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More Business of Being Born: We Are All Warriors

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In April, I wrote about Ricki Lake’s first birth documentary The Business of Being Born (BOBB), click here to read that post. Now it’s time to take a look at the follow-up film More Business of Being Born (MBOBB). It was another moving, enriching, powerful experience for me.

The first film, BOBB, looked at the data detailing the rise in interventions used in hospitals, the alarming increase in cesarean rates while at the same time there has been no increase in infant mortality.

MBOBB answers many of the questions women asked the makers about birth options. Director for both films, Abby Epstein, says when you know something should be a certain way it resonates and BOBB struck a cord in these women where they said that’s right and why are we putting up with all of this and why have we accepted these images in the media and where do we find out more about natural childbirth?

Ms. Lake calls it her “duh” moment, where Oprah has her “aha” moment Ms. Lake has “duh”. There was so much more that couldn’t go into the first film and people are still confused about different aspects of birth options the team wanted to make a series of educational videos for those who where inspired by BOBB and needed to see and hear and learn about more practical experiences of natural birth.

MBOBB is a series of four documentaries that can stand on their own and are in favor of natural birth education. Ms. Lake says she’s not telling women what do, she wants women to know their options and get all the information they can so they can choose what works for them.

The first two documentaries are more a conversation between women about birth trends and the birth experiences of celebrity moms. Parts three and four get into birth planning guidance by exploring birth options and debating the controversial Vaginal Birth After Cesarean (VBAC).

 It all begins Down On the Farm: Conversations with Legendary Midwife Ina May Gaskin.

Ms. Gaskin and her husband Stephen started The Farm in Summertown,Tennessee in 1971 along with all the people in his band of buses that had been traveling the country spreading their message love not war. It started as hippie commune and has evolved into a thriving sustainable living cooperative community today.

Early on, the community began to have babies and having no insurance they utilized their own knowledge to provide midwifery care. There were a few trained midwives among the women and they formed relationships with local doctors who supported their work on The Farm.

For Ms. Lake, spending time on The Farm was like a pilgrimage, like meeting the Beatles. Ms. Gaskin was the inspiration for her own exploration into natural birth leading to the home birth of her second child.

The women gathered around Ms. Gaskin’s kitchen table and talked candidly about the latest birth trends. I grabbed a cup of coffee and listened to their enlightening conversation.

The Farm midwives say that a healthy woman can have a natural birth more than 98% of the time but it’s that 2% that everyone focuses on and leads women to think is the norm.

On The Farm, it’s extremely rare and unseen for a healthy, normal low-risk birth to spontaneously and rapidly get to a high-risk situation. If just doesn’t happen. Yet in hospitals, it happens and it happens often.

Ms. Gaskin shared her quilt project which was inspired by the AIDS Quilt. She has gathered quilt squares memorializing women who died during pregnancy, labor, or postpartum. Many women died from adverse reactions to induction drugs, an infection after birth, and postpartum hemorrhage at home because there is little after-care provided to women in traditional hospital settings.

The Farm midwives have attended over 2,800 births. Their c-section rate remains 1.7%. In 2007, the US national rate was at 32%.

Special Deliveries: Celebrity Mothers Talk Straight on Birth is the second documentary in MBOBB and it’s my favorite by far. In BOBB, women and doctors lamented that it’s hard for women to find empowering birth stories because the negativity of birth pervades in the media and in women’s conversations with other women.

Celebrity moms talk straight about their birth experience from expectations and fears to labor and delivery through to transformations and finally motherhood. I needed the tissues for this part. For me, birth is empowering and these successful, famous women shared their heart-felt, deep spiritual experience of giving birth.

Cindy Crawford made waves in the media years ago by sharing her homebirth experience. She brought a real face, a real experience to giving birth at home into the spotlight when she shared her story. Ms. Crawford says in MBOBB that she loves how the midwife is there when you need them at a homebirth and they can blend into the walls and let you do what you need to do. Early in her labor she needed to just be. I needed to labor, she says.

We don’t make choices in our lives to put ourselves in pain, normally, says Ms. Crawford. Birth, for her, was doing something she knew was going to hurt her and she had to figure out she was going to get through.

A common theme among the women is feeling the sensation of being out of their body yet in their body at the same time during labor. Understanding that the pain of labor is a finite period of time and has an end.

The ocean and waves was another common thread woven through the women’s stories. Contractions were visualized and felt like waves by the women and they said knowing it was a save and know it had a crest that was painful but also an end empowered them through the process to the ultimate goal: holding their newborn.

