The Business of Being Born
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The Business of Being Born

2007, Health  -   68 Comments
Ratings: 7.39/10 from 61 users.

The Business of Being BornThe 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.

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5 years ago

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.

Kimmy Jo
6 years ago

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.)

Grimmauld 12
10 years ago

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.

11 years ago

I'd rather be knocked out and woken up when it's all over.

11 years ago

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.

11 years ago

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.

11 years ago

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!

11 years ago

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!

11 years ago

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!

11 years ago

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?

11 years ago

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.

12 years ago

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 :)

12 years ago

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 .

12 years ago

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.

12 years ago

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

12 years ago

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.

12 years ago

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,,,,,,

12 years ago

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.

12 years ago

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...

12 years ago

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.

12 years ago

has this video now been removed?

12 years ago

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?

12 years ago

the last video did not have sound.

12 years ago

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.

12 years ago

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.

12 years ago

This makes me very glad that I live in Ontario where midwife care is licensed, fully covered by public health care, and can be either in home or in the hospital - midwives can have and use all the hospital equipment and consult with Drs if necessary but admit, treat, and release on their discretion: an excellent compromise for those who may be uncomfortable with home birth. Not to gloat, this is all recent and hard-won, but oh man the treatment of the women in the hospitals in this video is terrifying.

12 years ago

In my opinion the example in the film is just the type of reason to have your baby in the hospital: first of all the baby is way dysmature (3 lb + a bit), which has apparently gone unnoiced. second of all it is in breech, which apparently has been unnoticed so far. Third of all the delay of calling the midwife in stead of going straight to hospital causes the water to break outside of the hospital with the serious risk of a umbilical cord prolaps! (breech, dysmature)I'm not sure what really happened here but am very interested in the Apgar score..... What would a 10 minute traffic jam have caused here?
It is not about all those times deliveries go well. It is about the risk the delivery goes wrong. If 500 women have a much nicer exprerience by home birthing at a cost of 50 women having to be transported to hospital with 8 cm dilation and one dead child you could question if that is worth it.
In Holland recent numbers have shown that midwife controlled deliveries without continous fetal monitoring have a 2.5 times increased risk of neonatal death. (despite the fact that the midwife controlled deliveries are only with presumably healthy babies as opposed to the high risk group that is deliverd by the doctor)

On the other side of the story I fully agree that docters should be much more aware of natural birthing. Women should be encouraged to stand, sit or walk during their delivery. (which is perfectly possible while monioring the foetus) It shortens the avarage delivery with approximately one hour and it significantly decreases the need for epidurals.

Too much thinking that it is all a natural process leads to closer to natural mortality........and there are plenty of typically African complications that the western world does not see anymore.

It is very important in this matter to end up somewhere in the middle: to much of a doctors view causes trouble, and too muh of a natural view does too

12 years ago

This film was amazing.I'm due in mid Feb. and am currently working with a midwife. she was suggested to me and I'm suggesting her to all of the pregnant woman I know. My Dr. before would have ruined the experience for me because there was no connection to the patient outside of my i.d. number. I appreciate the work that all these doctors do everyday but for the women who stand at a laboring womans bedside and coach her through something that intense every day deserve a ton of credit.

12 years ago

Great show. I really enjoyed seeing this film. We need more midwives around. The only bad thing was I didnt get to hear the last part. It was like the last 5 minutes, there was no sound. I could see the film, but not hear it. Other than that, great eye opener!!! More Doctors need to watch this and learn more about what is better for the baby and mother. Its too bad its about money rather than what is best. Thank god I didnt have to have any of my kids by c-section. But I did get some pain medicine because I was so scared of the pain and what I may have to go threw. Too bad I didnt know any of this before I gave birth. Im in school to become a CMA and will take this with me and spread the word.

12 years ago

I'm really glad I watched this. Sure makes you proud to be a woman.

