I made my 2008 documentary The Business of Being Born to educate women about choices in childbirth, and raise questions about maternity care in the U.S. For example, why were C-section rates skyrocketing? Why were options such as birth centers and home birth disappearing? And why does a country supposedly committed to health care reform seem opposed to safe, cost-effective options that include midwifery and well-woman care?
The impact of the documentary was monumental. The blogosphere blew up (I can handle a few people yelling at me if it means my message is being heard!) Every day women stop me on the street to share stories of their safe, successful, meaningful births. Many say they felt "in the dark" about their options until seeing The Business of Being Born. But unfortunately, due to the highly medicalized climate of hospital births and the financial interests of insurance and drug companies, our birth options are disappearing at an alarming rate. It's seems that the more we know, the fewer choices we have. In the last five years, New York City alone has witnessed the shuttering of its only freestanding birth center, two hospital-based birth centers, a popular childbirth education center and a major hospital that offered privileges to a large number of hospital midwifery practices and home birth midwives. This has left many parents-to-be struggling to find birth options outside of the traditional OB/GYN approach.
But why is all of this important? Why does it matter if a mother's prenatal visits are 10 minutes long or last more than an hour? Why does it matter if the care provider at her birth is someone she has built a trusting relationship with over 9 months or a stranger-on-call? Why does it matter if a woman brings her child into this world in a way that makes her feel empowered and respected, as opposed to feeling pushed through a delivery where she is not an active participant in her care? Does how we are born really matter if mom and baby are pronounced "healthy" in the end?
Well, I have seen that it matters quite a bit. For me, this is not about promoting natural birth or home birth or claiming one model of care is superior to another. What I have come to realize is that, at its core, the birth process is directly connected to most important thing in this world -- loving and caring for our children. The bottom line is that mothers who receive attentive prenatal care and have a positive birth experience are in a better position to create a healthy attachment to their babies, have more success breastfeeding, and enter the experience of motherhood feeling empowered and energized. And that concept -- the respect for birth as the sacred beginning of motherhood -- is what has become sorely lost in our mainstream medical system. Yes, having a healthy baby is of tantamount importance, but what could be more essential to the emotional and physical well-being of future generations than to honor and empower mothers through pregnancy and birth? Sometimes I think the only people who really understand the relevance of this issue are the mothers themselves, and we are all just too tired and busy raising our children to make a stink about it.
I, however, am making a stink. It concerns me to see that a growing number of mothers feel coerced and undermined during the birth process, and rates of post-traumatic-stress disorder after birth are on the rise. There is a blasé attitude toward rising cesarean rates, which now make up one third of all births in the United States. Any doctor will tell you that a Cesarean is major abdominal surgery, so why is this the only example in modern medicine where a post-op patient is sent home to care for a newborn? We have absolutely no system to follow-up on mothers after birth and make sure they are able to care properly for their babies. In other countries, new mothers are visited daily by nurses or doulas who help them with breastfeeding or household chores.
The entire pregnancy and birth process is physiologically designed to prepare women emotionally and physically for motherhood. Mother nature has endowed us with a complex interaction of hormones that literally reshape the human brain for motherhood. Doctors have not even begun to crack the surface of understanding the neuroscience behind the hormonal interactions between mom and baby during the time of birth. In fact, they do not even understand what causes a woman to go into labor, which is why labor induction methods remain crude and statistically double one's chances of ending up with a cesarean. (Most women aren't informed of this risk and blindly opt for the "convenience" of a scheduled induction.) There is a complete lack of evidence-based medicine when it comes to childbirth. Although I am worried about the effects of all this intervention, my true passion is making sure that new parents are informed.
To further this conversation and give expectant women more empowering information to make their own decisions about their births, I decided to create a series of educational DVD's called More Business of Being Born.
The topics covered in my new videos will not be discussed at the typical 5-10 minute obstetric appointment. But the information is essential -- so essential that we decided to forgo the traditional studio distribution model that we used for the original film and self-release, market and distribute these videos. This has been no small task as we have yet to see a dime of revenue from The Business of Being Born and had to ask our filmmaking team to create the 6 new hours of video for no salary. We have created a Kickstarter campaign to raise all the necessary funds for self-distribution.
I ask you to join me in fighting for the right of all mothers to have access to safe, intervention-free options, and to let other women know what those options are. How and where you decide to bring your child into this world is a choice that belongs to you.
To be a part of this movement, please click HERE.
Melanie Batley: Time to Reconsider Whether the NHS Should be Encouraging Home Births
Rabbi Jason Miller: Motherhood and the Rabbinate: A Male Rabbi Responds
YouTube - "The Business of Being Born" 2007 Trailer
Movie Review - The Business of Being Born - American Motherhood ...
Link to "midwife retiring due to dead baby" : http://skepticalob.blogspot.com/2011/06/prominent-midwife-retires-after.html
Link to "baby died due to home birth after c-section http://skepticalob.blogspot.com/2011/06/another-hbac-another-rupture-another.html
Link to "Mothering.com: more than 20 home birth preventable deaths in two years" http://skepticalob.blogspot.com/2011/05/motheringcom-more-than-20-preventable.html
Link to " baby died due to untreated Group B Strep by midwife" http://skepticalob.blogspot.com/2011/03/wrens-story-on-1st-anniversary-of-his.html
http://skepticalob.blogspot.com/2011/05/midwife-lets-baby-die-breaks-law-pleads.html
ETC, ETC.
