For Better or For Worse? Childbirth in Popular Culture

After watching the live cesarean birth on the TODAY show last week and then the commercial for Jennifer Lopez’s new movie The Back-Up Plan during the Superbowl*, I’ve been thinking a lot about the way childbirth is portrayed in popular culture – on TV and in the movies – and how that influences us. In a perfect world I’d like to believe that women (and men) would learn about childbirth from reading books and websites and talking to their care provider (doctor or midwife), to a doula, to their mother, aunts and friends, but the truth is that unless ya live under a rock, women (and men) also learn about childbirth every time they are bombarded with images on TV and in the movies that depict childbirth as something scary, painful and out of control. Whether we want to believe it or not, our perceptions of birth are bound to be influenced – for better or for worse – by what we view and hear in popular culture.


Movie: The Back-Up Plan, photo credit: Jezebel

On Rixa’s blog Stand and Deliver she lists 61 film clips she compiled for a conference presentation about depictions of childbirth in cinema. That’s just movie clips. Think about all of the episodes of A Baby Story, or ER and many other TV shows where women are giving birth. Each one further reinforces popular culture’s birthing stereotypes.

Birthing Beautiful Ideas believes:

it’s pretty foolish to dismiss the effects that popular culture has on a woman’s beliefs and decisions about pregnancy and childbirth. In fact, I would venture to say that these effects are pretty widespread. Of course, I’m not saying many of us literally turn to pop culture when we’re deciding whether or not to consent to an episiotomy or to request pain medication in labor or to choose one care provider over another. That would be stupid, right? But that doesn’t mean that what we see on television or read in a (non-birth-related) book or watch in a movie has no effect at all on our thoughts about pregnancy and childbirth. Quite the contrary, in fact.

Because every time a woman reads that she “won’t be able to make it without an epidural”…

…every time she sees natural childbirth portrayed as something only for hippies and freaks…

…every time she sees a movie in which birth is a crisis or a catastrophe or a comedy of errors in which the mom is a crazed, expletive-hurling woman who is seriously out of control…

…those images and words start to affect the way she thinks about birth in general, and they may even have an effect on her specific beliefs about birth.

She goes on to give a real-life example (a positive example) of how a TV show changed her beliefs about birth. She describes an episode of Sex and the City where Miranda gives birth. Miranda asks Carrie to be there for the birth and tells her that when it’s time to push, she doesn’t want everybody getting all “cheerleader-y” on her and shouting “PUSH! PUSH! and shit like that.” She said that when she saw that scene, “it signaled a major change in the way I thought about how I was going to give birth some day.” Her birth paradigm shifted and she believes she has the ladies of Sex and the City to thank for that. She’s currently a doula and future lactation educator who’s working on a PhD in philosophy.

Not all examples of how popular culture influences women are as positive though.

Heather from A Mama’s Blog told me that watching TLC’s A Baby Story – which she described as “high drama” and ending more often than not in a c-section – “seriously warped” her view of childbirth.

The Feminist Breeder said:

When I first found myself pregnant, I was just like the vast majority of pregnant American women who never get truly informed about the birth process, and instead spend their pregnancies watching “A Baby Story” and reading Jenny McCarthy books. I got my hands on “The Girlfriend’s Guide to Pregnancy” by Vicki Iovine, which told me that Lamaze was useless, as were all other birthing classes, and what I really needed to focus on was how quickly I could get the epidural.

Yeah — I got the epidural. The epidural that only went down half my body, that caused me uncontrollable shaking, that shut down my labor, that necessitated more pitocin, which put my baby in distress, which then necessitated a nice, traumatic cesarean surgery. Yep. That epidural.

Honey B., in her post Childbirth: Hollywood’s Take, wrote that after year of watching A Baby Story, 18 Kids and Counting, Knocked Up, Four Christmases, etc., she realized how much of what she thought she knew about childbirth was based on TV. She then shares sarcastically all that Hollywood taught her about birth. (The descriptions are longer on her blog.)

Natural Birth: The choice of masochists, women who don’t shave their armpits and have children named Moon Flower, and optimistic first-time mothers who don’t know any better. (My note: Case in point, The Back-Up Plan‘s home birth scene)

Birth with Epidural: This is the smart woman’s choice. This is what she does for the second birth, after going through the above ‘Natural Birth’.

C-Section (Emergent): These are completely normal, and happen all. the. time. And the doctor always knows best.

