This week I was lucky enough to be able to go to the premiere of the new Business of Being Born documentary, More Business of Being Born, at the Laemmle’s Royal Theater in Los Angeles. As a Midwife, I believe that the first ‘Business of Being Born’ documentary has done a lot to open the eyes of the masses, and educate people about modern childbirth and the maternity system, not just in the States, but around the world. It discusses the huge and somewhat controversial (to some people) topic of homebirth, natural birth, cesarean birth, obstetric care, aswell as Midwives and Doulas-which to the average American, are professions most people had never heard of. I think it has played a huge part in educating people in a topic that they wouldn’t have ordinarily thought about. Most women of childbearing age today, only consider birth once they become pregnant. It is no longer something which is talked about amongst family and friends, or witnessed before becoming pregnant. Since birth left the home around 50 years ago, birth has become shamed, hushed and secret. Something that takes place in a hospital bed, behind closed doors, in private, so that no-one can hear you. As a society we are overwhelmed with images and stories in the media of dramatic, medicalized, traumatic births with emergencies around every corner, where women are passive participants in their care, following the doctor’s every order. These are the only images of birth we ever see. The ones which make the news, or bring in the ratings. This is our only perspective. These births are fictional! We need some reality, and not ‘Reality TV’, but REAL birth stories from REAL families.
I have certainly noticed in the 3 years since the first documentary came out, the awareness of these issues has greatly increased. Many of our clients come to us having watched it, saying that this was the catalyst which launched them in to looking at different alternatives to mainstream obstetric care, or that it made them realize they did have options, or it was recommended to them from a friend or colleague. The birth world in America, and in California especially is changing, and Ricki Lake and her team, have helped to put those wheels in motion.
The new Business of Being Born documentary is a series of 4 mini documentaries, covering various topics which felt needed further explanation. Although the first documentary was extremely informative, it still left people with questions such as, ‘What’s the difference between a Midwife and a Doula?’. Producers Ricki Lake and Abby Epstein hope that this follow-up series will help to fill in a few more gaps. They cover conversations with Ina May Gaskin (America’s leading Midwife), celebrity mothers talking about their birth experiences, Doulas, birth centres, Cesarean and VBACs (vaginal birth after cesarean).
At the premiere we watched only the second in the series, ‘Special Deliveries’, which includes an hour’s worth of testimonials from Christy Turlington Burns, Cindy Crawford, Alyson Hannigan, Melissa Joan Hart, Gisele Bundchen, and Alanis Morissette, all of whom describe a wide range of birth experiences, including some tellingly unhappy ones. Their voices fuse into a compelling chorus of maternal will and desire. None of them paint a picture of labor and birth as an easy ride, but they are honest and open about their emotions and their journey.
Even as a Midwife, I found it hugely inspiring to watch. It ignited my passion behind creating an alternative for women and their families. There is a greater issue behind all of this. It is not just all about homebirth, or natural birth, or the hospital. It’s about choice. Something we all have the right to.
‘So if you’re thinking of having a baby, do what more and more people are doing. See The Business of Being Born (and More Business of Being Born). And decide what to do for yourself’.
‘If a Doula were a drug, it would be unethical not to use it’
Dr John Kennell 1998
DONA International Founder
I believe every mother should have a Doula.I believe that Doulas have the power to enable women to experience their birth in a way they thought was unimaginable.
Birth is, and should be an empowering, life changing event. Something that, no matter how many babies you have, will be magical and unique every time. Women remember their birth experiences for life. I believe it is our role and duty, as birth professionals, to make that memory as special as possible.
A good birth experience is not about how you do it, it’s how you feel about it.
