The Business of Being Born (Part I)

Big news: My approach to labor has been transformed. I'd always planned on trying to have a natural birth, and I was planning to hire a doula to help make my birth as holistic an experience as it could be. But a new documentary called, The Business of Being Born, has opened my eyes to an approach I like even better: Midwifery.

I am so glad that I got to screen the movie (you can see one image from the film above). It premiered at the Tribeca Film Festival but it doesn't get released nationally until January. My brother and sister-in-law saw it at the Festival and told me it was incredible, so I got in touch with one of the producers to see if I could screen it because I was interested on both a personal and professional level. The documentary was remarkable and it's changed the course of my pregnancy.

The film follows a handful of women in New York City who give birth at home or at a natural birthing center with a nurse-midwife. The film also flashes back to the home birth of the film's producer, actress Ricki Lake, who decided to give birth to her second child with a midwife because she was unsatisfied with how her first birth went. A certified nurse-midwife, by the way, is medically trained to handle prenatal care, postnatal care, delivery, and everything that childbirth entails. Pretty much the only thing the midwives can't do in the birthing process that obgyns can, is perform a C-section, since midwives are not surgeons. The reasons the women in the film chose to deliver with a midwife, as opposed to an obgyn are convincing:

Cesarean-delivery rates are now at an all time high in the United States — about 30 percent of births happen via C-section here. In the New York City area, that number is 40 percent. The 30 percent average nationwide represents a 40 percent increase in C-sections in the past 10 years. (In 1970 the rate was 5.5%)

Have women's bodies changed? No, but medical practices surrounding birth have — and not necessarily for the better. Despite the increase in C-sections and other medical interventions (like inducing labor), the health of mothers and babies in this country has not improved.

In fact, the US has the second worst newborn mortality rate in the developed world (per a 2006 Save the Children report), and complications from Cesarean surgery and anesthesia are the leading causes of maternal death in developed countries, including the United States, according to a World Health Organization report, published in the journal, Lancet.

What's more, in the five countries with the lowest infant mortality rates — Japan, Singapore, Sweden, Finland, and Norway — midwives were the main source of care for 70 percent of the birthing mothers, according to a March of Dimes report.

This movie makes the case, then, that the medical establishment in this country may have taken a wrong turn where birth is concerned. In its attempts to find ways to deliver babies safely, and often conveniently, many experts seem to have forgotten that women's bodies are made to deliver babies, and there often isn't a need to rush the process and, for instance, administer Pitocin (the drug given to women to induce labor, sometimes before they're naturally ready) or other meds during birth. And unfortunately, starting with one medical intervention often leads to another, and then another, and then another. A book I've been reading called Pushed: The painful truth about childbirth and modern maternity care by Jennifer Block, also makes these points.

Don't get me wrong. I believe that obgyns are necessary and serve a great purpose in childbirth. For many people, especially those who aren't interested in a natural birth or who have pregnancy complications that require interventions, obgyns are fantastic and essential. But for me, a low-risk pregnant woman, I want to try to have a natural experience. I don't want to have major surgery, which is what a C-section is, and a longer recovery time, if I can avoid it, just because I was pushed into medical interventions that eventually led to that end. And it seems that the more holistic the approach, the greater my odds of avoiding a C-section. In fact, the C-section rate for hospitals with nurse-midwifery services was about 13 percent lower than the average C-section rate for all hospitals, according to studies done by Public Citizen's health research group in Washington.

I've long known that I'd like to try delivering without the epidural (assuming I can take it!) since some studies show that epidurals tend to slow down the rate of contractions and the length of labor, and increase the odds of more medical interventions. And this is one of the main reasons I wanted a doula there during delivery — to be my advocate if my obgyn wanted to start with a medical intervention that may or may not be absolutely necessary. But after seeing this movie, I realized that I wasn't even comfortable with my obgyn, and the idea of delivering with a midwife — something I hadn't ever explored — instantly made me feel as though I would be in good hands — that someone would be taking care of me and looking out for me and my baby in the way that I wanted.

So, I decided to find a midwife — one who delivers in a hospital, mind you, since I'd rather be closer to a doctor's help if it's needed, but I'd still like the care of a holistic medical professional. Stay tuned for what I found...

Also, if you want to read someone else's blog about this very documentary, check out the Motherwear Breastfeeding Blog.