Thursday, April 24, 2008
On The Business of Being Born
What interest do at home dads -- or dads in general -- have in a film that makes a strong case for the virtues of home-birthing?
Because I would bet that no matter what your personal preferences regarding birthing methods, watching Ricki Lake's new documentary, The Business of Being Born, is more of an education than most parents are likely to receive about giving birth. And anything that brings the father into the process, rather than encouraging him to defer to experts, is a step in the erosion of gendered parenting roles and the more respectful treatment of expectant mothers.
Which means that mothers have potentially one more advocate as they enter into the medical-bureaucratic complex of modern obstetrics.
I buy Lake's argument that at-home birthing is far more marginalized in the United States than it should be. That doesn't mean that we've had or are planning an at-home birth ourselves. We anticipate having a second child in a hospital. But we plan to have at least one midwife in attendance, an obstetrician who is comfortable with this, and a doula for the postpartum recovery period.
All of which is to say that, despite the moderately polemical nature of the film and response to it, the issue is not black and white. It's not either the hospital or a bathtub in the living room. What is most significant about this film, as I see it, is simply its success in raising awareness of the way birthing methods have been shaped by various competing interests, and not always in favor of women and their children.
Birthing, and modern obstetrics, is an industry -- like agribusiness, transportation, or energy. It makes sense to understand how this fact might impinge on the ways women's bodies are manipulated during the birthing process.
The whole story is backgrounded by the fact that the rate of cesarean sections has skyrocketed in recent decades, and is higher in the US than in any other economically advanced nation. At the same time, infant mortality rates are also higher in the US than in peer nations, where at home birthing is much more widely practiced.
So what does this have to do with dads?
Science has for centuries been a male activity, medicine included. That has changed only in recent decades. Men have made science (with notable and often unacknowledged female contributions), and men have typically deferred to science.
It's the deferral part that causes the problems for the mother. It's easy when medical experts say that things are under control for dad to go sit in the waiting room and live out the old stereotype of the nervous father waiting to pass out cigars. This deferral has helped to legitimate the substitution of a series of medically-managed manipulations for the extremely complex and self-regulating process of human birth.
The increasing medicalization of the birthing process has been accompanied by a rise in the rate of cesarean sections in this country to just over 30% (15-20% higher than the rate in peer countries), with all the increases in risk that accompany a major surgical intervention of this sort. Lake's film makes the argument that many of the most common practices of hospital-based obstetrics themselves contribute to the chances of a delivery going cesarean, from the reclining position of the mother, the use of pitosin, epidurals, or whether a mother begins labor at the end of a shift when staff are eager to go home for the day.
These self-aggravating circumstances are avoided in a home-birth environment, or in a hospital situation in which the mother has sober and well-informed advocates at her side. A midwife is one such advocate. A dad should be another.