The concept of a birth Doula isn’t something new, it’s just now it has a name. Women have always been surrounded by loving women in childbirth. As recent as a hundred years ago, 90% of births took place at home. Women were surrounded by a sisterhood of mothers, sisters, friends and neighbors. Women were supported emotionally, physically and spiritually. It used to be common for women to have witnessed many births before she was having her first baby. This gave her a greater degree of comfort, knowledge, perspective and experience that benefited her in her own birthing experience. But times have changed. As birth moved out of the home and in through the shiny doors of the hospital, birth has become a mysterious event. It has become something that takes place behind closed doors. Women are no longer participating in this lesson of life. Birth has become a sterile and separate environment for both mother and baby, and to a large extent, the partner. We have become shielded from this normal life event. Birth has become an event dramatized by technology and interventions, portrayed as a medical emergency waiting to happen on soaps and dramas, and reality tv series, with the true potential of birth being lost along the way.
Since 1970 in the US alone, the cesarean rate has increased from 5.5% to 30% and rising, with no decrease in maternal or infant mortality. This is true in most countries around the world. The World Health Organization (WHO) states ‘there is no justification for cesarean rates to exceed 10-15% in any industrialized country’. Research shows us that continuous support from the Doula reduces the length of labor, reduces rates of intervention and the need for pain medications, therefore lowering the risk for both moms and babies. Research has also shown us the support from a Doula increases a mothers’ satisfaction with her birth. We know that post partum Doulas increase the bonding connection for moms and babies, and help reduce the risk of post partum depression by aiding the transition in to parenthood and providing support and education. It is important to recognize the long lasting powerful effects Doulas can have on women and their families.
‘Psychologically for many women, especially those who have had difficulties in their own childhood, there’s potential for internal re-organization…a feeling of higher self esteem and a greater sense of confidence, feeling good about themselves, and feeling good about the whole experience’.
Phyllis Klaus, DONA International Founder
‘I think Doulas have shown very, very clearly how essential they are for mothers…Doulas usually have a great drive to help other women, think of their needs and have the spirit to stick with the mother’
Dr John Kennell, DONA International Founder
Having a healthy and positive birth experience is far more than simply the method in which you give birth. A positive birth experience has physiological, emotional, behavioral and psychological benefits, not just for mothers, but to society as a whole.
This is an excellent informative video from DONA (Doulas of North America), explaining the wonderful impact Doulas can have on women, families and society, and the powerful results they can achieve.
I think everyone by now is fully aware that I am a big home and natural birth fan. However, as much as I like to talk about it, I am aware that this is not, and should not be for everyone. There are many different reasons (which I won’t get in to now) why some women are not suitable for a home birth, or even a natural vaginal birth, and that’s ok. But one thing I think EVERY women has the potential to do, given the right support, is breastfeed.
It is a rare exception when a woman truly cannot breastfeed for medical or physical reasons. I hear so many stories which sadden me, from women who couldn’t breastfeed for one reason or the other, or didn’t produce enough milk, and I can’t help but wonder, if given the right environment, encouragement, advice and support, would these moms have been more successful? Because if not, how would our species have survived all these generations. What did we do before infant formula was on the market?
We know that a woman’s ability to feel confident and secure in her decision to breastfeed can be challenged along the way by friends, family, media, healthcare providers as well as the health care settings. In fact, despite what you might think, the health care setting has a huge impact on new moms and their feeding choices. Hospitals and maternity units set a powerful example for new moms. It is a known fact that technology driven hospital routines and procedures common on labor and delivery wards, are not conducive to establishing the best start in breastfeeding. We should be doing everything we can to promote breastfeeding no matter what setting a mother chooses to give birth in.
If you are considering having your baby in a hospital or birth center, one thing I would advise you to look in to, is whether or not they are ‘Baby Friendly’.
Isn’t Every Maternity Unit Baby Friendly?
Sadly, this is far from the truth. 20,000 hospitals in 150 countries world-wide have been awarded Baby Friendly status. However, in the US, as of July 2011, only 114 hospitals and birth centers across 23 states have received this prestigious award, with California hosting 18 of these establishments. Some states in the US do not even have one!
