"The Business of Being Born."

If the incidence of a major surgery had increased by 50% in the last ten years, wouldn't it be big news?  I imagine so.  You'd probably see headlines like, "Researchers search for clues to dramatic increase in ____ surgery," or "Doesn't the ____ work anymore?"

That's what's happened to the cesarean section rate since 1997 and no one seems to have even noticed.

Well, that isn't entirely true.  Mothering Magazine's current issue asks "Cesareans: Why so many?" on its cover and has an incisive article on the topic.  But this message doesn't seem to have gotten any attention in the mainstream media at all.  And this isn't some obscure medical procedure - it's the most basic of human experiences.

In the last few weeks I've seen the play "Birth" and the film "The Business of Being Born," and this issue has been on my mind a lot.  The film was produced by Ricki Lake, who had one traditional hospital birth and one home birth, and decided to make a film about birth in the U.S. today.

First I have to recommend that anyone who cares about mothers and babies see this film.  I was fortunate enough to see it at a community screening, but the national release won't be until November, and the DVD won't be out until next year (though you can put it on your Netflix queue now).  Here's a list of community screenings in some lucky areas.  You may also be able to arrange a community showing.

"The Business of Being Born" demonstrates some disturbing trends.  First, it shows that vaginal birth is becoming endangered in this country.  Labor under strict time frames, with induction, medication, and surgery is fast becoming the norm.  Natural childbirth is just about extinct in most hospitals, and is viewed by many in the medical professions as a quaint pursuit having no particular value to the mother or baby (or worse, representing some kind of narcissistic "glory" for the mother). 

The film shows what normal birth looks like, and it provides historical and context for birth in the U.S. (which helped me understand, for the first time, what "twilight sleep" really meant).  And it hints at what birth looks like in other industrialized countries, where it's far less interventionist, cheaper, and with better outcomes for mothers and babies. (For a sense of how different it is in England, where women are now guaranteed the option of a homebirth, see this article)  The film is also not unrealistic about the need for medical intervention in some cases.

When it comes time to offer some explanations for the current state of birth in the U.S., it discusses a number of factors, from money, to liability, to the unfamiliarity of most new doctors with normal birth.  But I'm interested in another question:  What is going to make this change?

Here's my theory:  The only people who can change this trend is us.  Sure, the insurance companies may wise up to the fact that they can pay less for births - and as a side benefit get better outcomes - but I'm not holding my breath.  And as much as I believe in the power of our democracy, I doubt that this issue will ever make it onto the radar of our elected representatives. 

For better or worse, this is the United States of America, where money talks.  Birth is a business, after all, and you vote with your feet.  That is why "The Business of Being Born" and "Birth" are so important.  They might just open enough minds to the possibility of normal birth that we start demanding care that respects our ability to do the most human of all acts:  birth our babies.  I'd love to hear your thoughts in the comments section.

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Comments

[tara]

Wow. That film looks amazing. I suspect it would be very emotional - I got teary eyed just looking at that photo you posted. The state of birth today is just mind boggling to me.

I had no idea until I was pregnant with my daughter (now 15 months) that some of the things I thought of as normal would be considered crunchy, or downright bizarre. At the hospital where I gave birth, I believe the non-medicated route is under 1%. When my daughter was born, a crowd had actually gathered in the room to observe.

I think the worst part is that with all of the interventions, I see women themselves becoming convinced that their bodies are incapable of birthing a baby without lots of medical assistance.

[Meg]

"If the incidence of a major surgery had increased by 50% in the last ten years, wouldn't it be big news? I imagine so."

But you'd imagine wrong. Life-threatening food allergies in childhood have increased by more than 200% in the last five years, for instance, but you don't see that on the news, either.

There are many conditions, diseases, and procedures whose incidences have risen. Identifying and addressing each one is important for better medical care, but imagining that Caesarians are *uniquely* ignored by the mainstream media is ridiculous.

I'm tired of the way so many women present birth as a near-religious experience. I've done it twice, both vaginally, once medicated and once not. Who cares? The babies moved from Point A to Point B and we all survived it. Mission accomplished!

