Childbirth educator and documentary filmmaker Vicki Elson likes to say, aside from the typical hospital birth, there are essentially three kinds of births on television:
"One type is a pioneer woman or early Native American just pushing her baby out, no problem. Another type is an accidental birth on an airplane, in a tree, or during a hostage situation. The third type is a planned out-of-hospital birth. These look pretty flaky on TV, like what they call "extreme birth" with dolphins or in remote lagoons, although in reality planned home birth with good midwifery care is as safe as hospital birth."
After viewing Elson's new documentary, "Laboring Under An Illusion: Mass Media Childbirth vs. The Real Thing", you realize she's absolutely right. It would be hilarious (and it sometimes is) if not for the absurd reality that we're talking about society's visual storytelling of the single most connecting link between human beings in the history of all that is and ever was: birth. Why are we presenting childbirth in ways that repel, scare and misrepresent women (and our someday partners) and our birth experiences? By ceding the representation of childbirth to the "oh, it's just television" mode of thinking we surrender some of the wisdom of our own bodies, the knowledge about birth we can pass onto other women, the wonder of the beauty and the remembrance of the pain in a way, as well. Elson is determined to take it back.
It is a growing problem. Elson reminds us in the video "two-thirds of pregnant women watch reality television shows on childbirth but only one-quarter of these women actually attend childbirth education classes." What kind of "education" about birth are women getting? First off, babies can be beamed out, as one was from Deanna Troi on "Star Trek: Next Generation." Or, cesarean sections are becoming "the norm" as vaginal birth is being presented as 'the other' option on reality television shows about pregnancy and birth (view her video to learn more). And, finally, should you find yourself pregnant, on a beach sunbathing? Elson tells me that one of the weirdest television scenes about birth she's witnessed was from the old TV show, Baywatch, where one of the characters gives birth without taking off her one-piece bathing suit.
I spoke with Vicki Elson about her video documentary: the "panicky fathers" and "mothers screaming for drugs" on one end of the media-representation spectrum. And the "orgasmic" and "unassisted" births on the other. Because Elson has been working with women and their partners for many years, her answers to my questions and her perspective seem wonderfully balanced, rooted in a crystal clear concern for what is best for women, preparing women to have the healthiest birth experience they are able.
You've been educating pregnant women for 25 years! What made you originally decide to get into this line of work and what was the impetus for making this documentary?
VE: When I had my first baby, I was young and clueless and I considered myself a wimp. It was the hardest work I ever did, but it was a life-changing joy. Afterward I felt like I could do anything - which was great, because what I had to do next was raise a baby. I think it really set the stage for my daughter's entire life - and mine. There were certain elements that contributed to having such a positive experience - my care providers, childbirth classes, and support team especially. I wanted to share that with other families, and all these years later, teaching classes and watching new parents get born is still fun!
The impetus for the film was this: I was doing a workshop for nurse-midwives at a local hospital when a particularly ghastly and unrealistic (and Emmy-winning) episode of "E.R." came out. The midwives said their phones were ringing off the hooks because moms were scared that they could die like the lady on TV. Meanwhile, Murphy Brown was America's liberated TV mom who could anchor the news and stand up to Dan Quayle. But in labor, she was wilted and powerless, except when she was strangling men by their neckties. I wanted my kids and their friends to grow up with realistic, nourishing imagery about the power of their bodies to do normal things like have babies. I was working with midwives Rahima Baldwin Dancy and Catherine Stone on a workshop called "Empowering Women in the Childbearing Year," and we started collecting clips to show childbirth educators what they were up against from the culture. It's still a struggle to compete with compelling but unrealistic imagery that sticks in people's minds. I expanded on that project to write my master's thesis 10 years ago, and when the kids grew up I finally got around to updating the project and putting it on DVD so it's more useful and accessible. What's the film like?
VE: It's 100 birth scenes -- TV and movie comedies, dramas, real births -- plus narration. Birth films tend to be very romantic or absolutely terrifying. I wanted to juxtapose real and fake births and let people make up their own minds, and I wanted to make it funny, because the subject can be so intense. And I have to say that it is pretty entertaining. It can be really fun to examine cultural hopes and fears in a new way, and a lot of the clips are hilarious. Do the pregnant women in your classes (and/or partners) ever come in to class with visions about childbirth that they got from the media, that are just so bizarre or unrealistic that is noteworthy for you?
VE: I wish I had some hilarious anecdote to tell you - but really what's striking is that women who are otherwise smart and capable come to class feeling very scared of a normal physiological process. It's getting worse over time, too, as people are exposed to more and more media, and more people are watching birth "reality" shows than coming to childbirth classes. The reality shows often take footage of a nice normal birth and then re-contextualize it with a terrifying voiceover: "The most DANGEROUS journey of the baby's life...the four-inch trip...DOWN...the birth...canal."
What are the usual stories in TV and movie birth scenes?
VE: The mom is married, white, heterosexual, upper middle class, slender, and about 30. Labor starts and she needs to be rushed to the hospital - this started with Lucille Ball. She hits a traffic jam or a flood or some other drama on the way. The doctor is rude or maybe incompetent. She was planning a natural birth but then she dramatically requests drugs.
What about fathers and partners?
