Archive for Thursday, October 26, 2000

PBS looks at birth in America

Born in the U.S.A.’ destroys stereotypes of childbirth

October 26, 2000


— Murphy Brown is about to give birth, and it's not a pretty picture. She's writhing in pain, she's angry and she's taking it out on a hospital room full of friends and medical staff.

"Born in the U.S.A.," a new PBS documentary, opens with the sitcom scene for good reason: It neatly demonstrates an entrenched view of childbirth as a frenzied ordeal typically verging on a medical red alert.

The film asks that we cut the cord to those preconceptions which along with America's fascination with medical technology affect not only perceptions of childbirth but the process itself.

For women who have a low-risk pregnancy, one without complications such as diabetes, there are more options and less invasive ones than generally recognized, say filmmakers Marcia Jarmel and Ken Schneider.

In northern European countries such as Holland, about 70 percent of births take place with a midwife attending either at home or in the hospital, according to the creators of "Born in the U.S.A." In America, midwives are used in 7 percent of births.

More than one out of every five U.S. babies, 22 percent, is born by Cesarean section, among the highest rates worldwide and called excessive by some critics.

But "Born in the U.S.A." is not a polemic for natural childbirth and against the medical establishment. Scenes of hospital births do seem more impersonal than the intimate deliveries overseen by midwives, but the doctors are no less caring.

In several instances physicians and midwives are shown working as a team, using advanced medical equipment or surgery as needed.

"We kept hearing, 'You guys are making an advocacy film,"' Schneider recalled. "Marcia said, 'What does it feel like we're advocating?' The response was, 'Well, for women to have a choice.'

"If that's true, we're guilty."

The film, part of PBS' "Independent Lens" series, is airing beginning this month on PBS stations (check local listings).

For Schneider and Jarmel, the issue initially was personal, not political. The San Francisco filmmakers, who are husband and wife, began looking into delivery options when Jarmel was pregnant with their first baby.

"We're driving across country with all our camera gear in the car (for another film) and Ken is reading medical literature to me aloud," recalled Jarmel. "Somewhere about the middle of the country he said, 'Hey, this is really interesting. Why isn't this something more people are talking about? It's so emotionally compelling.'

"By the time we got to the East Coast, we had a film."

They also had reached a decision.

"I felt very confident as long as I remained low-risk that I would be safe at home," said Jarmel. Their son Mica, now 4, was born at home with a midwife; so was his baby brother, Jaden.

The hour-long "Born in the U.S.A." profiles a traditional physician as she treats patients with the most advanced medical equipment as well as midwives whose nurturing skills are as impressive as their experience.

They are also well-equipped. "This is not a Luddite movement, this is not a break-the-machine movement," said Schneider, noting that midwives use aids such as fetal monitors and oxygen.

The film also offers a revealing glimpse inside the Childbearing Center of Morris Heights in New York. Dr. Nate Mandelman is the medical director.

"There is an emotionalism rampant that somehow obstetrical emergencies occur with frightening frequency and that people are constantly being subjected to emergency deliveries and lifesaving gestures," said Mandelman. "That's just not true."

"As an obstetrician said to us, medical protocols change at a rate that could be called glacial," said Schneider. "There is a lot of room for new technology, but not a lot of room for a treatment (approach) that calls for less technology and more one-on-one human care."

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