I'm sure that apathy is shared by people who listen to me drone on about food allergies. The lesson is this: we all choose to die on different hills. We all crave awareness and validation of our choices, because our lives revolve around different issues. It needn't be "disturbing" that others don't share our zeal, and it's frankly offensive to state that "anyone who cares about mothers and babies [or cute children, puppy dogs, kindly grandmas, etc.]" needs to hop onto a particular bandwagon.

I am in favor of educating pregnant women without bias. If the movie is anything like this blog entry, I'll pass with a big yawn.

[appelsauce]

I'm American, but I live in Germany and had my daughter in a German hospital. The birth was natural, and it is my impression that a natural birth is the "goal" in most hospitals, with medication and intervention being available, but only when necessary or requested. In other words, if you don't ask for something and you don't need it for a medical reason, no one's going to give you an epidural or any other medication. Granted, there were a number of women in the maternity ward with me that had medication, but I just assume that's because there was a reason for it. The hospital actually has a no elective C-section policy, which means that you'll only get a Cesarean if there's a medical reason. Not all hospitals in Germany have such a policy, but there are lots of mainstream medical facilities here that have policies against elective Cesareans and in support of breastfeeding. I didn't realize how lucky I was until I read this post! This gives me reason to think about staying in Germany for my 2nd and 3rd kids!!

[Eilat]

Hey, that's my midwife Melanie in the picture!
She wasn't there for the birth of my son, her colleague Amanda caught my little boy in what looks like the room in that picture! Its the Birthing Center at Roosevelt Hospital. How cool!

[tanya@motherwearblog]

Hi Meg,

I think you're right that we all choose our issues and want other people to care as much about them as we do.

My point is not that women have to birth in one way or another, or that women have to breastfeed, for that matter. No one has to jump on any bandwagon. It's all about informed choice, and I think that films like this provide access to a point of view that is hard to find.

The point I was taken with as I watched the movie was that our choices around a moment that is important to many women (not all) are increasingly constrained by forces outside of women's control.

I do think that you would find the movie biased, just as I would probably find a more mainstream portrait of birth biased in a different way. The issue is so charged that there doesn't seem to be much neutral territory in the debate.

- Tanya

[Miki]

I think the thing that bothered me most was your claim that the increase in C-sections "doesn't seem to have gotten any attention in the mainstream media at all".

I have a really hard time getting how someone could say that, so I'm assuming that you're using a different meaning for either "attention" or "mainstream news media" than I would.

Most coverage of medical issues in big newspapers and TV news programs is triggered by press releases from articles in medical journals. In order to get published, those articles in medical journals have to be showing something *new*, that we don't already know.

So some years back (maybe 5?), there were several articles in medical journals about the rise in C-section rates, about the proportion that were purely the mother's (or doctor's) preference versus medically indicated, and about how this has changed the rates of certain birth-related complications (some have gone up, some have gone down, just like you'd expect with people switching from vaginal to c-section).

In response, there was a pretty immediate and broad media coverage -- maybe it didn't saturate every news source, but the issue *certainly* got more media coverage than 99% of medical news in a given year. There were AP/Reuters articles that were picked up by most of the major newspapers, plus several did their own, expanded coverage of the topic. It was covered in evening news programs -- maybe not in incredible depth, but still far more coverage than most medical news. In reaction to all of this media coverage, a few of the big relevant medical bodies (like ACOG) came out with their own statements about the issue.

No, there hasn't been a huge amount of media coverage since then (although I've certainly seen at least one piece a year). But that has nothing to do with "mainstream media" ignoring it, that's simply because there isn't any *news* to report. Something generally has to change significantly for it to count as news.

[Beth]

Great post, Tanya! I agree with so much of what you said. I have also seen Birth & the Business of Being Born. I was touched, outraged, and educated by both.

