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Review – The Business of Being Born

December 1, 2007

The Business of Being Born is a documentary film on childbirth practices in the United States directed by Abby Epstein and produced by Ricki Lake. It was inspired by Lake’s first hospital birth, after which she felt that there must be a better way for women to give birth, and set about finding out how and why midwives are supporting that very thing.

The film follows several women throughout pregnancy and labor, primarily depicting midwife-assisted home births and dispelling the myths of home birth as necessarily unsafe and of midwives as eccentric hippie women. In fact, the midwives in the documentary are women who could be your neighbor or your friend, trudging around New York City in taxis in order to help women give birth in supported, non-interventionist environments. In other words, normal.

The births we see on screen, however, are anything but normal under today’s active management of labor – they starkly illustrate how different a physiological birth can be as compared to the restrained, flat-on-her-back screaming and poking of the hospital environment. Although many of the physicians interviewed said they had never seen a normal birth, the viewer is treated to something that feels just right – women in a comfortable environment, supported by caring and skilled individuals, rocking their hips and giving birth with a grunt and a smile. The imagery of the medically managed woman with her whisked away infant, separated and left lying alone on a table, could not contrast more with the imagery of women who are instructed to “reach down and take your baby,” whose babies are immediately cradled against their damp skin and welcomed into the world in a hands-on, not instruments-on, manner.

The film also incorporated historical trends in the management of labor that clearly demonstrated how much of what was done, as is being done now, was not properly understood at the time for the real or long-term effects on women and babies, such as anti-midwife propaganda despite higher death rates in hospitals, and the use of thalidomide and cytotec. It reminds us that many of the interventions used so commonly today are often not medically necessary, and that very few have stopped to ask an extremely important question – is this helping or harming?

The Business of Being Born has two major strengths. The first is that important information about the cascade of interventions in managed birth, U.S. practices vs. other countries and the resulting outcomes, drugs, c-section rates, and medical evidence is presented in a way that is accessible and informative even to those who are taking their first look at birth issues. The relevant information is conveyed alongside the women’s stories, leaving the viewer better informed without beating her over the head with medical jargon and data, making it a perfect introduction to the topic for those who have not already immersed themselves in the literature of birth. There is a growing contingent of women who are informing themselves and speaking out on birth practices, but this film presents the story of birth management in a way that could reasonably encourage the uninitiated to seek more, and to speak up.

The second major strength is that the film clearly locates birth issues inside feminism and choice, noting the power disparities of the traditional hospital birth system, the often misguided focus on outcomes and potential litigation that ignores women’s needs and experiences, and the empowerment that many women feel when able to give birth on their own terms. The film notes the current emphasis solely on “taking a healthy baby home” and the playing of the “for the baby” card in hospitals that strips women of their ability to fully participate in a life-altering experience, and contrasts this with home birthing women who state afterwards, “If I could do that, I can do anything.” While the documentary does not suggest that the outcomes for babies are not important (as anti-home birth/anti-midwifery folks often seem to think), it does clearly illustrate how women are ignored, under-informed, over-powered, and failed by the current system. As Aunt B notes, “Women getting dicked around by the system is always a feminist issue.”

I would recommend this film to anyone who has given birth, plans to give birth, knows someone who might give birth, or assists women in birth. In other words, just about everyone. A list of upcoming screenings is available, and the documentary is expected to become available via Netflix in February; it can be saved to your queue now.

9 Comments leave one →
  1. December 2, 2007 6:35 pm


    THANK YOU, for such a thorough review. I have not had the pleasure of watching the movie myself yet, but I have faith that it will be worth watching. All the reviews I’ve read have indicated as much. I feel blessed that there is a screening close to where I live. I hope enough people will watch this movie so that positive change can take place for women’s birth experiences around the world (not just in this country).

    (Btw, I really like the way you mentioned the “for the baby” card hospitals often pull to justify their mistreatment of laboring women. Very insightful.)