Laboring with my second child, I was able to understand this wave metaphor and I gave into the rise and fall of each contraction and I had an easier time with it mentally. It was still painful and a tremendous physical challenge but knowing there was end gave me comfort through the pain and gave the pain purpose for me. I knew that each contraction brought my baby closer to being born and to being in my arms, each was a step in the right direction.

Alanis Morissette shared her birth story in her own spiritual, ethereal way. She said she was as prepared as any woman could possibly have been and nothing could prepare her for her birth experience. To transform through birth, she had to learn to let it be the sacred experience that it was meant to be. Now she says understand all outcomes of birth saying she respects the warrior who births at home to the warrior who births with drugs in the hospital.

And we are all warriors, right! To take on the challenge of carrying a baby, going through labor and birth and becoming mothers is transformative no matter what your birth choices and no matter the outcome of your birth experience. We, ladies, we are warriors.

Exploring Your Options: Doulas, Birth Centers and C-Sections. Just what is the difference between a doula and a midwife? MBOBB says a doula, from the Greek, means servant, a woman who assists women during labor and after childbirth. Professionally trained doulas provide support and information to the mother and father. Their role during labor is to provide confidence, information, awareness, and advocacy to the mother and the family. Doulas listen to the mom. They give both emotional and physical support and all the medial aspects are left to the midwife or doctor.

At the time of filming, Ms. Lake was in the process of getting her doula certificate. She feels it’s a privilege to a part of the miracle of life, to be able to support a woman and the family through birth is such a gift.

There are no filters between mother and doula, any question can be asked and any topic can be discussed. Offering love, dignity, and respect to the mother has been scientifically shown to generate better birth outcomes.

Birthing centers are toured in MBOBB and it’s explained that they can provide women a mid-way point between a home birth and a hospital birth. Birthing centers can be a part of a hospital on a separate floor, in a building next to a hospital, and even as a free-standing birth center with no direct connection to a hospital yet with established relationships with a hospital and its staff.

C-sections are discussed as in BOBB. The rates continue to rise in the US. In 1965, the c-section rate was 4.5% jumping to 31.8% in 2007.

 The VBAC Delemma: What Your Options Really Are. I was going to skip watching this part because it was late and I thought I could summarize it without watching but Oh. My. Gosh. The stories of VBAC made me cried so much I got tears all over my glasses.

 Once a cesarean always a cesarean is not always true. Dr. Paul Crane, OB/GYN, explained that up the mid-1970s all medical textbooks said no VBACs. By 1980, studies showed that VBACs were possible and in going into the 1990s were mandated by insurance companiesJournalist Pamela Paul says by 1996 the VBAC rate was 28% and todayonly 8% of pregnant women attempt a VBAC, of those women 75% are successful. 90% of women opt for a second cesarean.

However in the 1990s didn’t really know what makes a successful VBAC. Uterine ruptures were happening due to the type of incisions women had, use of pitocin, the length of labor. Because of the ruptures, the medical community changed its message to say that there are too many risks involved and doctors who perform VBACs run the risk of being sued by patients or being ostracized by the medical community.

For the last decade, women were told VBAC is not a safe option. The data and experience shows that VBAC can be safe when handled in a certain way, without inducements. However the issue is so wrapped in fear that doctors and insurance companies have stayed away from it.

Dr. Suzanne Gilberg-Lenz, OB/GYN, says the risks of VBAC are very important to appreciate. The numbers for VBAC are small and the risks so catastrophic that it scares the crap out of everyone. The VBAC debate gets to the heart of the overall practice of medicine in our culture – a fear-based system.

Women interested in a VBAC are encouraged, in the film, to do a ton of research and to talk to the medical community from doctors, nurses, and midwives until you find what fits and find the people who will inform and empower you.

Ms. Epstein had an unexpected emergency cesarean and documented that experience in BOBB. In MBOBB Ms. Epstein is pregnant with her second child and explores a VBAC. She goes back to the OB/GYN from her first birth. He cautions her that during labor she can’t have any inducements, everything has to go perfect, the baby’s heart rate has to stay normal because the second anything looks different she will be having another c-section.

She was successful in her VBAC. The difference between her two birth experiences is vastly different. She felt the bonding with her first son didn’t happen until weeks after birth yet with her second she says the attachment was so physical and visceral and immediate.

In 2010, the American Congress of OB/GYNs revised their stance on VBAC saying that more women should be considered appropriate candidates for a VBAC even women with two previous c-sections and women carrying twins.

And the reason that stance changed, I believe, is because women believed in themselves and fought for that belief in themselves and proved that it can be done. We are, after all, warriors.

Heather Ruch
Author: Heather Ruch

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  • comment avatar Lynn July 13, 2012

    Great review of MBOBB!

    • comment avatar Heather July 13, 2012

      Thanks Lynn!

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