I agree with Tara's assessment that so many American women have lost faith in their bodies' ability to give birth without intervention. The medicalization of birth began long ago, so this loss of knowledge has been decades in the making. I think the growing popularity of the BOLD (Birth on Labor Day) movement (including the play Birth) and the movie the Business of Being Born are starting to draw more & more attention to the state of birth care in this country. Gradually, as more women become truly informed of ALL of the options available to them for pregnancy & birth care, things will begin to change toward a more mother/baby centered model of care, rather than a one size fits all model. There are many options available to pregnant and birthing women and they must be fully informed in order to make the right decisions for themselves and their babies and not have the status quo thrust upon them.

It's true that money talks in this country, and one might think that lower costs of less-interventive births would speak to insurance companies. But, it's going to take a lot of effort to make the insurance companies listen. I agree, Tanya, that is up to us to make this change happen. As more women explore their choices and work to inform their insurance companies of the benefits of less-medicalized birth, hopefully the tides will begin to change.

[Navelgazing Midwife]

The movie is no longer coming out in November (late October was the actual expectation) as once anticipated, but is coming out in February in the 14 theaters (NYC, LA and SF + 11 other unnamed cities) before the DVD release in the spring sometime. Seeing it in the grassroots arena might be the closest many folks might get to the movie before owning it and seeing it in their own home.

I'm showing the movie all this week at my offices in San Diego (we've transformed the classroom into a theater!) and I've now seen the movie about 8 times and have listened to around 50 people come into the movie birthing advocates and walk out birthing fanatics. Women who were hospital patients have walked out with a plan to leave their doctors and either find a midwife or go to the birth centers in town.

This movie is transforming!

If it is within 100 miles of where you are, GO! Fill the car with friends, family, teens who haven't yet had kids... people NEED to see this movie.

I *highly* doubt it would bore any thinking person who cares about the effects of hormonal attachment/detachment that occurs during birth in our culture... can't imagine a person yawning about the economics of slicing a person open for convenience's sake (the convenience of the clock, the wallet and the courtroom)... can't imagine that a person who has any semblence of a heart wouldn't "get" that birth as it stands today is abhorrant and a complete overhaul is needed.

It goes far, FAR beyond not having or having medication at birth... it is an entire mindset of respect for a woman's autonomy and the understanding that CHOICES in birth create the most amazing human beings that walk in our neighborhoods. Damaged women and babies do nothing but hurt the world... why foster the continuation of such cruelty? What is so difficult about giving women the options that are possible in birth? (Oh, that's right... economics!)

It goes 'round and 'round.

[Jillah]

I saw a program where they were tracking the mother's last few weeks as well as her birth. She was planning on a C-section because vaginal child birth was "so primitive and outdated" or something to that effect.
I think the best way to change this attitude is convincing new mother's to be that this is completely untrue. I know when I first found out I was pregnant all I got was everybody's horror stories. I was very open minded to having a C-section (thinking that would be far easier) as well as taking all drugs necessary so I couldn't feel a thing. It took only a couple positive birth stories to start sending me down the path of looking more into a true natural child birth experience. I think removing the fear factor that most women have about child birth can be the key to changing that attitude. I know I was truely terrified of going through child birth, but thanks to a couple people who told me of their positive experiences, then my search for more positive information as well as positive preparation, I started my labor without any fear, even when I ended up having to push for almost 4 hours! Taking away my fears, as well as truely believing that what was happening was completely natural, normal process. Perhaps if women from all walks of life could share there positive birth experiences and answer questions with "mother's to be", maybe at child birth classes or maybe a special separate type of arrangement, this could help pregnant women deciding to choose natural and choosing a birth team who would follow through with their choice. I, for one, would be willing to donate my time to share my story, since I made such an incredibly radical change (at 8 months pregnant) of how I wanted my birth experience to be.

[onetinkerbell]

Think about this: it costs far more for inductions and c-sections and epidurals than it does to have a drug-free natural delivery. There is also a much greater risk to the mother when she has a c-section and a greater risk for c-section when a mother chooses an epidural.

Many doctors push the induction route for various unnecessary reasons (they'll be on vacation when the baby is due, mom can schedule the baby's birth on a specific day, etc.) but never tell the mother-to-be that she may not give birth on that day or that she may need a c-section if she doesn't progress past a certain point in a given time period.

