The Business of Being Born
The Business of Being Born is a 2008 documentary film that explores the contemporary experience of childbirth in the United States.
Produced by Ricki Lake, it compares various childbirth methods, including midwives, natural births, epidurals, and Cesarean sections.
The film criticizes the American health care system with its emphasis on drugs and costly interventions and its view of childbirth as a medical emergency rather than a natural occurrence.
The film documents actual home births and water births. They follow a midwife, Cara, in New York as she takes care of and attends several births.
They then give the audience several shocking statistics about our current birthing techniques and challenges today's doctors.
For example, the United States has the second worst newborn death rate in the developed world. Many experts are interviewed and they cite a multitude of reasons for this dismal statistic such as the overuse of medical procedures in the interest of saving time.
Another RN here. I worked in labor and delivery for 7 years. Sorry the following is long, but there are many complexities.
I began my L&D years in a rural hospital. We had family practice physicians, no OB/GYNs. The community midwives were experienced and when they did transfer women to the hospital, it was due to mom or baby soon were going to need emergent care soon. The majority of the time mom was exhausted, needed a nap, and opted for medication to get some rest. Typically we gave them an intramuscular injection of morphine and Vistaril, a relative of Benadryl. Mom got a nap. About 3/4 of those women then went home and delivered with their midwife, without any negative outcomes. If the baby or mom were in trouble medically and the midwives had performed their duties to the full extent of their knowledge and experience base, or if mom elected to stay at the hospital, our doctors usually allowed the midwives to do the cervical checks and assist with the delivery. The midwives didn't have privileges in our hospital, so their involvement was at the discretion of the doc.
In my four years in that rural hospital, the stats were excellent (and they continue to be)when compared to those in the cities. Our first-time C-section rate was 11 %, epidurals 35%, and 3 transfers of home-birthing women in labor, to the hospital, none of which required a C-section. The caveat here is we only had "low risk" patients, as women with high risk pregnancies were cared for in a larger community and hospital about 40 miles away. In addition, 92% of the moms and babies went home breastfeeding (we simply showed the moms that planned to formula feed that they *could* breast feed, and often they opted for the breast instead of the formula because they had the new confidence to breast feed). Our community had an incredible 6 month breastfeeding rate of 68%, the highest rate per capita in the US at that time
All of these wonderful stats were due to respect. Our doctors respected the nurses. Our doctors and nurses respected the midwives. Our relationships were collegial rather than hierarchical. Our docs respected the fact that women have given birth for thousands of years and mortality rates increased with the advent of the medical model in the Victorian Era. Our docs' approach was to be hands off, to intervene only at the request of the laboring woman (if she wanted an epidural, for instance) or if there was an actual medical reason to do so.
We also had an excellent Clinical Nurse Specialist/Department Manager. She ensured that all of us nurses were trained doulas an lactation counselors. We were also certified neonatal rescuscitation providers (this skill was rarely needed). We knew how to support and comfort a woman without the use of medications, for those that didn't want them. We knew how to support and comfort women who opted for interventions and medications. We respected and cared for women regardless of those choices because those choices were theirs to make. This was all in addition to the standard roles of any other labor and delivery nurse.
I moved to the city after that, and was dismayed to find what I had previously heard was true. The birth centers were assembly lines and the majority of inductions, C-sections, epidurals, internal fetal monitoring (a coiled wire is screwed into the baby's scalp), artificial rupture of membranes, and numerous other interventions were determined by the doctors and were centered around what was convenient for them, not the women. Epidural rates were 90+%, 1st time C-section rates were at approximately 50%. Breastfeeding was 10-15%. It was appalling and so sad.
Whenever a woman came in with a written birth plan and/or wanted to have an unmedicated labor and birth, the nurses would report that to the oncoming nurse, and had already pulled out the C-section paperwork packet for the woman. The nurses didn't know what to do with these women. They hadn't been trained to do anything other than intervene intervene intervene whether it was medically warranted or not. I was always assigned those laboring women, because I did know what to do for them. The other nurses would joke that I had come from a different planet because of this.
I eventually left the specialty after 3 years on the production line. I couldn't do it any more, knowing how it could be done, how it should be done. I miss it, but not on the city side of the Puget Sound. If I had remained in that rural town I am confident I would still be doing the work I loved so much.
