The Birth Monologues
The Business of Being Born Directed by Abby Epstein Produced by Ricki Lake
The Business of Being Born focuses on birth culture in the U.S. in much the same way Sicko spotlights healthcare. And the stats are equally shocking: America (tied with Hungary, Slovakia, Poland and Malta) has the second worst newborn death rate (five in 1,000 babies) among 33 industrialized nations in the developed world. Cesarean section is the most frequently performed surgery in the U.S., at a cost of $14 billion annually, and 82 percent of physicians said (in a 1999 survey) they performed C-sections to avoid negligence claims. And the reality slaps just keep coming.
The film asserts that OB/GYNs and hospital birthing centers cant handle natural childbirth, relying instead on drugs to stimulate contractions, C-sections and other invasive techniques that are distancing moms-to-be from essential physical and spiritual aspectsfrom the miracleof giving birth.
Thats what Ricki Lake, the films producer, experienced when she birthed her first child in a hospital setting. Her second childs midwife-guided delivery at home (in her bathtub) was more satisfying in every way.
Determined to compare the two experiences for the public, Lake pitched the film to director Abby Epstein, whom shed befriended while acting in The Vagina Monologues. Epstein was intrigued by Lakes birthing stories and topical books and, coincidentally, she became pregnant a year into the three-year project. (Both women appear in the film.)
Were not preaching, says Lake. Everyone should do what theyre comfortable with. We just want women to know their options. Many women dont understand natural childbirth, dont know that midwifery and homebirth are long-standing, very successful practices in other advanced nations with better statistics than ours. Here, we have great technology: 50 year old women, infertile women can have babies. Weve got these great possibilities, but were quickly losing the possibility of natural birthing.
This subjects a tsunami. The waters breakingpun intended. In Somalia, one-in-seven women dies in childbirth. And here, in our advanced, rich country, that the death rate for mothers and infants during childbirth is so high is shocking. Why is this happening here?
MERIN: Well, I guess were not that advanced... LAKE: Right. Ohio, Alabama and some other states are really bad for having a child outside a hospital, yet many women are forced to do that because they dont have health insurance. Thats not acceptable.
Youve never retreated from personal exposure in your career, but showing the birth of your childas you do in the filmseems particularly brave... Uh, oh I dont have to be scared do I?
No, not at all. But, Im curious to know where that courage comes from. Id say Im naive. Ive always jumped into whatever job came along. Thats what happened with the talk show: People said Id transformed myself into Oprah, but I was just offered a job. Same thing with Hairspray. I didnt know who John Waters was; I just took a job.
With this film, Id no idea how to do it. So I went to Abby for help. I had my experiences, books about birthing and home video wed shot of my sons birth. That tape was made to show my son when he reached 20, so he could see how he was born. It wasnt meant to be shown to the world.
I dont look beautiful, but its a beautiful moment. I dont want people to think Im exploiting it. Its an important part of the film, but its just one moment. The films not about me, and were not saying everyone should home birth like Ricki. Actually, there was a lot of discussion about where the scene fit into the film, and it was excluded from some cuts.
Has making the film been transformational for you? I think the film shows Ricki in a different light. After 11 years on TV, talking about important issuesand unimportant thingsI feel Im doing something that can have real impact. Women have alternatives for this extremely important aspect of their lives.
The film was a labor of love. I funded it. We thought wed get backing, but nobody wanted to fund it. HBO said to come back with the finished film. So I funded the entire project, everyone contributed, worked for nothing. And its paid off. Weve made an important movie for women, one that can promote change. I cant believe Im doing that with my life.
Im evolving into the person I want to be. My recent weight loss is part of that, too. Im purging myself. Im on a high. Holy shit! We went to Australia recently with the filmIm on the cover of Australias People magazine, wearing a size-four couture dress. Im speaking at the U.N., discussing the status of childbearing around the world with Norways prime minister and Somalias president. Its important. It can help change things. Thats quite a transformation from doing hoochie momma makeovers and hanging around the honey wagon. I dont mean to sound smug, but I think Ive done pretty well.
Its surreal, almost. Im very grateful. Ive had hardshipsmarriages, divorces and everythingthat Ive not been quiet about. So this feels good, but I know its fleeting. Life circumstances change all the time. Youre up one minute, down the next. The films a lasting statement, and I feel it can make a difference. And thats very important to me.
How did you get others to reveal their most intimate decisions, experiences on camera? To start, Abby and I walked around New York with a camera, asking women with strollers about their experiences. We went to baby groups on the East Side. Theyre all regular women who wanted to tell their birthing stories. We heard a lot of horror stories, but we didnt want to make this film an exposé. We wanted to show that women have a choice of alternatives, so they can take control and make the choice thats right for them. If they want home childbirth, thats fine; if they choose an epidural or C-section, thats fine. But they need to know the choice is theirs.
Still, the stats you present are a horror story. Has there been any backlash from the America Medical Association? No. Were not judgmental, so why should there be? As Ive said, the medical profession has made wonderful contributions, and there are child-birthing emergencies where doctors and invasive procedures are crucial. They save lives. But invasive procedures are often done unnecessarily and women whove experienced them feel theyve been denied the birthing experience they longed for. I had that feeling. Thats what led me to make this film.