My girlfriend, Catherine, is pregnant with her 3rd child. She has to have a c-section. Unfortunately this is because she was induced with her 1st child and didn't progress and had to have a c-section anyway. She wanted to do a VBAC with her 2nd child but after a trial of labor had to have the caesarian. This makes her really sad because she's never been able to experience vaginal childbirth. What makes it worse is that, had she waited to go into labor with her 1st child, things might have been different. Instead, she listened to her doctor (a woman!) who told her that an induction would be best, since she would be on vacation in the week to come and wouldn't be there if Catherine went into labor. So, to cash in on being at the birth, the doctor recommended the induction.

Giving birth in America has become an industry. I have given birth in the States and in Germany. I know that I will never have as good an experience in the States as I did in Germany.

There is no doubt that there are instances when an induction is necessary ( I had one with my first child due to pre-eclampsia) or when a c-section is warranted. But far more often they could be avoided.

[Sheryl]

This is such an interesting post. I've had three babies all 100% naturally. I've always worn that like a badge of honor. It's the most amazing thing. But, now that I'm pregnant with my 4th (14 weeks) I feel so tired and so warn out that there is a little part of me that says when the time comes, knock me out, cut me open, and take the baby out. I'll be happy to wake up when it's all over.

Of course, I will have this one naturally as well, but a part of me is starting to see the other side of the coin.

[amy]

Beth,

I can't wait to see this movie and am bummed that I won't be able to until next year. I noticed that you said you were screening the movie at your office in San Diego in early October...I live in San Diego and am just wondering if you plan to hold additional screeings in the near future?

[Rachel Rabkin Pechman]

Thank you for this post! I was just writing a post on my blog about this documentary and how it lead me to switch to a midwife- - and then I found your blog online about this. So at the bottom of my post, I put a link to your post about the movie. Hope you don't mind!

[Tracy]

Years before I was pregnant, I read books about natural births, and felt secure that when I was pregnant I would experience a drug free home birth with a mid-wife. I would fantasize about what this experience would look like. Then I visited Turkey, the country my husband is from. While there I met a few new moms who had chose to have c-sections. They chose to have c-sections for different reasons, but primarily to prevent pelvic floor damage. One problem with pelvic floor damage is it can cause a lack of control over the bladder. Another Turkish friend of mine, who is the wife of an ob/gyn told me most ob/gyns and their wives choose to have c-sections in Turkey. I also have a good friend here in the states who is an ob/gyn and she is also seriously considering having a c-section. After learning about elective c-sections, I attended my sister's labor and vaginal delivery of my nephew. My nephew was born 9 poungs 11 ounces and got stuck behind my sister's pelvic bone. It was a stressful and scary situation. So, when I became pregnant, I read and educated myself about the benefits and risks of both vaginal births and c-sections. In the end I made the choice to have a c-section. I am very happy with my choice, and feel I made an educated choice that was best for me. I want women to know what their choices are, and be fully educated about their choices.

[Tarcy Hilen]

I'm hosting a screening of The Business of Being Born in Aliso Viejo, CA January 5th, 2008. If you are interested in attending please email doulatarcy@yahoo.com or call 949-241-6617.

[John S]

It is a cultural thing. Parts of this country have women who want natural childbirth and other parts have women who want total intervention. I am sure there are all kinds everywhere as well.

Also, very little in the above postings tell how paranoid the doctors have become about being sued. The fear of being sued has made almost all OB/gyn's do way more c/sections than are necessary.

I am not a midwife (family doc,) but for 12 years I tried to practice somewhat like a midwife (non-interventional, supportive prenatal care) in a frontier city populated by no small number of strong women. I now believe that the c/section rate can safely be held to ~ 6% or less. This has to be done by caring dedicated midwives (and/or physicians) who trust birth. The mothers-to-be have to be generally interested and motivated.

Many times I have seen an experienced labor nurse or midwife (and I have done it also) come into a labor room and completely calm a frightened unmedicated teenage mother-to-be in less than a minute. It isn't magic but it does require some experience and confidence. The tone of voice, the soft touch, the knowing, encouraging, hopeful look on the face can be quite soothing.

