March 2008

Movie Review:
The Business of Being Born

By Cheryl Murfin

After giving birth to her second child in her home with a midwife, television talk-show host Ricki Lake is on a mission:

“Birth is big business in this country, a billion dollar business,” Lake recently told a Seattle audience. “I think people should know the facts and the alternatives before they buy into it.”

Lake’s primary tool for getting the facts out is her new documentary film The Business of Being Born. In it, the actress seeks answers to the questions she found herself asking after a disappointing birth experience with her first child.

Under the direction of filmmaker Abby Epstein, The Business of Being Born documents the stories of several New York women, including Lake and Epstein herself, who choose to birth with a midwife. The women’s experiences are interlaced with often shocking historical, political and scientific insights and statistics about the American maternity care system and its efforts to suppress midwifery.

Ultimately, Lake’s film brings to the general public the questions that midwives, doulas and other proponents of low-intervention birth want more Americans to ask: Why is a natural, healthy life process being treated as a potentially catastrophic medical emergency in hospitals across the country? Are low-risk women and their infants safer birthing in a hospital? The answer, Lake finds out to her surprise, is no. Home birth for low-risk women is as safe as, or safer for mothers and babies than, hospital birth according to the study, "Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America" published by the British Medical Journal in 2005. In this comprehensive study, researchers analyzed more than 5,000 home births involving certified professional midwives across the United States and Canada in 2000.

The Business of Being Born also includes several interviews with obstetricians and medical professionals who caution women against home birth, citing their concerns for safety. They and midwifery proponents in the film remind women that complications such as preeclampsia, gestational diabetes or continuous high blood pressure are medically-indicated reasons to seek obstetrical care in a hospital setting. It is important to note that professional midwives carry emergency supplies including oxygen and pitocin (to stop hemorrhaging) and are well-trained in assessing risk throughout pregnancy and during labor.

The film’s distributors have found avid partners in the hundreds of mother’s networks, midwifery organizations and gentle birth advocacy groups that have hosted private and public screenings across the country. Within two days of opening registration for Seattle Midwifery School’s recent screening with Lake, all 400 seats were taken. More than 300 people asked to be placed on a waiting list for the event.

As one woman at the Seattle screening put it, “If you are pregnant, you need to see this movie. If you understand what is driving birth care, you can make informed choices about where, how and with whom you trust your birth. I know I don’t want to line the medical system’s pocket with my birth.”

The Business of Being Born is both an unflinching and sometimes funny documentation of natural birth and a political statement. It provides a brief historical overview of industrial medicine’s entrance into a process almost exclusively attended by midwives until the 1940s. Continuous flashes of current statistics, including the nation’s astronomically high cesarean section rate, make the case of midwifery proponents (including Lake) that much decision-making in hospital births today is about money, not about the well being of mother or baby.

One statistic stood out to several Seattle viewers: despite spending more than any other country on birth-related medical services, the United States has the second worst infant mortality rate of all industrialized nations. Comparatively, countries that rely primarily on midwives for birth support boast the lowest infant mortality rates.

“That was the thing that really got me,” says Warren Etheredge, the father of a 4-year-old and owner of TheWarrenReport.com, an organization that screens more than 200 films a year. “If that money is not saving babies in America and the midwifery model is saving babies and money in other countries, what the hell are we doing?”

Etheredge, who moderated a post-screening question and answer session with Lake and Seattle-area midwifery and obstetrics experts, encouraged birthing families to see the film.

“This is the kind of film that brings home our motto at The Warren Report – question what you see, consider what you don’t and draw your own conclusions,” Etheredge said.

Cheryl Murfin is a Seattle writer and mother of two and is the executive director of the Seattle Midwifery School.

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