C-Section (Planned): This is the choice of the truly enlightened woman, the Real Housewives of Orange County type who view pregnancy as an invasion of their body. (My note: Perhaps this is why, according to the most recent data available (from 2006), the United States’ c-section rate was 31.1%, ranging from 21.5% in Utah all the way up to 37.4% in New Jersey. The World Health Organization actually recommends that the cesarean section rate should not be higher than 10% to 15%. When the rate is higher than 15% there is some research which shows it results in more harm than good. But who wants to talk about that in movies?)

Mallory who blogs at Pop Culture believes, “Childbirth in Hollywood movies is from a male perspective; rarely does childbirth show angles from the female viewpoint during the actual birthing.

We show killings, bombings, shootings, rapes and torture in movies, so why not show a woman giving birth accurately? Is it really that obscene and disgusting?”

Naomi, a birth doula, wrote her top 10 suggestions for an easier birth. Number two is “Prepare for an easier birth, now!” She cautions:

Don’t watch A Baby Story! Instead (if you are interested in watching birth videos), watch movies like The Business of Being Born, Orgasmic Birth, Pregnant in America, Water Birth, Special Women, and normal birth videos on YouTube which represent birth as it usually is. TV specials on birth are designed and promoted to offer drama and attract viewers, not to support women preparing for birth.

I also want to add What Babies Want and Birth Into Being to that list.

Teba told me that her sister was there when she had a home birth two months ago. “She said after seeing birth in movies she never imagined it could be so peaceful.”

That’s just it. Birth can be peaceful. It doesn’t have to be a hysterical emergency, but as a result of popular culture, most women are never exposed to anything that suggests a peaceful birth is even a possibility.

How has popular culture affected your beliefs and decisions surrounding childbirth?
* I didn’t actually watch the Superbowl, but have Lynn to thank for telling me about The Back-Up Plan commercial.

Cross-posted on BlogHer

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Home birth advocate’s baby dies during free birth, prompts questions

Janet Fraser, a home birth advocate and founder of the site Joyous Birth, recently experienced a personal tragedy when her baby died at her home in Australia on March 27 during her free birth or unassisted childbirth (where a woman gives birth at home without the aid of a midwife or doctor).

When a tragedy like this occurs, people are often left scratching their heads wondering how something like this could happen, what went wrong, and lastly, who’s to blame? I don’t know if we need to point a finger to make ourselves feel better, but it seems to be human nature to ask, “why did this happen?”

While I did not consider giving birth at home without a midwife in attendance for my home birth, I know a handful of women who chose an unassisted birth and I respect them for it. I believe these women did a great deal of research in advance, knew what they were doing, trusted their bodies and their babies and were prepared to go to the hospital if any issues arose. Although I don’t know her, I trust that Janet Fraser would fall into this category as well. Not everyone agrees with me though and some, like Amber Watson-Tardiff, are suggesting that what Fraser did by having her baby unassisted was “reckless, neglectful and borderline criminal.”

Jessica Gottlieb of Eco Child’s Play says, “I support women who chose a home birth. But a free birth? I cannot see the wisdom in it. Neither can Ms. Fraser’s baby.”

Watson-Tardiff goes on to say, “I hope she is at least subject to an investigation for child endangerment.”

Ronda Kaysen of MomLogic says she sees the value of home birth as a way of reducing medical intervention, but believes giving birth without medical assistance is “absurd.”

Fraser’s “free birth” argument, which on the surface appears feminist, is actually the opposite. It doesn’t empower women to take control of their own bodies. It sends them and their babies into the dark ages of medical care – where women give birth with no medical care at all and face the very real possibility of death as a consequence.

For the record the police are investigating the death and have said “it was not clear whether the baby was stillborn or died after delivery. If a baby is stillborn, there is no autopsy. If a baby is alive at birth and dies soon after, it is considered a matter for the coroner.”

I guess I give Fraser the benefit of the doubt and assume that like most mothers she was doing what she thought was in the best interest of her baby. Although she coined the term birth rape (birth interventions done against the woman’s wishes), I don’t believe she would put her child in harm’s way rather than accept a potentially life-saving intervention. Then again I don’t know Fraser and have not spoken to her, so I can only speculate just as others are doing, but I prefer to give her the benefit of the doubt. However, I do believe that whenever a child dies, there should be an investigation into the death.

While many are blaming Fraser for her baby’s death since she did not have a doctor or midwife in attendance, no one seems to mention the fact that babies die in the hospital, where doctors are present, all the time.