Don't get me started... It is such a wonderful miracle, it is just too bad it's gotten to the point it is today. :(

[Mindy]

Listen. The fact of the matter is that whether or not you have a medicated birth, vaginal, or cesarean section, your are still a mother. Doesn't really matter how you get there. I don't know why people feel so cheated out of "motherhood" when the baby doesn't come out of their vagina or feel like less ofa woman if they are medicated. With todays day and age, many babies aren't even conceived through the vagina (ie: invitro) so what does it matter if they come out of the vagina anyway? Whether the child comes out your vagina or though your nose, medicated birth or not, you love them the same. There is no prize or a "badge of honor" for a 'natural' birth. WHOO HOO. Yeah for your team!! The goal is a healthy mom and healthy baby. It doesn't really matter how you get there. Everyone is so wrapped up in the process of natural childbirth but no talks about how women in todays society are getting pregnant. Trust me when I say it is not 'natural'. Does having the child naturally make you a better mother? NO!! Don't give me this crap about bonding and attachment when you have a non-medicated birth. As a health care provider and previous labor & delivery nurse, I have witnessed all types of deliveries as well as the bonding that takes place after delivery. I have supported many women through medicated & non-medicated delivery as well as C-sections. Trust me, the medicated mothers still bond. It is not that women are convinced that their bodies are incapable of a non-medicated birth, they just know that they do not have to experience the pain if they choose not to. You might also be surprised to know that often times it is the women who want the scheduled induction or C-section even after the have been informed of the risks by their doctor. I agree that informing women of their choices is KEY. But whatever the woman chooses is her choice and it is OKAY.

[wpellajean]

I viewed the movie, and to me, as a midwifery apprentice, doula, and a mother the real point is- Sure you can birth any way you want, yes you are still a mother. HOWEVER if you want a natural beatufiul, spiritual birth where you are your partner are totally plugged in and connected to your baby then YOU SHOULD GET IT! Not manipulated, and practically raped in the hospital. We are lacking the CHOICE in this country, and is dominated by the hospitals, doctors, and pharm companies. Women are choosing, however are not being told the true costs of their decisions. This issue is about health, intergrity, honesty, and giving women power that has been taken away in our male dominating society. If a woman wants a drug and intervention free birth then DAMN IT! give it to her.

Hospitals are so arbitrary, and are using NON-Science to give once size fits all care to moms. Doctors have no idea how a normal labor and birth are suposed to go.

[Tina]

I am hosting a private screening of "The Business of Being Born" in Sausalito, CA. If you live in the area and would like to attend, please contact me at tinasausalito@yahoo.com, so I can send you the invite.

[Melissa]

I have had both home birth and hospital birth- 5 children. When I got pregnant I was 19 and proceeded to read everything I could about the birthing process. I went to the hospital and had a drug free natural labor. I had it all outlined and I stuck to my plan, no pacifiers, baby in my room, breastfed, no circumcision, etc. The problem here is we forget we have the power to choose. We need a movie about empowerment- people take what doctors or the hospital say as God's word and like programmed robots do whatever they suggest. Many people just are not educated about their choices- that is the real issue. I never had pain meds, never an episiotomy- I had my babies on my own terms, both at home and in the hospital- the experience for me was the same because I educated myself. When we bring awareness about choices available to women, without a lot of dramtic rhetoric, with facts and personal preference then women can be confident with what they choose.

[Elliott Kim - 21st Century Dad]

My wife and I were set up for a hospital birth. About halfway into the pregnancy, one of our friends suggested using a midwife instead. We're so glad we took her advice.

I saw the film this past Saturday. I'm already a believer in midwifery, and this film reinforced my stance. I never cried so much when watching a movie. Every time they showed a birth, it was followed by an eruption of tears.

[Lalla]

This is great to see a film like this coming out. I have been saddenned by the declining natural childbirth rate as well as the decline in breastfeeding.

I had my first child, 1991, in the hospital; completely naturally- and left less than 12 hours later. (Like someone above said- no meds, baby in room, breastfed immediately, no pacis, etc. etc.)

I had my last 3 at home, 1993, 1995, 1998, and am so glad. The difference for me was that I didn't have to fight for my choices and/or question each person that came into the room. At home, each person there was on board and supportive.