The reality of labor and birth is that this is a natural process, not medical, for the vast majority. If it wasn't, none of us would be here. There will always be exceptions to generalizations and majorities, so of course some will disagree. I see the solution to the issues that are prevalent today is the doctors need to be educated to keep their hands off until there is a damn good reason not to. The nurses need to be educated to care for women who are in pain, who make noise, who get primal as they experience this amazing process. I have found that fear is often eliminated when replaced with knowledge. The doctors, nurse, and the public need to the knowledge to change the current medical model and the birth culture . Until that happens, we'll be stuck where we are.
My first grandbaby will be born in my home in August.
Hey..actually midwife attended homebirths have continuously proven to be safer (for healthy and non-complicated pregnancies) than hospital births with only a 4% c-section rate. Many midwives have hospital privileges to facilitate transfer in the case of an emergency. Overall- do what you want to do. Research your options and choose what you deem best. Just know that if you get to choose hospital birth and the interventions (necessary and unnecessary) that go along with it, than someone else will get to choose homebirth-and that's OK. No need to judge and convince. These are internet comments, not the World Health Organization meeting notes. ;)
Do what you think is best and have a healthy baby in the process! (and hopefully a fulfilling and satisfying birth experience as well.)
Oooh wow, a "registered nurse" says "yuck" to Nature. I guess that completely dismisses all of that! All the thousands of successful stories of Natural births completely dismissed as "unintelligent women." I honestly think it was a low blow for that so-called nurse to claim "any INTELLIGENT woman would want to choose US" Hmm.. appealing to the human ego, I see. So a woman who wants her vagina prodded by stranger men and treated like "just another piece of meat that's paying us" is considered INTELLIGENT whilst getting injected by who knows what, knocked out, (possibly even molested while she's unconscious lol) but hey, having no conscious = intelligence, right. Makes 100% sense! Alright, but in all seriousness, if you look up "birth trauma" you will view many horrible experiences women have in the hospital where they're treated like pieces of meat just paying. Not saying doctors are evil, but in ANY occupation where you do something TOO MUCH, it's natural to lose your humanity and forget that the people who are coming to you for help are PEOPLE and not just "paying customers." So instead of giving you credibility, flashing your "registered nurse" card only shows that you're opinion is heavily biased and probably the only one you really know.
I'd rather be knocked out and woken up when it's all over.
My mother was a midwife living in Jamaica and in her 56 years of being a midwife and delivered hundreds of babies of which all have survived, these mothers said they would not have had it any other way.I believed, that the state of the environment is very important and the knowledge of the midwife. As well as, the quality of care that is offered by the midwives, this conforms the respect and value for the mother and the new life that is coming into the world; I think it is a beautiful thing be able to give birth in the privacy of your home ,with the assistance of a woman who is experience and mature, and who is able to share her life experience especially with some of these young mothers , not that I don`t respect the rights of parents who choose to go to the hospital. The gift of life is a beautiful thing and should be cherished.
I gave birth to all 4 of my heathy kids at home. No issues. None at all. Each time, I was eating a normal family meal at the table just a few hours afterwards. Many women the world over have had experiences like mine, am glad for it, and smile knowingly whenever someone says that homebirth is unsafe. Each of my births had its own special quality to it and my children came into to the world on their terms. I loved my home births, but recognize that I was low risk, physically fit, and have a calm but tenacious personality. I have no issues with anyone giving birth in a hospital or having a c-section. It's frankly none of my business, just as my choices for my children's births are none of anyones business. What this is about is choice; the ability to choose, and for birthing to be placed back in the hands of women where it belongs. Are home births safe? Damn straight they are...but not for all women. Are hospital births ok? Sure, if everything is done for the welfare of the mother and child with intervention only occuring when requested or absolutely necessary. Protection of the mother and baby are paramount, but it can be done without the medical establishment trying to control it with a vice grip. Childbirth is a personal process that cannot be rushed by medical agendas or by our hyper time-sensitive society. Somethings in life are meant to occur in their own due time and are not meant to be manhandled and adhere to preconcieved schedules. There is nothing wrong with home births if you are a good candidate. There is nothing wrong with hospital births if they try to adhere to a mothers birth plan. I recognize that things happen sometimes and medical intervention is necessary, and when it is, thank heavens for it. However, out of all of my friends, family members, grandmothers, great-grandmothers, aunts, great aunts, who have given birth to children AT HOME....a total of 152 children in all, spanning 3 centuries, not a single one ever died. NOT ONE. Not in the 1800's, not in the 1900's, not in the 2000's. Not one....not a single one....none of my living realitves and friends can even remember a single baby/mother needing medical intervention. What does that tell me? That women know how to give birth. How they choose to do it is ultimately up to them with minimal interference or with as much interference as they want. People should stop having opinions about things that they know nothing about, or have never experienced or witnessed in vast quanitites. I offer respect to all women who have been through this process, whether they had a birth like mine or the complete opposite. We are all sisters and we all want the same thing: healthy children and healthy mothers. How we arrive there is up to each of us individually.