Laura Shanley, author of the book Unassisted Childbirth and owner of the Bornfree! website who blogs at Letters from Laura – Thoughts on Unassisted Childbirth, brought up that point and shared another perspective many of us may not have thought of when she shared the following statement with me:

I don’t know Janet, but of course my heart goes out to her. An Australian friend of mine has told me that despite what the media is saying, Janet’s baby was stillborn and the outcome wouldn’t have been different had the baby been born in the hospital. Regardless of whether or not this is true, I find it sad that so many people are blaming Janet for her baby’s death. A baby is stillborn in an American hospital every fifteen to twenty minutes. According to a story on my local newscast, this is double what it was ten years ago. Yet almost no one blames hospital birth mothers (nor should they) for these babies’ deaths. This is because it’s assumed that if a baby dies or is stillborn in the hospital, everything possible was done to save the baby’s life. The possibility that at least some of these deaths might have been caused by early inductions, c-sections and other interventions is rarely discussed.

I can tell you, however, that as a homebirth advocate I have received numerous letters over the years from grieving mothers who wonder if their hospital born baby might have survived (or avoided injury) had they been born at home. The fact is, in most cases we may never know. Sometimes medical intervention saves lives, and sometimes it takes them. This is why I encourage parents to do their own research and decide for themselves where and with whom they want to give birth. In my case, I chose to give birth at home unassisted because from the research I had done I felt that the majority of problems in birth – both now and in the past – could be traced to three main causes: poverty, unnecessary medical intervention, and fear which triggers the fight/flight response and shuts down labor. Despite what most people believe, the act of birth itself is not dangerous. But our cultural beliefs and practices can make it so. In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home. Regardless of the outcome of this case, I will continue to speak out about unassisted childbirth as I believe that in most cases it’s the safest and most satisfying way to give birth.

Genie, an Australian blogger who writes at Home Is Where the Heart Is, blogged extensively about her thoughts regarding Janet Fraser and defends her choice to have her baby unassisted at home. She feels the insinuation that women who birth at home do it to feed their own ego at the expense of their child is “a crock.”

Women choose to homebirth with their baby’s best interest at heart. They do it FOR the baby, not in spite of the baby. Yes they want to feel empowered and blissed out, but the lack of trauma and the satisfaction a mother gets after a natural birth all benefits the baby too. A mother’s health and well being has a HUGE impact on the baby. So why should we ignore the interest and well-being of the mother?

In the wake of this tragedy and surrounding media coverage, some feel the need to point out that there is a difference between home birth and free birth. Dr. Meredith Nash of The Baby Bump Project says homebirth and freebirth are not the same.

The media has failed to differentiate between freebirth or unassisted birth (no midwife or doctor) and homebirth (a birth at home, usually with a midwife or homebirth doctor). For the most part, for low-risk births that are attended properly, homebirth has been proven to be a safe alternative to hospital birth. Freebirthing is significantly more risky (sorry, I’m a supporter but also a realist). It is essential to make this differentiation. Now that homebirth is on the precipice of being banned given that independent midwives are likely going to be denied indemnity insurance from next year, the suggestion that all women who homebirth are crazy radicals or that homebirth represents the majority of birthing women in Australia (only about 2%) is ridiculous. If anything, midwives and their ability to attend homebirths will be the saving grace of the Australian maternity system. Rather than convincing the small proportion of women who avoid a medicalized birth, why not support these women in their choices by making homebirth safe and easy?

Summer Minor, who blogs at Wired for Noise and gave birth to her daughter at home a little over a week ago, references the recent Nederlands study that says home birth is as safe as hospital birth. “A new study is out from the Netherlands that gives us home birthing mothers a nice little pat on the back. Despite the labels of ‘dangerous’ and ‘unsafe’ by some, once again it’s been found to be just as safe as giving birth in a hospital.” From the BBC:

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

I think that Shanley said it best when she said, “In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home.” We all must do our research and make the choices that we feel are the best for ourselves and our babies and then, find peace with our decisions.

I offer Janet Fraser and her family my deepest sympathy. My thoughts are with them.

Cross-posted on BlogHer.