  2. December 2, 2007 10:10 pm

    It’s great to read this wonderful review. This film is part of a sweeping national trend in attention to maternity care in hospitals and the right of women to have access to a full spectrum of maternity care options that honor their agency in health care decisions. Home birth is such an amazing, empowering alternative to “traditional” hospital birth, and this film is helping more and more people understand why women are making this choice across the nation. I encourage anyone interested in this issue to look for their state’s midwifery support group and learn more about the legal status of home birth where they live. About a dozen states are proposing legislation to license midwives in 2008, and others are already hard at work in their own. Another exciting development is The Big Push for Midwives, a nationally coordinated campaign to license Certified Professional Midwives in all 50 states and the District of Columbia, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care. If this film inspires you to learn more about women’s choices in childbirth, this is a GREAT time to be active and involved!

  3. dewi permalink
    December 5, 2007 6:54 pm

    I took my 20 year old daughter to see this movie.
    She adored it.
    I know she had never thought aobut giving birth and the current state of womans health. Her right to make a choice how she gives birth is now floating in her head. SHe also knows that giving birth does not have to be like what she sees on TV or in Movies.

  4. December 5, 2007 7:55 pm

    Dewi, that’s great! The more information, the better, right? Glad you could share that with your daughter.

  5. ryan permalink
    November 7, 2010 3:20 pm

    I had some serious issues with this film. Me and my wife are planning our first child, so it’s a subject of great interest to us.

    First off, after following up on a lot of the statistics in the film, it was clear the film was overly biased and went against the main message it claimed to making. Which was informing women about facts and options.
    The part of the film I appreciated was a much needed crtitical review of hospital birthing techniques and it’s disturbing trend towards 0ver-intervention. It also raised a lot of very important questions, such as “Why does this country have such a high c-section rate?”.

    Unfortunately all the great stuff was encased within a pro-homebirth propaganda piece.
    Which I didn’t even fully realize until taking the time to research the films contents. Which I highly recommended all prospective parents do, before really taking in all of the information from this film. I’m a film editor by trade, so i know a well crafter propaganda film when I see one. Which I would forgive it for, if it deliverd (pun intended) on atleast it’s facts being unbiased.

    The vast majority of the numbers/stats reported in the film are cherrypicked, misreported or taken out of context to favor home-birth. Which is sad, what I’d love to see is a documentary that is equally critical of both sides, displays full study findings and is also supportive and nurturing to prospective moths who choose either option.

    I can be empathic and agree with the reality that a lot of hospitals and OBGYNs are focused on the monetary aspect of childbirth. But let’s be real here. Midwives collect paychecks as well. and a more journalistic approach to the facts presented in this documentry would have informed the viewers that they were cherrypicked from the he Johnson and Daviss study. Johnson and Daviss are not independent researchers. Johnson is the former Director of Research for the Midwives Alliance of North America (MANA); Daviss, his wife, is a homebirth midwife. The study was commissioned by MANA, data was collected by MANA, and the study was funded by money from a homebirth advocacy foundation. So two long time passionate advocates of homebirth undertook a study of homebirth at the behest of the homebirth trade union, using money from a homebirth foundation AND managed to obscure the fact that their study ACTUALLY showed homebirth to have a neonatal death rate almost TRIPLE that of hospital birth for low risk women.

    Finally, MANA has continued to collect detailed statistics (just like the ones they collected for Johnson and Daviss) from 2001 to the present. They have made a public offer of that data to midwives who can prove that they will use the data for the “advancement of midwifery”. Even so, anyone applying for access to the data must sign a legal confidentiality agreement promising not to disclose the data to anyone else. It does not take a rocket scientist to suspect that the data almost certainly confirms that homebirth has an increased risk of neonatal death, and that they don’t want women to know the truth.

    So what this all tells me is we have to competing interests here, the Home Birth industry vs. the OBGYN one. neither truly invested fully into the well-being of mothers , their experience or the health of the child. and when you attempt to research either, you get lambasted with passionate misinformation, fear and propaganda of one side against the other. Since most studies, research, articles and discussions are helmed/funded/managed by one side or the other.

    That’s what this documentary could have been about. A filmed which was a true advocate for empowering women and prospective parents. Instead it just replaces the misinformation, confusion and fear you might receive from a Hospital, with an opposite and equal does from the Home Birthing Industry.

    It’s a sad state of affairs all around.

    • April 3, 2011 10:25 am

      I understand what you’re trying to say. The strong bias in the documentary could be a cause for concern, but I believe that the main point of this documentary was to open our eyes. I learned a universal lesson that there are many approaches to the same task..and the most popular approach is not best one.
      Social Science Medley


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