And did I mention all of these babies would be alive if the mothers had gone to a hospital to give birth. SAD!
All the latest research confirms the fact that planned home births for low risk mothers that are supervised by a trained birth attendant are as safe, if not slightly safer, as hospital births.
That is the data, plain and simple. Your campaign to needlessly scare women into thinking that they are irresponsible for giving birth at home is misinformed. On the same note, I could find story after story of infant and maternal deaths due to hospital negligence. It is time that we start looking at the facts for what they are and supporting each other as mothers. The truth is that the US has one of the worst neonatal/maternal mortality rates in the industrialized world (As an aside, perinatal mortality is an ADDITIONAL indicator, not the most important, as you stated. http://www.who.int/healthinfo/statistics/indneonatalmortality/en/) "The Business of Being Born" is bringing this debate into the mainstream and I commend the filmmakers for their efforts. At the very least, do your research before making inflammatory statements.
http://www.naturalchildbirth.org/natural/resources/homebirth/homebirth01.htm
http://ajph.aphapublications.org/cgi/reprint/82/3/450.pdf
http://www.lamaze.org/Research/WhenResearchisFlawed/Homebirth/tabid/172/Default.aspx
http://www.thefarm.org/charities/mid.l
http://www2.cochrane.org/reviews/en/ab000352.html
From Sciencebasedmedicine:
"Highly-paid obstetrical expertise is not needed for most births. There is no reason well-trained, well-equipped midwives could not deliver babies at home for those who prefer it and are willing to accept the small risk. There is also no reason midwives could not deliver most babies within the hospital in a patient-friendly homelike environment with expert emergency backup right next door. That would be the best of both worlds."
Then you will understand why we have such a poor OB outcome in this country.
The correct statistic for measuring obstetric care (according to the World Health Organization) is perinatal mortality. Perinatal mortality is death from 28 weeks of pregnancy to 28 days of life. Therefore it includes late stillbirths and deaths during labor.
The US has one of the lowest rates of perinatal mortality in the world.
2. The Netherlands, which places the greatest reliance on midwives, has low mortality rates.
Both of my kiddos were induced at about 8 months due to kidney failure caused by severe pre-eclampsia.
I've never had high pressure in my life except during pregnancy.
Thank the stars I have 2 healthy kiddos despite being forced out of the womb at 32 wks & 34 wks, but my inductions were attempts to save my life and the lives of my unborn children, not conveniences.
What is convenient about having synthetic hormones pumped into your veins at a rapid rate to force your unready body to begin labor?
What is convenient about having your OB/GYN break your water for you in an attempt to force your unready body to begin labor?
What is convenient about having to being hooked up to an IV of Magnesium Sulfate (used to prevent or stop seizures caused by high blood pressure) for the entire labor and delivery and then being continued by IV for an additional 24hrs following delivery?
Maybe some women view that as a convenience, but I'd have given plenty to have 2 labors that were begun because my baby and my body were simply full-term and ready to deliver.
Now as far as labor being so excruciating in order to prepare us for motherhood - well that's just silly. Labor is excruciating no matter how you do it and we shouldn't judge people because they had a C or heaven forbid, an epidural. I speak of this with bias because after delivering my first two drug free and getting an epidural the third around- I don't know WTH I was thinking the first two times.
Home births? Don't get me started. What's more important - feeling empowered because you did this in your bedroom or feeling safe because you were in a hospital if anything went wrong?
Mothers who receive good care raise healthy cared for babies, who are then more likely to become responsible thoughtful adults.
That must be stopped.
The capitalists need poor, uneducated, emotinally damaged population to exploit and manipulate.
I just meant that motherhood is important, and everyone deserves that basic human rite of passage (as long as they want it), but Im not sure every woman should have children. It can often be more selfless to refrain - like if you don't really have enough money for a child, you are hurting that child.
Also, I found it somewhat alarming the amount of pleasure the women in the film were getting out of the experience. It was almost fetishistic and by the end it seemed almost an addiction. They took the "getting back to nature" approach, but I doubt that in nature your husband would be laying behind you and spooning you.
Bottom line: It hurts for a reason. There are too many people for everyone to have multiple kids.
Women who feel the need to roll the dice and who feel that the only way they can feel empowered is to squat in a thatch hut & chant (exaggerating, of course)...let them sign away their rights to collect more than $100,000 from their health insurance company, have the state pay for treatment and/or sue the 'birther'.
See, all of us pay for the massive costs for caring for these children via higher insurance rates $ tax dollars. If more women go natural, more children will need $$$ care, and we don't want to pay.
The only area where I want liability caps to be in effect is ob/gyn medicine. Too many doctors are being sued for things they can't control/correct during births.
To really help the situation caps must be placed on malpractice suits.
http://www.northshorelij.com/NSLIJ/High+Med+Mal+Rates+Drive+Out+Ob+Gyns
As I wrote in my original post, this one can be squarely blamed on the medico-legal environment in this country.
Docs are scared of two major things, CP and Distoscia. Both of them can be avoided via Csection.
On the grim side of the math, it is cheaper to risk the mothers life than risk a CP claim.