Film – The Business of Being Born

This review won’t be about my two births, so it’s safe to read on!

However, I found the process of birthing in the hospital system a profoundly radicalising experience – one where I felt the machine of hospital policy and interventionist medical practice (things that I knew from my independent reading were not justified by current medical research) were placed well above my wishes – the way I wanted to birth. Am I sounding like a selfish latte-swilling twat? I mean, what is most important, the baby’s health or my wishes to birth as naturally as possible, without interventions?

The fallaciousness of believing the health and safety of a child is at odds with a mother’s desire to birth normally (no epidurals, no constant fetal monitoring/ vaginal examinations in labor, no drug augmentation and certainly no induction) – whether in a hospital setting or at home, is at the heart of this movie. It clearly lays out why midwifery-led care, midwives being the experts in normal birth, is where Australia should be moving our maternity services, instead of the US-led model of interventionist OB/GYN hospital delivery, with truly alarming rates of caesarean section.

We’re mammals, and have evolved a birth method over hundreds of thousands of years. It’s not perfect, but it serves most women fine. Particularly if a woman has confidence that she knows how to birth – and allows her body to just do it. A panicking woman will often retreat in her labor – that old “fight or flight” mechanism, and of course, if you are afraid, feel vunerable, are being put under pressure to make decisions “for the good of the baby” without the luxury of asking questions about alternatives – well, the physiological response does not help with birth any more than trying to labor lying down. And there’s the issue of pain too – a panicked woman rarely breathes well, or relaxes her body – both of which assist massively in reducing the pain of labor, in my experience.

A woman births “best” when she feels emotionally secure and supported. This results in the best possible outcome for the baby. For you, this may mean having an OB at your elbow – but for me and many other women, this means being left alone to go where we need to go, drawing on our own resources (which are AMAZING) to birth our babies.

And there’s the issue of continuity of care too – if you employ a midwife, the same person sees you all through pregnancy, to birth, and beyond birth to assist in the huge adjustment we make as new parents. This model is unavailable with hospital care for the most part, even in a birthing centre – which run on “team” midwifery. And when you leave hospital you are pretty much on your own.

OB/GYNs are experts in high-risk and complicated births, or what one OB in this doco refers to as the 2% of “oh shit” in birthing. My issue is that their expertise is actually wasted in management of normal birth – I’d like to have them available for when things go wrong, instead of micro-managing normal labor. The very nature of their training means they are highly risk adverse – they see potential complications and pre-empt them, where a midwife sees potential resolution, given time and observation, as well as natural assistance, for example, utilising optimal fetal positioning. (I am generalising, of course –individual practitioners don’t so neatly fit the boxes).

C-sections offer the shortest distance between two points for hospitals and management of risk, but at a high price for birthing women. Monty Python’s Meaning of Life makes an appearance in the film – the famous “machine that goes ping” sketch.

The woman giving birth asks: “What do I do?” John Cleese as surgeon answers: “Nothing dear, you’re not qualified.” Haaahaaahhaaa……….mmmmm. Not so funny. Massively disempowering, actually.

If you’ve wondered about the benefits of using a midwife in real terms – giving up the baby bonus to pay for it is a big ask, after all – this film will help clarify the grounds for you to make a decision. It is partisan of course – the agenda is clear – but I didn’t have a problem with that because it was upfront in taking a position. Birthing information and options in Australia are so weighted towards a medicalised model that I think anyone who is going to birth would benefit from watching this, even if you will never homebirth. An eye-opener.

And to think, legislation just tabled federally may make independent midwifery effectively illegal in Australia by 2010.