Thursday, April 14, 2011


I recently watched two documentaries about birthing in America. The first was Pregnant in America. The second was The Business of Being Born.

I might be out of the loop, but I haven't heard much about either of these before I viewed them.

Pregnant In America is made by a man who decided to make this film when his wife became pregnant and he didn't like the flaws he saw in the American maternity system. 

I didn't hate this film, but I didn't like it either. It's very Michael Moore-esque. At one point he got to the billing office of his sister-in-law's former OB (did you follow that) to demand answers as to why she was treated a certain way. 

A. It's a billing office? They have no medical knowledge, and tell him as much. 

B. Why would anyone discuss his sister-in-law's care with him anyway?

This is very pro-home birth documentary. I feel the film maker is very one sided in the information he shares. In my opinion the discussion from the medical community and "experts" was very informative regarding home birthing. What I didn't like was the way the facts were exaggerated and misstated to "support" the films agenda.

For example, one of the woman profiled, Betsy, said she had to go to Canada for a VBAC because her insurance wouldn't cover it, and if they attempted it here in the U.S. and ended up needing an emergency c-section she would have to pay out of pocket. During her interview she said it would be upwards of $40,000 in an American hospital. At the Canadian hospital she said the section would only cost $2,000 and the whole stay would be $8,000 at the most. So Betsy and her husband traveled to Canada to attempt a VBAC. The attempt was unsuccessful and she ended up needing a c-section. This is the part that irked me: her bill was $10,000 and the movie said that since she would have spent $50,000 in America her family saved $40,000.

This bothered me for several reasons:

1. They have insurance in the US. If they had done what her doctor recommend and had the c-section they wouldn't have had to pay for the whole thing, if any, depending on their insurance plan. So in fact, they cost their family $10,000 (plus the cost of travel).

2. I have never heard of anyone being charged $50,000 for a c-section. I had about the worst outcome you could have (ruptured uterus, fetal death, emergency surgery) and my bills totaled almost $60,000 but that included an hour long ambulance ride, five day hospital stay, blood transfusion and my prenatal care. It is my understanding that most c-sections in the U.S. cost between $10,000 and $20,000. I felt that this was an unfair portrayal.

The other problem I have with this documentary is that the risks of a c-section are grossly misquoted. I think the viewers intelligence is insulted. Some of the risks that the film attributes to a c-section are: low fetal birth weight, malformation, placental abruption, and uterine rupture (among many others). I disagree with all of these but for the sake of time I'm only going to focus on the placental abruption.

According to the March of Dimes "Placental abruption (sometimes called abruptio placentae) is a condition in which the placenta peels away from the uterine wall, partially or almost completely, before birth."

Now let's think about this: The c-section is the birth. If there was an abruption it would happen before the birth, hence before the c-section. It's nearly impossible for the c-section to be the cause of  something before it was even performed. The placenta normally detaches from the uterine wall after birth. So it should detach after a c-section. Maybe I'm missing something?

At the end of the the film maker and his wife had a successful home birth. (Only a man would describe a woman's pain in the last stage of hard labor as "discomfort"). They had a beautiful daughter. The midwife had some concerns about the baby and the decision was made to take her to the hospital. She spent seven days in the hospital, three in the NICU. They didn't seem happy with their experience in the hospital. He says he asked over a dozen times for a diagnosis and was never given one. She was kept for observation. I have a feeling that if they had let her go home sooner he would have been upset about that too. He just didn't want her in the hospital. Then he complained about the hospital hospital bill. He just seemed ungrateful.

While I agree with the point this documentary was trying to get to, which is woman in the U.S. are not really allowed to birth naturally. The c-section rate is too high. The fetal mortality rate too high. I just don't feel that the film maker went about delivering his message in the best way. I also think he too took many liberties with the "facts".

The next film I watched was The Business of Being Born. I had no idea Ricki Lake was involved in this movie. I was completely shocked when she was showed, stark naked, giving birth in her bathtub. Wow, didn't expect that!

This movie basically had the same theme as the first movie, but it was presented in a different way. This was a no-nonsense presentation of woman's stories.

Like the first movie it discussed the high c-section rate in this country, and how the U.S. has an unusually high infant mortality rate. It discussed how in the hospital woman are not usually allowed to labor at their own pace. It also talked about how midwives are the norm in many other nations, but are the minority in the U.S.

Both movies talked about how in the hospital, and especially after c-sections, woman miss out on bonding with their babies. This bothered me because they act like there is only one chance to bond with your new baby, and if you don't have those first few minutes with your baby you "miss out" on bonding. I don't believe that is true. There are plenty of opportunities to bond with your baby if you don't get to spend the first days, weeks, or even months together. Ask any mother who's had a baby in the NICU. Ask anyone who's ever adopted.

These movies opened my eyes to what giving birth is like for some woman. One woman in the first film had a horrible story of being stitched up without anesthetic. But I know two woman who lost their babies due to botched home births. I've also read many stories about tragic home births. (You can read one here.) I don't appreciate that neither of these films mentioned the risks of home birth, at least not to any length. There weren't really any positive stories of a hospital birth either. I wish that the movies were more well rounded and educated people on how to go about a home birth safely.

The truth is, pregnancy is a very dangerous time in a woman's life. She needs care.

Please don't get me wrong- I am in favor of home birth. I think that every woman should birth how they want. But I think that we really need to be open to that fact that things may not turn out how we envision. Women need to remember that birth is about a baby being born. As long as that baby is born safe I consider it to be a "successful birth".

This post is part of the A to Z Challenge.


Denise said...

I think cesarean's in general get a bad wrap. And I think some women start to care more about THEIR birthing experience than the health and well being of their baby. I had an awful cesarean with my son (spinal didn't take effect in time, I felt EVERYTHING), and I really wanted a VBAC with my daughter. But, because of our history it didn't work that way and I had another cesarean. It was so much nicer, and I had her with me the entire time (except when the hubby took her to the waiting room to meet the family). I think it's all the attitude you have and taking personal responsibility in finding a good doctor and hospital.

Teenage Bride said...

I recently did a post on The Business of Being born. I found it fascinating... and a little concerning. I will certainly have to check out the other documentary.

It is truly sad some of the drastic measures pregnant women have to take these days due to insurance issues.

Funsize said...

I had to have a c-section because I had a complete placental abruption. My bill was about $15,000- that included my 3 day stay, my $100 ambulance ride over to the hospital, general anesthesia, a morphine drip, and intubating my son when he started to flat line. Luckily, we only had to pay 10% of that $15,000. For my second, I was discouraged against a VBAC because I could risk a uterine rupture.

I would have loved a VBAC, but it was not worth the risk for me- I'd much rather have my baby and I could care less if it had to be through a repeat c-section or if I had to deliver him through my fingernail. I find it sad the other woman didn't feel the same way.

The Superintendent's Wife said...

I appreciate your comments. I took a doula training a few years back...very interesting. Afterwards, I attended a birth of a friend's third child. I was glad that I could be part of the experience and any help to her that I could be. Two times someone needs a friend to be present, birth and death. I have been at both and both were a beautiful experience. I have had two c-sections and I bonded with all of my children just fine. The bonding process begins way before birth. I think the key to a successful birthing experience is to educate oneself about the whole process. The unknown can be a frightful thing. When a baby is born...that is a success story in itself!

Cindy said...

Interesting.. I haven't seen either movies, but had two home births with wonderful midwives (my first midwife has been delivering babies since 1981, and has never lost one! She does know well when to transfer to a hospital though)

My A-Z post today was about how sad it is that women in this country fight about the choices they make, while in many other countries women don't get a choice at all, which is incredibly sad to me.