Oh and one other thing, I gave birth to a 3.84kg boy at 37 weeks who's umbilical cord was around his neck, and he had no problems what so ever!
So many people with their opinion of what is best.
You have those that wouldn't do it anywhere other than a hospital and those that wouldn't go near a hospital. I luckily got the best of both worlds. I gave birth in a bath in a room with a king sized bed, with my husband, doula and midwife. The Place was perfect - a home away from home, but they had a theatre on site in case anything went wrong. There is a full medical staff on site if they are needed.
I could labour comfortably without having any concerns for the safety of my child "should" anything go wrong. I was blessed to have a perfect labour. I did require medical attention after the birth (which my midwife could have provided even if we weren't in a "hospital").
I believe the medical industry doesn't allow woman to have complete control over the one thing they should be able to have control over. But they have allowed so many mothers and babies to live when medical intervention was needed. I don't believe it should be one or the other. I believe it should be the best of both options!
I'm so glad that this information about the natural birth process is out there. It shouldn't be as medical-ized as it is, and we WILL lose the experience of natural birth if we don't start talking about it. Thank you Rikki Lake for choosing to tackle this topic!
Wasn´t able to watch the document in full b/c some links are not working any more.
But as a health care professional (NICU nurse) I would never ever recommend a home birth to anyone.
It seems to me there is a crisis in the world of obstetrics - there are 2 extremes - western style - planning a C-section just because you want to have a convenient birth versus the home birth (prefereably water birth - yuck!) - letting the nature do the trick...
I think every normal and intellingent woman wants a healhy baby with as little medical intervetion during her labour as possible. In Czech (my home country) when delivering a child in a hospital you can still get all the care that´s needed in order to give birth to a healhy baby - and the care does NOT have to include an episiotomy or a C-section (among others). If something goes wrong (and it does, sometimes) you have the trained staff and supplies at hand when needed.
Another thing is that once the baby is born, the pediatrician in the hospital can check him for any congenital defects and other possible conditions that can be treated well when caught early.
I have seen a good couple of babies who were delivered the "au naturelle" way and ended up severely handicapped or died after the birth. Many of them would have surely benefit from care given at hospital...
I believe staying sensible about this is the way to go. It´s not only about the mum and her comfort...
As for the water birth - would you want to swim a pool of poop water?
A lot of lies and misinformation in this one. For example, the one with mortality rate - exceptionally deceptive.
What they don't tell you is that the USA has the toughest definition of what to write down as a birth (and then subsequent death).
In some countries they don't even count the baby as having been born unless it survives 48 hours past birth.
Regarding the cord - it all depends on how tightly it is wrapped around the neck..and this can be seen before the moment of birth as the baby does not tend to move the last weeks - once it is in "position". And it is very easy to see how the blood is flowing, via ultrasound. So no - I do not buy into the whole "chord around neck" discourse. Many many children are born with the chord once around the neck that it can actually be thought of as normal. But hey - that's just my opinion :)
i have never seen the movie but i had both of my children all natural in a at home birthing center and wouldn't change it for the world .
I really like this. Its been a while since I have seen it however I wanted to comment. This is the way that I wanted to birth when I have a baby, however I may go it with family only. Have not decided and I still have time to plan.
