Debunking the Business of Being Born: part 4

This is part 4 in a series debunking the Business of Being Born. Descriptions of the movie are in bold.

A woman complains about the ‘intense interventions’ and claims that there is no medically justified reason for interventions in obstetrics.  She also says that there is no common sense reason for many things, such as the lithotomy position in labor.

Once again, no evidence is presented and the claims are so vague that they are impossible to investigate. Its an opinion, that is all. I cannot tell if she is saying that there is never a good reason for ‘intense’ interventions, or if there is never a good reason for any of the interventions OBGYNs use, or that there is not a medical reason the majority of the time.

There is a montage of hospital births and interventions that seem selected to make viewers feel uncomfortable. They cut to a home birth mother. She says “the more you can move with labor, the more you can move through your contractions, they don’t seem as intense.” There is footage of her moving during a contraction. “To lay still its like ‘who would want to do this? I just want to get up and move my hips!’ “

That was her experience during labor. I believed that it was the experience of women in general because of this movie and other NCB advocates. I believed it fully until I went into labor and tried it. I tried for hours to ‘move through’ my contractions. It didn’t do a god damn thing for the pain, it actually made it worse. I’m not saying the mom in the movie is full of shit, just that her experience isn’t shared by everyone. Even if every hospital pushed NCB on patients there would still be people like me who need something stronger than a butt-dance to deal with the pain.

The same woman as before claims “the lithotomy position is the most physiologically dysfunctional position ever invented for birth. Because putting a woman flat on her back literally makes the pelvis smaller. It makes it much more difficult for the woman to use her stomach muscles to push. And therefore makes it much more likely that an episiotomy will be cut or forceps will be used. Or the vaccuum extractor will be used. ” More creepy hospital footage and modern hospital deliveries are shown on screen. 

I could not find any real data about these claims, but (as I discussed in part 3) epidurals are the intervention most strongly correlated with instrumental deliveries. It makes absolute sense that moms who use epidural anesthesia would be positioned in a way that could facilitate interventions, because women with epidurals obviously cannot move around without assistance and any emergency interventions would be delayed by having to re-position her.

What is really strange is that I watched The MORE business of being born, and recall one of the super models talking about how being on her back was most comfortable for her during her unmedicated birth. If our bodies “know how to give birth” and all that I am not sure why her body would choose the most “physiologically dysfunctional position ever invented for birth”, which resulted in an uncomplicated vaginal delivery.

A man speaks a foreign language, he gestures towards a patient bed and references the lithotomy position. Subtitles read “this position here, it is easiest for the doctor. But its nearly impossible for the baby to come out alone in this position.

If its “nearly impossible” why does it happen so often? All the information I could find demonstrated that operative vaginal deliveries were 5% or less of all births in the U.S., and the vast majority of vaginal delivery patients were in the lithotomy position.

A woman uses a toy doll and a foam pelvis to demonstrate that babies need to turn after their heads engage in the pelvis in order to be born. She claims that shaking the pelvis and moving around helps. 

The same man as before (who we now know is an OBGYN) says Now if she was squatting I would have to be sitting on this little seat right here…

Footage of a birth where the mother is moving around on her own is shown, presumably not in a hospital. 

The dr continues: So the mother is active and thats very important, shes participating. As opposed to when shes laying down, the doctor is telling her “Push! Stronger now!”

Footage is shown on the screen of a hospital birth with a lot of people telling a mom to push. She is yelping in pain and there are hands all over her. Her face is blurred out.

This kind of footage freaked me out when I watched this movie. Peoples hands all over the mom while they barked orders at her really squicked me out as a person with an abuse history. Pretending that midwives are never grabby or never yell at women to push or that all doctors are aggressive in this manner is just nonsense. It is another attempt to put anecdotes in our minds instead of actual data. The degree a person obtains does not determine how much respect they will give you.

A doula/rn says: Women here have given up their autonomy about birth. Women are so afraid of birth. Because you do not have an image of what birth looks like. Women in america don’t know what’s normal about birth.

A CNM says “they watch A Baby Story and they watch Maternity Ward. They watch these programs. I think there is a lot of fear instilled in women around birth.”

The screen shows footage of terrified mothers in hospitals, presumably from the programs mentioned by the CNM.

A birth center owner says “Every birth that you see on television is women screaming and being rushed down the hallway and looking like an absolute dire emergency. So why should women feel confident about giving birth when the whole culture is telling them this is scary, this is dangerous? “

Those shows are the real stories of real women who really did have a terrifying experience. Why are women supposed to ignore the possibility of something terrifying happening? How are women supposed to make reasonable plans without contemplating what could go wrong? I am not advocating for anxiety or non-stop worry about complications, but the experiences of women who had emergencies in birth shouldn’t be ignored or buried in favor of the more positive experiences. I also know for a fact that they have shown unmedicated and home births on the shows mentioned. I remember being a teenager and watching a woman give birth in a kiddie pool in her home on the discovery health channel. I usually did not watch the birth shows, but she was screaming “CYOTEEEEEEEEEE” over and over again and I needed to know why she would yell “cyote” during birth so I tuned in. It was what she named her son.

