The Benefits of
The Business of Being Born
As a self-proclaimed homebirth skeptic before "The Business of
Being Born" project, what eventually drew you to make this film?
An Interview with Abby Epstein, Director and
Producer of The Business of Being Born
think I was first inspired by watching the video of Ricki's home
birth. I had never seen anyone give birth like that in my
life. She looked like a goddess in that bathtub! It
completely re-wired my brain as to what the possibilities were for an
amazing birth experience. Soon after, I read Ina May Gaskin's
book Spiritual Midwifery and that sealed the deal. After
that, I really understood that there were so many more aspects, layers,
and gender politics around childbirth than I had ever imagined.
Natural birth critics and anti-homebirth advocates contend
that homebirth is an outdated approach that should be replaced with the
technologies of today, stating that hospitals are better and safer
because of the medications and emergency equipment available.
How do you respond?
First and foremost I feel this is a matter of
Choice. I would never advocate homebirth or even natural
birth to any of my friends. I would only advocate they have
as informed and empowered a birth as possible. This is a deeply
personal choice that couples need to make on their own and its none of
anyone's business to tell them what is 'safer' or 'better.'
It's akin to the abortion issue in the sense that this is a
reproductive right, where all mothers should have the right to choose
where they feel safest giving birth. The statistics
just do not exist to say that hospital birth is safer. In
fact, the studies show the opposite – that homebirth is just as safe as
hospital birth for low-risk women. So we need to pay
attention to the studies that are published in medical and midwifery
journals and not use fear tactics and anecdotal evidence to discourage
homebirth because it frightens some people or adds competition to the
What are some of the reasons you discovered women choose
homebirth with a midwife over hospital birth?
I think many women had their first child in a hospital
setting and either had an unsatisfying experience, or just felt
confident enough in the process that they wanted to birth at home the
second time around. I think the personalities of many of the
homebirth mothers I meet are very confident and 'take
charge.' They trust their bodies on an intuitive level and
many also feel that a homebirth will be the safest and gentlest
experience for their newborns. Also, I think that women who
have homebirths with a midwife are usually totally transformed and
empowered by the experience. They did not expect it to be as
life-changing as it was.
Did your pregnancy affect the direction of "The Business of Being Born"?
My pregnancy was only included in the film on a lark – at the
suggestion of my editor. I was very much against it, as I
didn't see what the director's birth story was going to add to a film
already full of great birth stories.
But when my birth became the 'exception to the rule' dramatic
experience that it was, we knew we had to include it to balance out the
film. We wanted to show the importance of the medical and
midwifery models working together.
How did you decide which births to include in the final cut
of the film?
This was very difficult and a few were omitted because we
had too many characters!
Once you went into preterm labor, did the knowledge you
gained during your work on "The Business of Being Born" affect your response to the medical
care you received?
The knowledge I had gained during the making
of the film was so invaluable that I don't know how anyone has a baby
without doing all the preparation that I did! (Especially
seeing a few live births firsthand) So, I was never
frightened. I knew exactly what was happening at every
moment. I knew we were in amazing hands at home and in the
hospital and that we were never in any danger. (Except maybe for the
taxi cab ride!) Several people who had babies after seeing
the film, also told me that they felt the same way. They felt
very empowered to become participants in their own births.
As I'm sure you're aware, the AMA recently backed ACOG with a
resolution to draft anti-homebirth legislation, asserting
hospitals are the safest place to give birth, even referencing your
work in their first draft. What is your response?
You know, I find it very sad and desperate that such noble
organizations who are supposed to have women's healthcare as their
first priority would waste their precious time and energy on such a
petty turf war. When you think of all the problems facing our
maternity care system and the overwhelming amount of uninsured, the
growing premature birth rates, the terrible infant mortality stats, the
disappearance of VBAC, etc... It's amazing they would put so much
energy into the less than 1% of mothers giving birth at home.
These mothers and midwives will continue to birth at home whether it's
legal or not, so by threatening legislation they are going to push
homebirth into the 'back alley abortion' territory and move this
country backwards instead of working WITH the midwives on licensure to
make birth safer for all women and babies. But they are
fighting an economic battle here and I find it very sad. I
see great hope and compassion in the new generation of medical students
and doctors who support our film and I think that eventually this new
generation will rise above the hundred-year-old competition and fear of
midwives that dominate the current medical profession.
What do you hope people will take away from "The Business of Being Born"?
I just hope people will re-examine all their fear-based
assumptions about birth, like I did. I hope they will see
birth as a joyful, powerful experience and open their eyes to all the
different options available to them.
What type of changes would you most like to see implemented
in the course of modern maternity care practices?
I would like to see midwives integrated into the system more
autonomously. I would like to see more obstetricians backing
up midwives and supporting natural deliveries. I would like
to see more birth centers opening all over the country. I
would like to see insurance carriers reimbursing midwives equally to
doctors for doing the same job better and more cheaply. I
would like to see the malpractice crisis resolve itself somehow so that
doctors and midwives don't have to work everyday with a lawyer looking
over their shoulders, worrying that every medical decision can be
defended in a court of law.
Finally, can you tell us a little bit about any forthcoming
Ricki and I have a book coming out next May called YOUR BEST
BIRTH, which will be a wonderful practical guide to planning your
birth. We are also working on a follow-up DVD to 'The
Business of Being Born,' which should be completed by next spring.
If you haven't yet had the
chance to see "The Business of Being Born", you can rent it on Netflix.
Also, dvd copies of The Business of Being Born are still
available for purchase directly from TheBusinessofBeingBorn.com
Page Last Modified
by Catherine Beier, MS, CBE