I do believe that being calm is the most important and of all my friends that I have seen give birth in hospitals, They are not calm.
was really worried at the start because during the home births the babies wern't screaming their heads off compaired to 'normal' but its pretty obvious its because they're calmer, that speaks volumes
What I think this documentary is missing is the health reasons for having a natural birth. The baby must pick up its original gut bugs [culture as it goes through the birth cana]l-in a caesar there are no initial innoculations happening. Up to 70% of immune function is initiated in the gut, so we deny these babies a fully functioning immune system. Look at the incidence of Asthma and caesarian births-they are huge. Is called TH1 dominance and it will continue to climb along with the intervention rates. What was also missed is the fact that women are now going into labour so malnourished and ill prepared pyhsically that they are not dilating, or able to push[you need a lot of magnesium for this to happen and it is a common deficiency]. Ive even known women to imediatly give up that gym membership because they were pregnant! They dont call it labour for nothing-there needs to be a lot more information on the nourishment and health of the mother way before conception and labour. Having a "natural birth is not a box you can tick, often you need to put some effort in to achieve this. I am a nutritionist who works with women trying to get pregnant and the diets before they see me are very inadequate-women arent going into labour with enough "fuel" to get the job done. I personally had my child naturally at 40 then went home 4 hours after [birthing centre with a midwife] and cooked dinner. But I gave myself 8 months to get nutritionally dense and was working out until the day before-that's how I managed it-but really its about having the healthiest baby you can and that was also achieved with nutrition. Not rocket science-try putting the wrong petrol in your car-its not going to work.Good luck to all the wonderful women out there doing there own research and choosing to find out whats good for them.
Very good. Social justice bent, educational........Just chaps me to see that with this country's crappy infant and mother mortality rates, the establishment pushes hospital births just for the damn money. It's an abuse.....All other developed countries use midwives regularly and have way better birth outcomes....heeeelllllo! Oh, but what about the MONEY??????......As long as woman and not men are the ones to give birth, we will be subjected to all kinda of indignities and inequities,,,,,,
Megan, think about it - how does a baby breathe before it's born? It gets oxygen through the umbilical cord, which continues to occur during birth, right up until sometimes minutes after the baby's whole body has exited the birth canal. A cord around the neck really isn't very serious and doesn't obstruct any airway - because that isn't yet the airway! Any knowledgeable practitioner will tell you that, physiologically, a baby will only commence attempts at breathing when a) it is exposed to the air and b) it's full body is out of the birth canal and chest is no longer compressed by the birth canal. What you know as the reason for your caesarian birth is actually quite possibly just ignorant scare-mongering from doctors, sorry.
Great documentary - I've never considered giving birth anywhere but at home, hospital seems bizarre to me, given birth is not a medical condition, it's a physiological transition. Hopefully this helps women flailing in the dark see a bit of the light! One comment though: you can absolutely give birth vaginally to a breech baby, even if it has the cord around the neck. Breech is no reason to panic and have a c-section. Just a shame so many practitioners (midwives and obgyns) don't have the confidence or skill to assist with natural breech birth, which is simply a variation, not an abnormality. Just ask Dr Sarah J Buckley...
When it's time for me to have a baby, I prefer a home, natural birth. Hospital birthing is frightening. C-sections are even scarier (infection, death, drug overuse, pain.) I'd only opt for that if the situation calls for it - otherwise, I want do be able to give birth like our maternal ancestors have been for thousands of generations.
@Renee so long as the mother is being supported by a qualified midwife, able to be transferred to a hospital nearby or do it in a birth center, the "risk" of home birth stats look better than hospital births. I don't care what the potential risks are, show me the statistics. If the odds are better, women are better off choosing home births. There's financial gain for hospitals to demonize home births, painting it as some kind of unsafe, hippie practice, so you need to question the motive behind their scare tactics.
has this video now been removed?
home birth can be a great risk to take, child birth can go wrong so instantaniously and can result in jeopordising the mother and/or childs life in such a short time.......... @ umrania what if the midwife can't handle it and you need an emergency c section? just cop it as a loss and try again?
the last video did not have sound.
I've watched hospital childbirth many times in my anatomy classes. It's always been a contraceptive to me. Watching a woman cradling her child after natural childbirth is the only time I've ever seen it as something beautiful.
Having had 3 home births I can fully say that it would take a lot for me to deliver in the hospital without a solid health reason (baby being breech, etc.) I hate when people use the "well so and so would have DIED if they hadnt delivered in the hospital because...." almost every reason they give is something a midwife can handle (excessive bleeding, umbilical cord around neck, etc) most things can be taken care of by a midwife, and a good midwife would have enough knowledge to know early enough that she cant do something. In the movie the midwife also tells her over and over that she should leave, so its the womans own problem, and she made it. It would be frightening to go through what she went through and I wouldnt hope for anyone to have to, however the statistics show that homebirth has a higher sucess rate.