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Home birth is a choice that the AMA wants to outlaw

 

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Whether or not you’ve had a home birth or would choose one for yourself in the future, I think most women would agree that they should have the right to choose where they give birth. Just as every woman is unique, every baby is unique and every birth experience is unique. What works best for one woman will not work best for the next. Some women feel the most comfortable giving birth in a hospital with an OB. Some feel comfortable birthing with a family practitioner or midwife in a birthing center. Others feel comfortable birthing with a midwife at home. All of these are options are safe choices, so why is the American Medical Association (AMA) trying to outlaw home birth?

Are they scared that Ricki Lake is raising awareness that women have options with her movie The Business of Being Born? They specifically cite Ricki’s and other celebrities’ home births in the media. “There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as ‘Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film.'” Ricki responds to the AMA here, and, over on the Huffington Post, Ricki, Abby Epstein and Jennifer Block have posted Docs to Women: Pay No Attention to Ricki Lake’s Home Birth. Are they scared that women might question the establishment and demand better care for themselves and their babies? Are they scared that they might (gasp) lose money? Are they scared that women might take back birth?

I’ve done a lot of research over the past few years regarding home birth and, of course, came to the conclusion that it was a good choice for me and my family. I’ve also written extensively about my research regarding home birth and my own home birth story as well. I would never say that it is the right choice for every woman, but it do believe it’s a woman’s right to know what her options are, do her research and decide what is best for her and her baby. I do not believe it is the AMA’s right or the ACOG’s (American College of Obstetricians and Gynecologists) right to tell a woman where she has to give birth. As Steff Hedenkamp from The Big Push for Midwives states, “a law dictating where a woman must give birth would be a clear violation of fundamental rights to privacy and other freedoms currently protected by the U.S. Constitution.”

So what now? What can we as women, or men who support women’s right to choose, do? You can sign the Keep Home Birth Legal petition and I also encourage you to spread the word about this. Feel free to grab the button (which links back to this post) and put it in your sidebar or blog about this on your own blog. Get the word out there that the AMA is trying to take away our rights. Home birth is a choice. Let’s keep it that way.

I’ve been trying to get the code for the ‘Home birth is a choice’ button to work, but to no avail. If you’d like to add the button to your sidebar please email me – amygeekgrl AT gmail DOT com – and I’ll send it to you directly.

And if you feel like a debate today, check out the lively discussion on this topic going on over at BlogHer.

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Planning for a homebirth

By now you may have gathered that instead of choosing to have an OB-attended hospital birth this time around, we are planning to have a midwife-attended homebirth. There are a number of varied factors that have led me down such a different path with this baby and I’d like to share some of them here.

I have to first admit that I’ve been a little reticent to post about this, not because I’m not excited about it, but because homebirth in our culture is not seen as a safe or wise choice (though in reality it is as safe or safer than hospital births in most cases – there are a number of studies that indicate as such). I am open to questions about why I’ve made this decision or things specific to homebirths, but I don’t wish to be attacked for my choice. I have no desire to get into a debate over which is better – hospital or home. Rest assured I’ve done a lot of soul searching and research to come to the conclusion that planning a homebirth is right for me. In the event that a condition arises during my pregnancy or labor that indicates that a homebirth is no longer a safe, responsible choice, I have no qualms about going back to my OB (whom I like and respect) or being transferred to a hospital (which is literally less than five minutes from our house) if necessary.
OK, now that we’ve gotten that out of the way, let’s dive in, shall we? :)

First of all, I believe that – in the majority of cases – birth is a normal, natural and healthy process. I believe in a woman’s (and my own) ability to give birth naturally, normally, without intervention, as women have been doing for thousands of years.

I am drawn to the midwifery model of care because it feels normal and natural. I like that a typical midwife prenatal visit lasts 60 minutes (as opposed to the typical 6 minute OB prenatal visit) and does not feel rushed. I like that I am getting to know the woman who will be there for my labor and birth and that she will gain my trust so that I feel comfortable with her while laboring and birthing. I like that my midwife is interested in my nutrition and in suggesting preventative measures (such as acupuncture) to help ensure that I have a healthy birth.

My midwife in particular has a 15 year background as an EMT (emergency medical technician). I feel her experience in that capacity has helped her develop critical thinking skills and the ability to think quickly on her feet. After all, how can you be an EMT without that ability? So I feel very comfortable that if a situation should arise that is beyond her comfort level, she will know what steps to take (i.e. a hospital transfer). Because of my history of complications with Ava, this was very important for us. Both Jody and I feel very confident in her experience and abilities.

