“The Business of Being Born” is a passionate, ground-breaking documentary by executive producer, actress and former talk-show host Ricki Lake, making a strong case for home childbirth. In the film, the number of home births in the United States are shown to have virtually disappeared, compared to the number of at-home births in Europe and Japan, increased by technological advances in medicine, thereby turning the birthing process into a surgical procedure involving multiple and far too often unnecessary procedures.

In the film, Ricki Lake and Director Abby Epstein, strive to drive home the point that nearly all American babies are born in hospitals, yet the U.S. ranks near the bottom of the list in infant and mother mortality. The Business of Being Born suggests that the drugs American hospitals use to induce labor, as well as epidurals to reduce pain during childbirth, may very well contribute to the alarming high rate of Cesareans being performed. In the year 1900, 95% of births in the United States took place at home, but by the year 1938 the number had shrunk to half. Today the number of home births is less than 1 percent.

The film examines the political, economical and history of how and where most American births occur, including the births of Epstein’s and Lake’s own babies. The overall message of the documentary focuses on the need for expectant fathers and mothers to know all the options available to them, and make an informed choice for themselves and their baby, rather than unknowingly accept whatever advice is given by doctors and hospitals.

Various disadvantages of hospital births are discussed in the film, suggesting the possible attempts of the medical establishment to control any and all decisions regarding childbirth for economic and psychological reasons, while the medical establishment would make the argument that a hospital is the safest place to give birth in case something goes wrong during labor. The use of a Cesarean section to deliver a baby was once the last resort in the event of an emergency, but has largely become commonplace, with increased risk of serious complications with subsequent C-sections.

Lake and Epstein insist that their mission is about empowering women with knowledge, reminding them that there are more choices regarding childbirth than expectant mothers may realize. Lake says, “The film is not advocating anything but choice. I’m not at all telling people to have a home birth like me”, who decided she wanted to give birth to her second child at home. Watch this brief, 2:34 minute video-trailer of The Business of Being Born.

According to Lake and Epstein, the most important point is not that the technology of a modern delivery room is necessarily a bad thing but that the great majority of women in the United States seem to believe it is their only option. The film also suggests that the rise in C-section surgeries is a “doctor-friendly” trend that helps hospitals avoid malpractice suits and moves women out of the maternity ward much faster. “I don’t want women to walk away feeling bad if they had a C-section” says Lake. “You can still be empowered with an elected C-section, as long as you’re informed and educated.”

Some of the disadvantages of hospital births discussed in the film include the point that, while Obstetricians have surgical training, many have never seen nor are prepared to supervise and assist a fully natural birth. Since hospitals are businesses that thrive on a high turnover rate, drugs are often given to induce and speed labor (which makes labor more intense and painful), which only serves the medical system by filling and emptying beds at a much faster rate. Cha-ching, cha-ching?

Having delivered the last two of my six children in the comfort of my own home, with the assistance of a home-birth doctor and midwife in close association with a nearby hospital, giving birth at home was by far the most appealing and best option for me and my baby.

My last baby was in breech position when labor began, but with the skill of the home-birth doctor and painless maneuvering of the baby’s position, she was born headfirst without any problems. Each and every one of my births (one of them weighing 11 lbs) were done fully natural, without any form of medication or pain relief whatsoever, including the four babies born in the hospital.

“I’ve never been a conspiracy theorist, but my God, it’s getting to the point where we’re soon going to be at over a 50 percent C-section rate,” says Epstein. While researching midwifery for the documentary, Epstein visited private hospitals in Brazil that report a planned C-section rate as high as 90 percent.

“You’d think that’s some kind of science fiction of the future, but it’s not,” Epstein says. “You walk in these private hospitals in South America and there is literally a piano and a bar in the labor room. I am not kidding. There is no labor room because everybody has a C-section unless, as the joke goes, your doctor gets stuck in traffic.”

“Moms want more control,” says Lis Worcester, a licensed midwife in San Francisco, speaking of the attitudes of her newer pregnant patients. “They don’t like being in the setting of an institution that they feel so vulnerable. Moms want somebody they know to be there so that they can completely let go. They can’t do that in a hospital, where there are constant changes in shifts, beds, nurse attitudes and the pressure of time.”

The documentary criticizes the supine position, in which the mother is required to lay flat on her back while being told to “push.” Because this position makes the pelvis smaller, it increases the likelihood of having to deliver a baby with forceps or a vacuum extractor. The natural births in the film, including that of Ms. Lake, are carried out in a squatting position which is much less stressful for the mother, but far more stressful for the doctor who must catch the baby.

The supine position quickly became a bone of contention between me and my doctor, during one of my hospital births. Having mostly back labor, with pain streaming down my spine, being told to stay flat on my flat infuriated me. That, along with the fetal monitor strapped around my midsection for no apparent reason caused an argument in the labor room, hours before I was moved to the delivery room.

Upon questioning my doctor about the “need” for me to be in that tortuous position before being ready to deliver, as well as the doctor’s admission that there were no medical concerns about the baby’s health or well-being, the doctor agreed to remove the fetal monitor and allow me to move around freely. I dare say that I doubt many women would even think to question their doctor or the hospital staff about their “routine practices” and make an informed choice such as I did.

Midwifery and home-birth continues to be a controversial topic with enormous ingrained prejudice. The Business of Being Born argues the point, quite successfully in my opinion, that most women can and should deliver most babies outside of the pharmaceutically controlled production line of the maternity ward, with the assistance of a midwife, either at home or in a birthing center affiliated with a hospital. And, home-births are much cheaper than a hospital birth.

The bottom line truth of the film is that many, if not most, moms- and dads-to-be don’t know everything they should and need to know about childbirth options in order to make an informed choice for themselves, and this film helps accomplish that goal. Kudos to Ricki Lake and Ms. Epstein.

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