I was lucky enough to not only have trained at one of only 3 universities in the UK (at the time) to have received full Baby Friendly Accreditation, but I also worked within a hospital where the Baby Friendly Initiative was facilitated. The maternity and neonatal services I worked in had maintained their Baby Friendly status since 1998. This enabled me as a healthcare provider to provide the best quality of care to support parents, in order for them to make informed choices regarding feeding and caring for their babies.
Click here to read more about how Baby Friendly training increases breastfeeding rates.
What is Baby Friendly?
The Baby Friendly Hospital Initiative is a global program sponsored by UNICEF and the World Health Organization (WHO), which aims to improve the effect of hospital maternity services on a mother’s ability to initiate breastfeeding for their babies. It encourages and recognizes hospitals and birthing centers which implement the ‘Ten Steps to Successful Breastfeeding’ and practice in accordance with the International Code of Marketing of Breastmilk Substitutes. The Baby Friendly Initiative (BFI) works with the health-care system to ensure a high standard of care in relation to infant feeding for pregnant women, mothers and babies. Following the specific ‘Ten Steps’ creates the best possible environment for successful breastfeeding. Baby Friendly establishments aim to give mothers the information, confidence and skills needed to successfully initiate and continue breastfeeding their babies.
A maternity facility can be designated ‘Baby-Friendly’ when it does not accept free or low-cost breastmilk substitutes, feeding bottles or teats, and has implemented the ten specific steps to support successful breastfeeding.
The BFI status is awarded based on strict independent evaluation. Sponsors conduct an ongoing review of the facility and evaluate its commitment to offering an optimal breastfeeding environment. If the establishment is falling short of any of the ‘Ten Steps’, the unit can lose their status.
Baby Friendly USA envisions,
‘an American culture that values the enduring benefits of breastfeeding and human milk for mothers, babies, and society’
Does Baby Friendly Work?
Implementing the Baby Friendly best practice standards is a proven way of increasing breastfeeding rates in terms of breastfeeding initiation, duration, exclusivity and related child health outcomes. By adopting Baby Friendly practices, health professionals can give mothers the support, information and encouragement to continue their chosen method of feeding for as long as they wish.
Click here to find your nearest Baby Friendly Hospital
- Birth Practices Which Interfere With Breastfeeding (smiffybaby.com)
I’m happy to hear that home births are starting to hit the media in a positive light!
Celebs, Ordinary Women Embracing Home birth With the Help of Midwives – ABC News Aug 1st 2011
- Boy for Blair!! (smiffybaby.com)
Le Leche League is a wonderful international organization whose mission is to help mothers to breastfeed through mother-to mother support, encouragement, information and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.
Here’s a snippet of what they do…
- Birth Practices Which Interfere With Breastfeeding (smiffybaby.com)
- The Baby Friendly Way (smiffybaby.com)
Great article from Ricki Lake, ‘Mothers Deserve Options’, discussing why she felt it necessary to bring out ‘More Business of Being Born’.
Join Ricki Lake in her fight for the right of all mothers to have access to safe, intervention-free options. Click here to support her Kickstarter campaign.
(This project will only be funded if at least $100,000 is pledged by Thursday Jul 14, 1:03pm EDT.)
So what are you waiting for?-Get Involved!
How and where you decide to bring your child into this world is a choice that belongs to you.
An amusing blog post from the Analytical Armadillo about the complicated rules of breast coverage.
Thanks for sharing.
Ever wondered what Midwives do? Here’s a quick snippet!
- Neonatal Mortality Rate Reduces by the Hands of Midwives (smiffybaby.com)
I have just come across a great article by actress, Mayim Bialik discussing why women should not be fearful of homebirth. She talks about the most commonly cited reasons not to have a homebirth to try to illustrate why women do choose and advocate homebirth.
Mayim Bialik has given birth at home, loved it, and thinks people need to know more about it.
Click to read her full article…’Mayim Bialik:Why Women Shouldn’t Fear Homebirth‘.