Friday, February 22, 2008

The Business of Being Born...my 2 cents

The buzz surrounding "The Business of Being Born" had been building around the mama circles, so when the University offered a showing and a panel discussion, some fellow mamas and I left the babes with Daddy and headed out.

First, I want to say that I think the movie was very well done. It opened my eyes and gave me some insight into the reasons why women make some of the choices they do. I particularly enjoyed the portions that followed a Certified Nurse Midwife through Manhattan. As the filmmakers interview her clients, discuss their views and decisions, and eventually film the births themselves, it really solidifies home birth as a valid choice. Home birth is a topic that can cause visceral reactions in some people. Most often, those are the people who know next to nothing about it. I think the film could be very useful in educating those groups who are obsessed with the idea of potential tragedy and “unnecessary risk” in association with the term “home birth.”This film does a wonderful job showing why people choose a home birth, what preparations are made and how any complications are addressed.

Being that the vast majority of the movie is filmed in New York City it was kinda hard, as a Vermonter, trying to relate to some of views and culture around birth in New York City. There is some talk of the “Too Posh to Push” phenomenon, which has lead to the increase in elective C-Sections…something we don’t hear much about around here. On the contrary, the area in which I live in is very pro-natural childbirth, pro-breastfeeding (pro-extended breastfeeding for that matter), lots of people co-sleep, cloth diaper, ect. So in our case , the movie was kinda preaching to the choir.

As a result, the issues I had with the movie are primarily the same issues I often have with the birth culture in Vermont, which was evident in the discussion that took place after the film. The panel was comprised of a couple of midwives (including Burlington’s only homebirth midwife), Lactation Consultant from LaLeche, a birth educator and doula, an OB GYN (from the practice that delivered Sam) and someone else I must be forgetting? The discussion that took place was interesting, though there was little diversity in the opinions or reactions to the film. There was a lot of discussion about Vermont culture. The panel often brought up how lucky we are to birth in a culture like Vermont. Though I wholeheartedly agree, there is also the flip side. When women have trouble following the natural path, due to personal choice, medical intervention or complications, or cannot follow post natal recommendations (in particular, breastfeeding), there is judgement. Women often have to justify their actions, or are at least are made to feel as though they have to. There were a few women who expressed this concern, (one of which was one of my Mama friends) and mentioned that this movie may serve to reinforce those feelings of inadequacy or a “less-than-perfect” birth experience. When one way of birthing is held up as an ideal, and you fall short of that, whether by choice or circumstance, it’s difficult not to have a sense of failure. Not that home birth shouldn’t be portrayed as the wonderful experience it is. I must admit, after watching the beautiful, calm (for the most part, these are not superwomen after all), intimate, and private births I wish I was a candidate for a home birth. But since my last birth resulted in an unplanned C-section, it’s best I birth my next one in a hospital.

And I’m ok with that. And I’ve always been Ok with Sam’s birth. Sure, not what I had envisioned, but perfect nonetheless. I had been someone who wanted to try for no drugs. I had the big tub, ready to labor and hopefully give birth in water. Pretty much the opposite happened. I was lucky that I didn’t mourn my ideal birth, like some people do. I was able to own my birth experience and embrace it. While watching this movie I, for the first time, felt bad about Sam’s birth. ‘Felt bad’ isnt’ really a good way to describe the feeling. Sad, maybe? Then angry? Defensive? Let me explain….

The issues that came up for me with the movie revolved around a few things. Minorly, I just felt bad for doctors. They kinda grouped all Obs together. Depicting them all as having the same mindset of trying to keep something bad from happening, as opposed to letting something beautiful take place. And also obsessed with the bottom line. Like people who want to just cut you open, get the baby out so they can hurry up and fill the bed with another laboring mom. Though I have no doubt there aspects of that mindset, especially in metropolitan areas, I wish they had shown some Mds who do things differently. Because I know they exist.

Now, the MAJOR issue I had with the movie was the emphasis they put on attachment following birth. In one portion of the movie they talk about the love cocktail of hormones the mother and baby share after birth. They talk about how this promotes attachment and that C-section mothers are missing out on this. That alone, wasn’t enough to make me feel too bad, after all I knew I missed out on some Oxytocin, but then it went on to say….that when Chimpanzees give birth via C-section they reject the baby and will not nurture or take care of it.

Excuse me? What are you implying? How the hell is that relevant?

They really should be careful. In their effort to empower women to make an informed choice, they are devaluing the experiences of those who, whether by choice or not, have done differently. I believe every woman has the right to give birth how she sees fit, in a way she feels safe, and has the right to feel good about it. It is the moment we meet our children for the first time. The pure love and joy should never be tainted by guilt, shame or regret. In order to insure that, education and knowledge is vital, and I think this movie does a good job at providing important information, shedding light on many misconceptions about midwives and homebirth, and challenging the existing medical establishment. But as a consequence, though most likely unintended, they are diminishing the c-section mothers experience and setting up future mothers for disappointment and feelings of failure. And in particular, to question the capability of a woman to be a good mother, simply due to the manner in which she gives birth. Which I found personally offensive.