[Laura]

I'm pregnant with my 6th child and have delivered in 4 different hospitals with 3 different OB/GYNs. This 6th baby will be delivered at my 5th hospital with my 4th OB/GYN. I have several friends and relatives who have had homebirths. I have been supportive of them and happy for how things have turned out for them. However, when I watched the film "The Business of Being Born" I was struck by how scarey hospitals births were made out to be. As I've indicated, I have had a lot of different experiences delivering babies in a variety of hospitals with various doctors. It wasn't the scarey, horrible experience the film made it out to be! I've never had a C-section, nor was that possibility ever raised EVER. I had pitocin with inductions, epidurals, episiotomies, no medication, minimal tearing, and a midwife deliver my 3rd baby because I was left to labor by myself rather comfortably and my water broke, my baby crowned, no doctor, and the nurse/midwife delivered quite capably. I've had wonderful nurses and very marginal nurses. I've had good doctors and one very insensitive, overworked doctor that I've refused to ever go to again. So, with educating myself, researching hospitals, and asking many questions I've made very different choices with this next baby due in July. Besides, a skilled midwife would charge at least $4,000 for a homebirth and that's not a financial option for me and my husband. I can have a free hospital birth on my own terms with a lot of preparation and communication with my doctor and nurses. I wish the film would have been more balanced with women like me. I can't wholheartedly recommend it to all my first-time pregnant friends who will have hospital births because it is so biased against hospital births.

[Lisa]

I'm 3 months pregnant with my first baby and this movie is scaring the hell out of me (I'm watching it on Netflix right now). I feel like I'm making the wrong choice by having a OB/GYN and having the baby in a hospital. My dr. said he supports a "Burger King delivery" i.e., however I want it is how it will be but now I don't know. All I know is I want a healthy baby. I'm sure the documentary is great but I had to turn it off, delivery is not something I want to get wound up and scared about, it's going to be scary enough since this is my first child.

[Ari]

I watched the documentary and found it to be very informative and all around wonderful. As someone who advocates a more natural approach to both labor and childbirth, this film was something that I knew that I would enjoy.

I think some of the people that are commenting are completely missing the point. The film was designed to show how modern maternity care truly is and what it has become over the years. The film was showing how things generally happen in hospitals, and was presenting cold hard facts. This is reality. Everyone's experience is going to be different, but when you're speaking in a more general sense, this is how things are.

The film was giving a view into what is not normally seen. Natural childbirth is not something that we normally see or hear about. You turn on the television and all you see are television shows depicting childbirth as it usually happens in hospitals. Anyone can tell you that MOST hospitals births end up with one intervention after another after another which is what is called "cascade of interventions". It's not opinion, it's fact. The film wanted to show the other side of the coin on how things CAN be. Birth doesn't have to be scary or an emergency. The film shows how normal and natural is truly can be and should be. It shows women that they have choices outside of the hospital. That labor isn't always an emergency, nor is childbirth a medical procedure.

Are there needs for interventions? Sure are. But there's no doubt that they're overused. Modern maternity care is in desperate need of a makeover. Medical professionals are in desperate need of a reality check. Bottom line, No matter what you choose to do, be informed, educate yourself, and realize that you HAVE options. I personally loved the film and will be recommending it to a lot of people.

And to anyone that says that "the birth experience doesn't matter", walk a mile in the shoes of a woman that had a much less than ideal experience. One that left her feeling cheated out of something that could have been much more than what it was.
I am unfortunately one of those people. I know many mothers who had a traumatic birth and too have to suffer the emotional effects of that. It's much much more than just a healthy mom and baby.

Needless to say, my next child will be born at home into my arms, midwife assisted.

