Thoughts on the Business of Being Born

“Birth: it’s a miracle. A rite of passage. A natural part of life. But      more than anything, birth is a business. Compelled to find answers after a disappointing birth experience with her first child, actress Ricki Lake recruits filmmaker Abby Epstein to explore the maternity care system in America. Focusing on New York City, the film reveals that there is much to distrust behind hospital doors and follows several couples who decide to give birth on their own terms. There is an unexpected turn when director Epstein not only discovers she is pregnant, but finds the life of her child on the line. Should most births should be viewed as a natural life process, or should every delivery be treated as a potential medical emergency?”

Sex education taught me to associate motherhood with punishment; sexual activity during one’s  teen years was “reckless,” a form of misbehavior which had dire consequences. Preventative messages highlighted the “un-glamorous” side of motherhood: absent fathers, poverty, “baby weight,” etc. As a 20-year-old young woman, I have been socialized to fear unplanned pregnancy above all else.  Ten years from now, however, when it is socially acceptable for me to bear children, I will be bombarded with contradictions, i.e., “a baby is a blessing” and “motherhood is the greatest thing that will ever happen to you.” When a woman reaches a certain age, she becomes a pariah if she is childless, but how can she see “baby as blessing” after having already accepted “baby as mistake?”

When motherhood happens too early:

When motherhood never happens:

Prior to viewing The Business of Being Born, my conception of childbirth was misinformed, constructed by bits of hearsay and talk-show testimonials. Popular culture has done little to romanticize the birthing experience; in films and television shows, scenes of women’s labor are either omitted or portrayed as trials of agony. I remember watching Jennifer Aniston give birth as Rachel Green in the NBC sitcom Friends, her tears and appeals for drugs competing with a raucous laugh track, her hair and makeup remaining flawless as she pushed out a perfectly clean three-month-old. It was jarring to see her pain made into comedy and, perhaps, more jarring, to see screaming and crying used as the universal signal of  “a woman in labor.”

Check out the scene here:

Our country’s obsession with making every task faster, easier, and less intrusive has made us unwilling to experience discomfort. We want everything and more than our parents had, but are willing to put in exponentially less effort to be deserving of it. We want Rachel Green’s flawless post-baby figure, but could do without her scream-inducing labor pains. Because painless is preferred to painful, modern women often welcome interventions by medical professionals who are able to expedite the process and achieve the same end result.

There are still women, though, who believe that “the journey is the reward,” who value every month of pregnancy and every hour of labor for its contribution to the overall experience. These are the women who choose natural childbirth; they are amazed by the intuition of the female body, and seek to be an active participant during the birthing process rather than a semi-conscious vessel. In the film, one critic of natural childbirth states “It’s the macho-feminists who like to say ‘I did this naturally,’ but [either way] they’ll be pushing a stroller three months later.” On a math exam, if two students choose the correct answer “B,” Student 1 will receive no more credit than Student 2 if s/he uses a more complicated method to solve the problem. In fact, Student 2 may be praised for his/her ability to produce the correct answer more efficiently. The same should not be true for birth. It is an achievement to “do it the hard way,” not one that women expect to get extra credit for but, rather, a personal achievement. I suspect that a certain self-satisfaction, or sense of empowerment, comes from the ability to say “My body did this.”

The Business of Being Born prompted me to reconsider the meaning of the term “natural birth.” I always assumed that “naturally” was synonymous with (1) vaginally and (2) drug-free. Like the doctors in the film, I failed to acknowledge the emotional and environmental components which make a “natural birth” truly unique. The majority of the natural births featured in the film took place in mothers’ homes, rather than in a hospital. While in her own home, a mother has more control over her environment, and feels more at ease because she is familiar with her surroundings. She is free from the anxiety of giving birth in a “private” vs. “semi-private” vs. “shared” space, because her home is her own space. Hospitals possess an innately fast-paced environment, because they are public facilities which have many patients to see in one day. For this reason, doctors must learn to manage their time efficiently. Mothers who want a one-on-one relationship with healthcare professionals should steer clear of hospitals, because hospitals are simply not organized to run that way. Often times, mothers see nurses or nurse practitioners more often than their obstetricians. A midwife has fewer clients than doctors do patients and, therefore, can provide them with more personal care. Midwives are able to make home visits and spend hours with mothers discussing the birth plan and setting up the birthing space.

Another advantage of home birth is freedom from hospital protocol. The     most shocking part of the documentary, for me, was the realization that when a woman gives birth in a hospital she has very little control over her own body. Also surprising were the number of accommodations made for doctors, and disproportionate number made for the comfort and convenience of the mother. In hospitals, women are often urged to compromise their original plan for the convenience of the doctor. If labor lasts longer than the doctor wants it too, the mother may be pressured to take Pitocin when she had previously decided against induction. Women are also forced into the “legs over head” position which restricts their movement, but is easier for the doctor. In a hospital setting, birth is standardized so that it becomes an easily replicable, error-free process. Doctors establish “standard procedures” so that can protect themselves from being held accountable if something goes wrong.

For further insight into birthing in America, Birth Story: Ina May Gaskin & the Farm Midwives is a must-see; watch the trailer here:


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