I love the idea of birthing at my own home, where I am comfortable and able to relax without worrying about who’s going to be walking in the door next (nurse shift changes, etc.), where Ava can play or sleep or do whatever she needs to (in a safe environment) and still be in close proximity to me and Jody. (My sister will be her primary caregiver while I am in labor.) And when the baby is born, Ava can chose whether or not she wants to be present. (Yes, we will be preparing her with regard to what to expect when mommy is in labor, etc. We actually watched a birth video – “Giving Birth: Challenges and Choices” by Suzanne Arms – this week.) I’d like her to be there, but I’m not going to force her. If she is meant to be there, she will be. After seeing her interest in watching the birth video though, I am pretty certain she’ll want to see baby brother join us.

I also love the idea of being able to sleep in my own bed after the birth. That was one of the hardest things for me in the hospital, not being able to sleep. I eventually had to ask for sleeping pills because it’d been something like three days since I’d slept for more than a few minutes at a time, and having hallucinations while trying to care for a newborn is no fun. Having my own bed will be heavenly. And I’m sure Jody would agree as well after sleeping on a flimsy mattress on the cold, hard hospital floor for 5 days after Ava’s birth.

Another compelling reason for me to have a homebirth is I’d like to labor and possibly birth in water and my midwife has a birthing pool that we can set up right in our house.

Because of all of this and more, I feel planning for a homebirth makes sense for us.
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The following information was taken from The Homebirth Choice by Jill Cohen and Marti Dorsey and further illustrates why I’ve decided a homebirth is the right choice for me and my family. I cut and pasted some things that I feel are particularly important to me.

A BRIEF HISTORY OF MIDWIFERY:
“Midwife means “with woman.” Traditionally, women have attended and assisted other women during labor and birth. As modern medicine emerged in the West, birth fell into the realm of the medical. Since women were barred from attending medical schools, men became the birth practitioners. Having never had a baby themselves, they were unable to approach women and childbirth with the inner knowledge and experience of a woman. Childbirth became viewed as pathological rather than natural; unnecessary, and often dangerous or unproven, medical techniques and interventions became commonplace.

During the 1960s and 1970s, along with the women’s movement and renewed interest in homebirth, the midwifery movement rekindled. It has been growing steadily ever since. Midwives are becoming more and more involved with birthing families and have been instrumental in redefining birth as a natural event in women’s lives.

Midwifery empowers women and their families with the experience of birth.”

PRENATAL CARE:

“Prenatal visits may take place at the midwife’s home or clinic or at the family’s home. Prenatal visits are a time for the midwife to get to know the family and friends, neighbors, or other children who plan to be present at the birth.

Prenatal care for the pregnant woman includes discussion of nutrition, exercise and overall physical and emotional well-being, as well as overseeing the healthy development of the fetus.

Midwives include the family during prenatal care, inviting them to ask questions and to listen to the baby’s heartbeat. Intimate involvement of the family throughout the pregnancy allows for early bonding of the newly emerging family unit.

The midwife and family will often discuss the mechanics of birth. The more people know what’s going to happen, the more comfortable they may be while awaiting the birth.”

LABOR:
“In the safety and security of her own home, the mom is likely to be less inhibited about trying different labor positions and locations. She can sit on the toilet or go for a walk outside. She can eat or drink whatever she wants. She writes her own script. When it’s time to deliver, she can often try whatever position she wants: on her side, squatting, sitting or kneeling.”

BIRTH:
“Homebirth allows for full participation of family members. Under the guidance and assistance of the midwife, the opportunity is available for husbands or partners to “catch” their child as it is born. These moments can be very powerful and transformational in the lives of the new parents.

At homebirths, babies are usually immediately placed on the mom’s stomach or breast, providing security, warmth and immediate bonding between mom and baby. This contact provides security for both mom and baby.

In the rare case when the baby has difficulty breathing on its own, midwives are fully trained in infant CPR. Usually, putting the baby right to the breast and having mom talk to her baby will encourage it to take those first breaths.

Putting the baby immediately to the breast helps reduce any bleeding the mom may have. The sucking action stimulates the uterus and causes it to contract. This closes off blood vessels and reduces bleeding.

Some members of the medical community have recently acknowledged that having a homebirth decreases the mother’s and baby’s chances of contracting an infection. The mother is used to the bacteria in her own environment and has built up immunities to it. This is passed on to the baby through the colostrum. Even when women are segregated in maternity wards, infections are much more commonplace after hospital births than homebirths.”

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