VE: They're panicking and driving badly or getting waylaid on the way to the hospital. Or, they're being beaten up or sworn at by the mom. But I think the same thing works for moms and for their partners, whether their partners are male or female: counteract the unrealistic imagery with realistic imagery and solid information. Birth does have some risks, it is painful, it is messy and noisy and joyful and sweaty. But it's not the embarrassment or the catastrophe it looks like on TV - it's just the hard work that we mammals do. Partners can make a world of difference with nothing more fancy than love and backrubs and words of encouragement.
There is a film "Being Dad" that's been getting good reviews. I think it's important for moms to know what it's like for dads as well as vice versa, and this film may help. I am also a big fan of women's groups and men's groups. My partner and I have been in our respective groups for many years, and there is a lot to be said for the candor and intimacy of gender-specific socializing. Such groups are also a great safety net when one member or another hits a rough patch in life. One line really struck me in the video. When a woman says, "Some of my friends feel sorry for me that I had a c-section. I had a healthy baby and that's what matters." How do we present more realistic experiences of women who have c-sections, while simultaneously addressing how important it is not to treat c-sections as just "another way to give birth" - that it is major surgery?
VE: I tried to make the film inclusive of all mothers. It is important to acknowledge that cesarean birth is indeed a birth: it is every bit as meaningful, and it can be every bit as joyful as birth the old-fashioned way. There are two other things we should acknowledge simultaneously, though. One is that outcomes don't improve significantly when the cesarean rate is over 5 or 10 percent, and now it's 32 percent in the U.S. Therefore the majority of cesareans are medically unnecessary, with attendant risks and costs. The other thing to keep in mind is that cesarean birth can be harder to recover from physically and emotionally, and moms will need extra support. A woman healing from a cesarean may need to work on acceptance, and people should be absolutely respectful. She may experience conflicting feelings from losing her ideal birth and gaining a healthy baby. She may also wish to investigate whether her surgery was medically necessary, or to educate other mothers about making informed decisions, but such activism must come from her.
In the video, one woman asks: "Are these my only choices? An unnecessary cesarean or an orgasm in a hot tub?" I think, for women who are set on having a natural childbirth, sometimes the pressure to think they have to have the most wondrous, orgasmic birth is another level of perfectionism for women. Do you think more realistic images of birth in the mainstream media can help women on this end of the spectrum as well?
VE: Absolutely. Imagery can be overly romanticized OR overly medicalized. From the beginning, childbirth education has run the risk of giving the impression that there's a "right" way to give birth. I love the orgasmic birth films because it's great to know that birth is not necessarily a medical event that's all about pain - birth is, in fact, part of the continuum of a couple's love life. (Hey, if I'd known orgasmic birth was a possibility, I might have had more kids!) But just because a few women have such pleasure doesn't mean the rest of us should compare ourselves to them. No two women give birth alike, and even the same woman will have different experiences with each baby. Yes, the media should be more realistic, AND women need to take responsibility for filtering what they take in. Each of us needs to own and honor our own unique experience. And our friends and care providers should support that.
Are you promoting home birth or natural birth?
VE: I tried to make a film that doesn't propagandize any particular way of giving birth, because everybody's different and there can always be surprises no matter what kind of birth you've planned. The film has a wide variety of births: real, imaginary, fast, slow, simple, complicated, natural, surgical, orgasmic...
We see virtually no images of childbirth doulas in mass media. Do you show your childbirth students images of doulas at work with their clients?
VE: I can think of only one or two doulas (non-medical labor support providers) who appear in my film, but I agree that it's an extremely important topic that should be emphasized wherever possible. I'm a doula myself and I loved having doulas at my children's births. Doulas help moms and partners and siblings through labor, and often provide more continuity than doctors, midwives, or nurses can offer. The reassuring presence of a doula - even one who doesn't speak the same language! - has been shown to shorten labor, decrease intervention rates, and improve maternal-infant bonding. There is a related profession called post-partum doula. These fabulous people cook and clean and massage and support breastfeeding in the early weeks.
It seems obvious why the mass media portrays birth in the way it does - it's traditionally, like most cultural institutions in this country, been a male-dominated institution, on the whole. So, how do we go about changing these portrayals?
VE: I think that it's not just a problem of patriarchy - it's a problem of profit. Hollywood is under the impression that what sells is danger, speed, indignity. To remedy this, we have to start with media literacy - making ourselves less vulnerable to media imagery. If we have to wait for Hollywood, we might wait a long time. I'm giving it a try, though - I'm starting up an Authentic Birth Clearinghouse (www.authenticbirthclearinghouse.com will launch soon). It will offer assistance to mass media writers, producers, actors, and directors. There will be guidelines, connections with expert advisors, links to websites that offer realistic birth imagery, and workshops in Los Angeles, New York, and elsewhere.
Who is this documentary for?
VE: It's great for childbirth classes, high school health classes, and college courses in media studies, medical anthropology, or women's studies. It's a good film to screen as a fundraiser for childbirth or media literacy organizations. It's a good resource for libraries. And it's an offbeat gift (or activity) for baby showers!
You can view the feel good trailer below but one word of warning to all: have a box of tissues nearby because birth, when it's shown in all its glory, is a beauty to behold:
For more information on the video or to order a copy, visit Birth-Media.com.