In the end, I found The Business of Being Born empowering and I would recommend it to anyone thinking of having a baby. Just take it with a grain of salt. I think they did a really good job shedding light on the expertise of midwives in contrast to Obs. That Certified Nurse Midwives are specialized in the female process of giving birth, while Obs are surgeons. I think many people in this country view midwives as someone who took a correspondence course, or is one step up from a massage therapist. In some states it is even illegal to have a midwife deliver your baby. The movie illuminates midwives as the skillful and knowledgeable professionals they truly are, helping to shatter many myths and misconceptions. Ricky and the other filmmakers hearts are in the right place, they just need to look outside themselves a little. And it’s important to know that more often than not, your birth does not go how you imagined.

And it's still perfect.

4 comments:

Pauline said...

I'd just like to say how refreshing it is to read a review that challenges this documentary’s focus on one birth choice to the detriment of another. I am the editor of www.electivecesarean.com and it is my aim to provide women who are having a cesarean (whether for medical reasons or through personal choice) with a wealth of information on the research and medical opinion that is available.

I wholly support a woman's decision to request a cesarean (in fact, this is exactly what I did, and up until the point it was discovered that our baby was breech, there was no medical reason for surgery) but I also wholly support a woman's decision to deliver vaginally. What I think is important going forward, is for advocates of vaginal delivery to focus on achieving their preferred choice WITHOUT criticizing (or worse, trying to stop) women wish to make the equally legitimate choice of cesarean delivery.

Pauline McDonagh Hull
Editor, electivecesarean.com

KL said...

Thanks for your comment Pauline.

Though I do not think women who elect to have cesareans as a preference should be kept from doing so, I must admit I would never do so personally and the practice does concern me a little. I worry that the medical establishment may push this practice on mothers based on cost and the reduction in malpractice exposure. And the added convenience for the doctors makes it appealing to hospitals as well. The medical culture has a lot of sway in the minds of their patients. It would be easy for them to convince an uninformed mother looking for guidance. And to be frank, I have not heard a good argument for elective C-section. But that is ME. What seems good or bad to me, maybe completely different to you.

Again, though I don't fully understand the choice, I would never deny a woman that choice. And I don't think that choice has ANY effect on a woman's ability to be a good mother, which is the main issue I had with the film.

I think the most important thing is education so women can make informed choices. I understand that is the goal of your website. I couldn't see much, as I did not register.

In the end, we are responsible for our own bodies and we need to respect each others very personal choices. It is important that our medical and insurance industry supports the mothers right to have the birth she wants. But perhaps most important is that we have access to the information to make the best decision for ourselves and our families.

Thanks again.

rockergirrl said...

I think any documentary should always be taken with a grain of salt. It should challenge discussion and opinions. I cannot speak for the filmakers of course but I doubt it was ever their intention to make anyone feel guilty about their choice. This is such a touchy subject for so many. I can't imagine making this kind of film without stiring up emotions from someone on whatever side you are on.

Every birth is so different and it never goes the way we plan as you mentioned kl. In my opinion though it is the norm if you use a hospital for birth to more than not be faced with a more medical approach to birth. I am not saying all OBs are like this and I am sure they didn't mean to either but the stats are there and they show that more interventions and c-cections are performed with OBs than not. Of course not all OBs are like this but it is the norm that you find in a hospital unless you are informed and know what your rights and choices are.

For me this movie was trying to shed light and bring up the fact of choice. Not to make anyone feel guilty but to let people know there is another way. I don't think they can be held responsible for whatever guilt this might bring up in someone just because they are trying to give the facts.

Now the comment from Pauline I am sorry but I do not agree with you or what you are doing at all. I do not believe in elective C-sections. I am not saying I would take one's right away to do this but I do not agree at all in having an elective one. It makes me sick to see so many of young hollywood girls announcing their elective C-sections because of their fear of birth. They clearly have never recovered from abdominal surgery before.

KL said...

Hey K! Nice to see you!

I think this film was very successful in showing choices, reasons why alternatives to the typical hospital birth should be considered and why it is of paramount importance for women to take control and responsibility for their births. I think they also did a very good job of providing information that the medical establishment does not readily share with it's patients.

As far as "guilt" I suppose I'm more concerned with the dialog in the community rather as opposed to the film. The film just brought up those concerns in the panel discussion following the movie. And a few of the comments made during the panel discussion got under my skin a little. However, I completely agree with you that it was in no way the filmmakers intention (or that one lady from the audience for that matter) to make anyone feel bad, and that with such personal subject matter it is bound to bring up some emotions in people.

The only big issue I had with the film is that chimpanzee/lack of attachment portion. I don't expect them to ignore the science, the truth about the hormones and what they do, but when they use examples of chimp babies being rejected and motherly neglect as the consequences of c-sections...though this may be true in the case of chimps, I am not a chimp and I don't think it has any bearing on anything.

Oh, and the comment from Pauline threw me for a total loop! When I talk about "choice" in my little blog post, I was referring primarily to drugs or the fact that some women may just feel safer with a doctor/hospital in the mix. I wasn't prepared to respond to elective c-sections...the whole idea is very Aldus Huxley to me. It seems a sorta slippery slope. What if women decide they don't want the discomfort of being pregnant? Do we start growing babies in jars like Brave New World?