8/10
Eye-opening documentary
8 July 2008
Warning: Spoilers
According to statistics, the infant mortality rate in the United States exceeds that of virtually every other nation in the industrialized world. The U.S. is also the only place in which far more women give birth in hospitals than at home under the care of a professional midwife. The documentary "The Business of Being Born" sees a connection between those two facts.

Executive producer Ricki Lake first conceived of this film after she delivered her first baby in the hospital and then felt cheated of the potentially beautiful and meaningful experience a home birth might have provided. With the aid of director Abby Epstein, Lake has gathered together a group of women, couples, midwives and physicians who, through their own personal experiences and/or studies on the matter, help to provide evidence for her case that, for the large majority of women, delivering at home is preferable, on both a practical and spiritual level, to delivering in a hospital. Lake has even allowed herself to be filmed in the process of giving birth to her second child at home.

This is an eye-opening and informative movie that admittedly provides really only one side to the issue. But it makes a pretty convincing case for that side and certainly gets the audience thinking. First, it offers a number of startling statistics, the prime one being that roughly one third of all babies born in America are now delivered through Caesarian Section, a procedure that is classified as "major surgery" but which is often treated with casual indifference by both physicians and patients (the shots of a Caesarian are far more "gruesome" than any of the shots of actual childbirth we are shown). The movie also recounts a brief but somewhat disturbing history of obstetrics practices in the United States during the past century when many women were put into "twilight sleep" and missed the birthing experience entirely. The movie also points out that, in a hospital setting, a "cascade of interventions" often prevents women from having the ultimate say in how they choose to deliver their babies. But the majority of the case is made through personal anecdotes from mothers and midwives concerning their own birthing experiences, as well as by the recording of many of those actual home births live on camera. Interestingly, after all the successful home births, the movie ends on one in which the child arrives prematurely and is in a breach position and thus must enter the world in a hospital room after all. It's an indication of the honesty and courage of the filmmakers that they didn't feel called upon to edit that sequence out of the movie.

Yet, for the most part, the film takes the multi-billion dollar medical industry to task for being too quick to use drugs and a scalpel in the birthing experience. The movie also harshly criticizes the insurance industry for failing to recognize the much greater cost efficiency of home-birthing and hence refusing to cover it in their policies, thereby forcing many midwives to simply close up shop.

In many ways, "The Business of Being Born" is fighting something of an uphill battle in that it appears counterintuitive - especially to a generation raised on the belief that the medical industry can do anything - to suggest that a birthing process with a physician and modern medical equipment on hand could actually be less safe than a birthing process without them (though the movie is quick to point out that the midwives are all state-certified and trained to deal with any unforeseen complications that might arise). Still, for women facing this decision - as well as for a society that for over a century now has frowned upon even the thought of natural childbirth - "The Business of Being Born" may serve as a paradigm-shifting event.
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