the business of being born

I just watched the powerful movie, The Business of Being Born.  If you have not had the opportunity to see it yet, I highly recommend it to any adult who cares about the process of birth in this country.  (You can get it from Netflix, or you can ask your local library to order it! Nudge, nudge!)  Regular readers of this blog and those who know me personally will know that normal birth is a passion of mine!  This is such an important topic and a timely movie, as the c-section rates in America have risen 400% in some places over the last fifteen years, spiraling out of control to levels of 45% or more of births in some urban hospitals.  I cannot state this strongly enough: this is a crisis of health-care in our supposedly "developed" country.  C-sections are major abdominal surgery and pose much greater risks for the health of the mother and baby.  Yes, they are medically necessary sometimes, (in my calmer moments, I like to think that mine saved Clara's life) but there is no accounting for the rate they've reached in this country.  Actually, our maternal and infant mortality rates are among the worst in the industrialized world. In a UN study of 171 countries, the US ranked 41st on maternal mortality rates, far behind our global peers in Europe and Japan, and below developing countries such as South Korea (1).  According to an article published on CNN.com, highlighting a study by Save the Children researchers, the US has an infant death rate second only to Latvia in the industrialized world.  Incidentally, one of the key differences between America's birthing industry and the birthing practices of the rest of the world is midwife attendance.  Midwives attend upwards of 70% of births in Japan and many European countries in stark contrast to less than 8% in America. When midwives attend births, the levels of c-sections and other medical interventions decrease accordingly.

Bewilderingly, TIME magazine just published a chilling article on the popularity of elective c-sections among "choosy moms."  (I'm linking to this article, even though it is full of misinformation and flat out contradictions to well-documented medical facts.  PLEASE educate yourself about the reality of the situation before reading an article like this and believing it!)  This is a sickness in our country, that we would choose the "convenience" of an elective cesarean and subsequent tummy tuck over the potential health risks to our children and ourselves.  Vaginal birth provides a variety of documented health and safety benefits to our babies, ones that should only be overlooked for the option of cesarean only in the most extreme of circumstances.  A woman is five to seven times more likely to die from a cesarean delivery than from a vaginal delivery.  This should not be taken lightly to accommodate the schedules of mothers or doctors.

But the issue of c-sections aside, even "standard" medical interventions such as the use of pitocin and epidurals come with a host of risks (read this excellent article to find out more details). The unfortunate reality is that we have created a system in this country where one medical intervention leads to another.  Often, just showing up at a hospital to birth your baby is cause enough to start the chain of interventions.  If labor isn't "progressing" according to the desires of the doctors or hospital protocol (this does vary among practitioners and hospitals, so it's a good question to ask when choosing a birthing location) then pitocin is administered to speed up contractions.  Unfortunately, pitocin generally causes very intense and painful contractions, that frequently don't let up the way natural contractions do.  Withstanding the pain of pitocin-induced contractions without pain meds is a feat indeed (yeah, Brook!) but most women understandably then ask for an epidural, which numbs the pain, but incidentally slows down labor, often leading to the need to up the pitocin levels, or, if labor is really stalled, an "emergency" c-section.  What a sad cycle!

The saddest part of it all is that birth is an inherently empowering, life-changing experience for women, and this is being handed over to the "experts."  When did a woman's body cease to be the expert on birthing her own baby?  What is the price we are willing to pay for this "expertise"?  Where is the feminist outrage that we are being "manhandled" by the powerful medical lobby?  Of course, it isn't all doom and gloom.  Women all across our country are choosing to birth their own way, be it in the comfort and safety of their own homes, in a free-standing birth center, or bravely birthing mindfully in a hospital setting.  Many smaller hospitals are more birth-friendly, such as the incredible hospital where Clara was supposed to be born and where my nephew(!) will be born this summer.  Many hospitals are developing homey birthing centers where you can be attended by a Certified Nurse Midwife, rather than an OB.  (A woman interviewed in The Business of Being Born points out that Obstetricians are trained as surgeons and specialists in childbirth pathology or illness, and receive little to no education in healthy, normal births.  It is wonderful to have an Obstetrician on hand to handle emergencies, but there is no reason that they should be attending normal births!)  Birth can be an exhilarating experience for the mother, that leaves her feeling powerful and charged with the brain chemicals and hormones that are only released through a vaginal birth.  These chemicals and hormones provide her with a strong sense of love and protection for her child, and give her an adrenaline rush that gives her the strength to keep going after the exhausting birth experience.  Being medicated out of this experience should not be done casually or routinely.  I love the picture below and the look of pure ecstasy and wonder on the mother's face.  When I think about my own traumatic birth experience, pictures like this make me cry!   Oh, what a miracle birth is, medical or not!  But there is a unique magic to normal birth that is not replicated through medical intervention...

So, that was my long explanation of why you should check out the challenging, inspiring, moving and funny new film, The Business of Being Born.  As the tag line says, you'll never look at birth the same way again!  Take a look at the trailer, below:

Comments

[Lindsey]

Good job, Caren! I'm so inspired after watching that film!

[Lizz]

I'll wave my hand for traditional midwifery and homebirth. It's in my blood in oh so many ways and I'm glad!

(Yes, it's a good film.) nodding

[Varenia]

i'm going to have to get that film. luckily, although i am and have chosen to give birth in a (somewhat large) hospital in southern california, i have always been cared for by a midwife, and can't sing the praises of a midwife enough. in an emergency situation recently my midwife was unavailable and i had to see one of the top regarded ob's with the hospital and i couldn't believe the difference in care! the ob was very well educated, and even compassionate to my situation, which i appreciated, but so ready to medicate, recommend surgery, labs, tests, etc. after only knowing me for about five minutes. i know there are some situations where i would be really grateful to have access to what i would consider invasive medicine, but other than those life or death encounters, thank goodness for my faith in my own body and spirit to perform this miracle, and for women like my midwife who are much more apt to take a wait and see approach to pregnancy and birthing. anyway, sorry for my rant! your post just really hit home for me, especially being 4 months along with my fourth baby! thank you for the info on that movie, i can't wait to see it!

[lara]

thanks caren for the beautiful post that made me cry. i work in labor and delivery now for one of the best hospitals in philly for high risk patients. but what is sad is that every woman that walks through those doors is viewed as high risk. every single mom receives pit, is limited to the bed and ice chips, and about 95% receive epidurals! we had a mom die two weeks ago as a result of a c section! yes, moms must be informed. i couldn't agree more. I don't think i will last long in this assembly line of birthing babies. hopefully, in God's timing, I will find a job working with midwives.

[Caren]

Lara, I'm so glad to think of someone like you in that hospital situation nurturing the moms through their birth process. But, yes, it must be hard on you after a while!