight children, and none of my experiences ever matched the picture that is broadcast everywhere.  Actually, when I got to the hospital with my first, I was at 8 cm, which I couldn’t believe – I kept waiting to be dying from pain, and I was managing and I wasn’t yet dead, so I thought I wasn’t so far along.  I’m not joking or exaggerating about that.  I had always heard there is no worse pain, seen women on tv screaming and rolling back and forth in agony, begging for help, and though I was pretty uncomfortable, I was grimacing during contractions – not screaming, not shrieking, not begging for my mother.  And then the birth was over, and I found out first hand that the worst part is what no one tells you about – how you’re just a body, how your wishes are disregarded and you’re unimportant, how you have no privacy or right to say anything about the birth experience once the medical caretakers have decided what they want – and that they won’t even notify you of what they’re doing or why, even though legally and ethically it’s required.  But for baby #2, I thought that was normal and there was nothing I could do about it, except get there as late in labor as I could, and block my mind to how I was treated.

But then I actually got myself more educated during my third pregnancy (took a typical childbirth class with my first that basically prepares you for what will happen at the hospital, didn’t give many tools or enough alternative information to provoke any thought), and wow, did the quality of my births dramatically shoot up from #3 and on!  I had #3 and #4 in a hospital with the most friendly birthing practices around, and then went on to home births from there – and the experience just can’t be compared to a hospital birth.  No matter how nice the staff, how friendly and supportive, it’s not the same as when the caretaker of your choice comes to you, in your environment, when you want them there, and is available to you in the way you want them to be there. 

Some people think that someone choosing a home birth cares more about the ‘experience’ than health and safety, but in actuality, home birthing moms are highly educated about birth, far more than the average mom, and have done a lot of research before coming to that decision.  That’s the nature of making choices that are unusual and that don’t have wide support – it forces you to educate yourself and start sifting through what is fact and what is propaganda.  They know that statistically, the maternal and infant mortality rates are much lower for home births, with significantly better healthy outcomes – and that doesn’t include the emotional satisfaction that is much more important than currently recognized.  After all, birth is a life changing event – every woman remembers every detail of her births; the imprinting is so deep and powerful, and the significance of a negative or positive birth experience will stay with her forever. 

There’s no question that my first home birth, my fifth child, would have been a c-section for failure to progress.  And for 2 of 3 of the next home births, my water broke three days before I gave birth, and I would have been induced after 24 hours.  Had that induction failed, I would have have a c-section for each of them.  That’s three c-sections out of four births avoided by being at home with a qualified and well educated midwife who understood the natural birth process, who was comfortable with different labor patterns that didn’t match the ‘norm’, who knew how to monitor a woman and baby’s health and make sure all vital signs were fine and to let time take time since all was otherwise fine.  Most women in the hospital will never have the luxury of birthing without having the clock ticking on them, and that leads to a lot of unnecessary and damaging interventions, that are justified by ‘we have to do what is best for the baby’.  Which ignores the fact that without these interventions, in the majority of cases the baby and mother wouldn’t have been in danger in the first place!

Now you see why I  never write about pregnancy here – there’s too much to say and I try not to think about what goes on out there and the damage it’s doing to women and babies.  If someone speaks to me, I give them information, but that’s only suitable one on on.

Avivah