12 years ago

I have 4 children, 3 of whom were delivered by a midwife in a birthing center. One was born in a hospital with my own midwife in attendance and not once did i see a doctor.
I am shocked and horrified by the birth state in the USA. All births here in New Zealand that are normal are handled by midwives and we have great control over our births, how we want them to go and what we want to achieve. Our choices give us power in these special times in our lives and our child's lives.
We have the opposite fear a lot I think, the hospital birth is something to avoid.
Birth is natural and healing. A wonderful thing not to be drugged away. It's a real bonding with your child and your body. Midwives are well trained in what to do if something goes wrong and will not hesitate to get help if there is a risk...but this view that they are hillbillies or under qualified is total garbage.

12 years ago

I watched this documentary elsewhere online before DH and I started trying for a baby earlier this year. He is totally against home birth for the same reasons Megan stated. My mother wanted to have me at home also (I was her last child) and my father protested. Fortunately so, b/c if she had not been in the hospital, she would have bled to death. I am moved by this documentary and shared it with DH, but I think that every woman must make the choice for her and her family; no one else's choice should be viewed as right or wrong in this matter.

12 years ago

I usually associate Rikki Lake with garbage TV, but this documentary is pretty good. Some of the stats are...weird... kind of layperson stats, but I see that everywhere.

Charles B.
12 years ago

I wish my babies had been born this way. This is a much better way!

A standard hospital birth is terrible in comparison.

13 years ago

modern culture spreads fear, fear is the cause of pain. They capitalize on fear.

13 years ago

I could never encourage a woman to give birth outside of a hospital. While I think that it is a great idea to change birthing practices, maybe having more midwives in hospitals, if you're having the baby at home there is always a risk that something could go wrong very quickly. I wouldn't be alive today if my mum had decided to give birth at home. I got the umbilical cord wrapped around my neck and it cut off my airway. If I hadn't been born via Caesarian I would have died.

anne V
13 years ago

....but great doc though! I feel lucky that the province I live in Canada, having a midwife is covered in our health plan. My friend had hers at home a month ago, and it went very well. I am shocked at how it works in the states, cause here from all of my friends who went to the hospital to have theirs, it isn't as bad...glad these docs are all coming out!

anne V
13 years ago

it stinks that the last part, the audio got cut off, I suspecting the Jane Siberry song "Calling all angels" did it in youtube regulation. I love that song but all links to hear it on youtube has been cut off for copyright reasons...would've loved to hear the last part:(

13 years ago

regardless of previous comments, I just have to say this is a beautiful film that everyone should see. It involves nearly any one of us at some point in our lives, whether having children ourselves or knowing one who does. But, this is not a bandwagon either, it is something that should be well thought out to balance the benefits of our medical technology and the excellent work nature seems to do when left alone. But in the case of a healthy pregnancy and mother, I am choosing home birth after watching this film. I was always scared of the birthing process until I saw how it was meant to be: a wonderfully connecting experience with not so much screaming and hooplah. (sp?)

Dr. Dunkleosteus
13 years ago

Haha, @david. I dunno, if you were a woman who got impregnated by a man, would you want another man there during the birthing process telling you "it's okay, that pain will pass, I've been there before"? If I were a woman in labor, I'd want another mom there. I don't think it's sexist. Pregnant apes tend to stay around other pregnant apes and shy out of socializing with males and receptive females. I think it's just natural.

13 years ago

I'll probably cop a lot of flack for this; but I couldn't help but be put off by the rampant sexualised nature of the topic exploration.

Is this not mean't be midwife ( a sexist word might I add..and before you flair up, consider if it was called midman) v Doctor investigation? Not Male Doctors vs Female Midwifes???

I enjoyed this doco, but IMO, it was extremely sexist.

Looking forward to your angry responses! :-)

Dr. Dunkleosteus
13 years ago

Saw this on netflix. Very enlightening. I love the scenes from Monty Python's The Meaning of Life, so true!

13 years ago

Interesting point of view! I just needed to know what the whole in-home birth experience was all grandma had 10 babies & all healthy with the help of a midwife...I couldn't believe it.... but however a baby is brought into this world, I think he/she definitely leaves quite an impact on that mother.

Cliff T
13 years ago

Lori, I take it you know how to have a child now.

13 years ago

The water birthing scenes were so beautiful that I got teary-eyed. Every time I've seen a video of a birth in a hospital, I just want to gag.