Anyway.

Birth is what it is- why does it need to be portrayed a certain way?

NCBers know why- they believe, like many alt-med folks, that your attitude can determine your outcome. They believe that if you just aren’t afraid of birth it won’t hurt you. It sounds ridiculous when the theory is stated outright, so the movie does a good job of easing you into the idea that your attitude will determine the outcome of childbirth.  Several NCB icons like grantly dick reed and Ina May Gaskin state this theory in their books. They believe that giving birth while scared is like trying to pee with an audience- fear interrupts the process. It is a hypothesis, but it isn’t one that is testable. The hypothesis relies on the subjective inner experiences of women over a period of hours, it is something that can change dramatically in a matter of minutes. If a woman has even a moment of fear during childbirth any problem that occurred can be blamed on her. It is unspeakably cruel to blame women for something they have no control over. The movie accomplishes it very stealthily, and I believe that women are so used to accepting blame for things that it can be hard to even notice that its happening.

“Women expect to have traumatic experiences. Thats why women are having epidurals, they are all terrified of what this is.”

This is another subtle jab at women who chose interventions. She is implying that women chose epidurals because they are ninnies who were brainwashed by the media into believing they needed one. Women have epidurals because they are in pain.

A childbirth educator complains about the fear present in the depictions on television. She says that once the doctor plays the “your baby is in danger card” the battle is over. There is footage of a mom whose baby is having heart trouble during delivery, her OB is trying to avoid instrumental delivery but mentions it as a possibility. He tells her to push. 

“That’s one of the great manipulative techniques that are used, is when a woman starts to question, “wait, why do we need to do this? Wait, is there something else we can do? the first thing you turn to is ‘its for the good of the baby’.  Weather or not it is, you’ll do anything because if you go on to question it, well, then you’re a bad mom. 

There is more footage of a different OB recommending a vaccuum assisted delivery in a hospital.

As I stated before, there are very few instrumental deliveries. This part of the film gives the impression that it is much more likely to happen than it actually is, and they pretend that there is no danger in maternal exhaustion or pushing for a very long time.

Sometimes ‘its for the good of the baby’ is just the simple truth of the matter, or it is the truth to the best of the physician’s knowledge.  This film basically promotes paranoia about why your physician would recommend something. Why are midwives exempt from paranoia about non-intervention? The Business of Being Born very rarely questions the actions or recommendations of midwives, but constantly questions physicians. The physicians have the disadvantage of having many years of training based on a large amount of complicated data. Issues like that are hard to explain concisely. Midwives can usually explain themselves in a slogan. It is superficially more convincing to lay people. It is very much the same as creationism, where snappy lines are more compelling to people who do not know better.

Discussion of the themes so far:

Negligence is usually defined as doing something a reasonable person would not do, or failing to do something a reasonable person would do. Both can cause death or problems. The Business of Being Born makes it seem like only the first kind of negligence is dangerous, when in fact both are.  The movie, and NCB advocates, repeatedly suggests the second kind of negligence as desirable without explaining why. The fact of the matter is that many women find the risk of intervention preferable to the risk of not using an intervention, and its understandable. There is a certain percentage of the time that the intervention would not have been needed, but it is not possible to know until something bad has happened.

I got irritated with statements that I could not investigate in this portion of the movie. If you make a statement using dramatic, emotional language, but never get specific enough to actually have your statement investigated for validity then people will hear whatever they want to hear when they listen. Its something politicians are experts at. It is a red flag for dishonesty. I wish I had spotted it before I decided to use a midwife at an out of hospital birth.

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2 thoughts on “Debunking the Business of Being Born: part 4”

  1. You lost me at the Creationism jab. Just because you don’t want to see the evidence, there is A LOT out there that is conveniently ignored, doesn’t mean you’re justified to insult it. Go watch tons of YouTube debates and have an open mind. Thanks.

    1. You’re entitled to your opinion on creationism, I hope that my opinion on the matter doesn’t dissuade you from considering my other arguments about natural child birth.

      Anyway, I have college education in biology as well as a lot of experience in the creationism vs evolution debate. The only person who is a biologist who does not subscribe to the theory of evolution (to my knowledge) is Michael Behe, and he has notoriously poor arguments against evolution. It would take very little evidence to disprove evolution, but so far nothing has emerged. DNA specifically has provided invaluable support for the theory of evolution, in addition to examples that have happened over a period of decades (like antibiotic resistant bacteria, and other bacteria experiments in which adaptive mutations became ubiquitous in populations). If you are interested in talking evolution more (politely of course) I can be reached at skeptifemblog@gmail.com.

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