Review: The Business of Being Born

"Medical decisions are made for monetary and legal reasons, not because they're good for the mother and the baby," This quote that is said in the beginning montage of the documentary basically sums up the entire film. This film grew out of executive producer Ricki Lake's own experiences with birth, and her search to find other options. It interviews both medical doctors and midwives, as well as birth experts from around the world such as Ina May Gaskin and Dr. Michel Odent, as well as following several mothers in New York who are trying to take the natural birth path. The film doesn't focus as much on Ricki Lake as initial advertisements might represent, and I think that strengthened the film. She is in the background, only the guide for the position she wants to get across, not the star. There are shocking and interesting numbers presented, as well as an interesting segment following the problems with labor and delivery medicine over the years. It was narrated by a medical anthropologist, and I actually wish that they went more in depth about the history of obstetrics. I wish the short segment about the twilight sleepers and then the treatment of women in labor was longer, because I think it would highlight the point they were trying to make. There was a little bit of commentary about different medicines and processes used from the 1930s up to 1999 and the consequences from them, such as damage from X-Rays and birth defects from medicines prescribed. Again, I think more details and information on this topic would have only strengthened their argument, and their cursory dealing with it detracted from the final message.

While I enjoyed the documentary, and very much agree with the message of the film, there was not much of a counter-argument to their opinions. However, the movie itself is covering the obscurer side of an argument, so one can point out that the opposition's point of view is the dominant idea in the country. So while there isn't much of a counter argument, the theories and ideas of the American Medical Association can easily be found and are the prevailing ideas in the industry, and the point of the documentary was to show the lesser-known facts and points of view, so it's not much of a downside. But having both medical professionals and midwives give interviews generally agreeing with the message of the film gave it credence and made it more than a hippie, alternative medicine sort of documentary. Seeing the split in both professionals and midwives in reference to home birth as a solution to the industry's problems was good, showing that some professionals are in general agreement with the problems with the system, but are against other parts of the movement. This made the general one-sidedness of the documentary better as well, since not every person giving their opinion in the film was in complete agreement with the filmmakers. It would have been good if the filmmakers had followed someone not going the home birth/birth center route in the film, so they could create a comparison arch, to show exactly how different a hospital birth versus a home birth can be, to use cinematography and editing structure to highlight the differences, rather than just listening to people talk about it. The film also had a narrow focus on specifically home births, rather than expanding to include birth center births, and births in the hospital overseen by a midwife rather than a doctor. This would also expand the points the film could make, although it might have made it too long, and that might be why the film only focused on one segment of the non-doctor attended births.

Part way through the film, while speaking on the phone with a potential interviewee, we find out that Abby Epstein, the director of the film, found out that she was pregnant completely separate from the filming of the documentary. Now she becomes one of the women whose birth story is followed over the course of the documentary. This added a lot to the film, but the way it was kind of stuck in midway through the film was a little awkward, and several parts of her story didn't mesh well with the rest of the film. I thought it could have been handled better than it was. It was an important addition, but it could have been blended into the narrative flow better than it was. She also served the purpose of being the woman who wanted to have a home birth, and medical problems legitimately made a hospital birth necessary. The focus of the film is that hospital births are overkill for normal births without any complications, and this really drove the point home that supporters of natural births and midwifery are not trying to completely abolish doctor's role in birth and that they appreciate that they are needed in emergencies. Abby's caesarian section is basically the end of any narrative structure to the movie. The end is lackluster, and there isn't much closure, other than an Abby speaking to Ricki several months after her son's birth about how not having the natural, vaginal home birth that she wanted affected her. Again, this is a complaint with the structure of parts of the movie, and adds to the feeling that the director's pregnancy was just kind of tacked on to the movie, rather than really being a part of the film.

All in all, I felt it was an honest, heartfelt film, despite it's issues. It is a definite watch for any expecting mothers, if just to see the other options available to them. I agree with the general message, that it is a woman's choice how and where she wants to give birth, and the medical industry is failing miserably in making sure women know what their choices are. The movie is a good introduction to these choices, and the idea that the medical industry might not have the best intentions in mind for mothers and babies with the interventions they use. It's not the end all of information for the movement or the options, but it is a good primer to those who are curious about other options. I think the film accomplished its goal in making information available about women's experiences, and some of the reasons behind the state of maternal care in the nation.