[KaritaG]

I just posted about this movie on my blog, and just went back and edited to add a link to this story, so I hope you don't mind. One thing I haven't seen mentioned (and maybe it's because I am a big pansy) is that hospitals and doctors are scary to some people. I, personally, get totally freaked out by needles, the idea of being hooked to an IV/catheter for hours at a time, feeling like I have no control (i.e. the doctor makes all the decisions), taking unnecessary and/or unknown chemicals/medications into my body, and (perhaps irrationally) I really don't like the idea of a needle in my spinal area. These fears are severe enough that I have had serious doubts as to my ability to emotionally/mentally handle a so-called "normal" hospital birth. My reasons for wanting a natural birth are mostly selfish. That disclaimer having been made, I loved this movie because it made me realize I had other options - I don't HAVE to have a baby in a hospital. Though that's still where I would prefer to do it, this movie gave me the knowledge to start investigating birthing centers, midwifery, certified nurse midwives with hospital privileges, OBGYNs who practice a more natural approach, etc. Had I not seen this movie, I would have been approaching pregnancy/childbirth with a lot of misconceptions and intense fear, not only for my physical well-being (i.e., the pain) but for my emotional and mental well-being as well. Regardless of whether you agree with the pro-midwife/homebirth slant of it, can't we just all agree that knowledge and informed choices are a good thing? I don't judge anyone for the choices they have made, so long as they MADE A CHOICE of their own and were provided with the knowledge to do so.

[Michele]

I was impressed with the movie, yet at the same time, disappointed. I was kind of hoping to hear pros and cons, yet it was basically "bashing" the entire healthcare industry. I get irate about some of the issues, too. Yet, I all in all, I had a great birthing experience-one I will always remember. I am so supportive of mid-wives and the medical choices for moms having their baby, yet, it might make other women who did not have natural childbirth, feel a bit down. There was a comment by one doctor who said that "Women who don't go natural will not be able to love/bond with their child the same." I thought this was extremely biased to even include in this film. I was SO in love, and would never change that moment with my child. Yes, there were several behind the scenes issues in the office, which I am still upset about, but I have to let that roll off my shoulder. My child is healthy, was born in a clean atmosphere with loving relatives waiting to see him.

[Montse Anderson]

I am 3 and a half months pregnant and watched "The Business of Being Born" several times (netflix). I think the movie is powerful and emotional. I felt the experts were legitimate and made excellent comments about the state of maternal care in America. I encouraged my husband to see it too. He was profoundly moved by it and supports my decision to birth outside the hospital. I was relieved because he is very traditional and thought I had lost my mind when I first expressed my desire for a natural birth attended by a midwife. In fact, I find it difficult to accept giving birth in a hospital unless a legitimate medical emergency necessitates that course. The movie validates my beliefs and strengthens my conviction to work with a midwife. I currently see an OB and when I told her I wanted her care as an addendum to midwifery care, she was very annoyed and suggested my desire was something less educated and economically challenged women did, when in fact, 96% of women in the U.S. who choose midwifery care are in fact educated and middle class. Regrettably, my city - Phoenix - doesn't have a birthing center. The only one closed a couple of years ago. Not one hospital supports waterbirthing and very few offer midwifery care. I am moving to Dallas in a few weeks and am relieved to find a birth center operated by Certified Nurse Midwives! I am grateful for the movie mainly because it let me know that I have choices. I don't have to go the traditional hospital route. I want to experience birth the way nature intended.

[hoshimaru]

Laura and Melissa, thanks for your comments! While the film was less biased than I expected, I did sense that it's depiction of hospital births was a bit skewed. The film seemed to totally gloss over the fact that a mother can stand her ground in a hospital setting. I think the film would have been much more empowering had it shown examples of women going into hospital settings and still getting the birth experiences they planned on.

[Claire Skinner]

I just got back from visiting my twin sister in the hospital. I had given her the movie the Business of Being Born to watch so she would be informed and she had a Dula lined up. She was 2 weeks late so they induced her. Before we know it she has a c-section. It turns out 6 of the 12 women on her floor had c-sections. Seeing my sister drugged out on morphine was so heartbreaking. I feel depressed, I feel robbed.

I am planning to get pregnant soon and I will be having a home birth with a midwife. I agree with the film that the medical establishment is taking away this right of passage, this sacred event for profits. It angers me greatly.

I did some research on the internet and found that c-sections create greater rates of post partum depression. Not the way we want mothers to start out caring for their baby.