Ricki Lake never imagined that one of her more memorable film roles would involve giving birth in a bathtub. When the actress and former talk-show host delivered her son Owen six years ago, she recorded his home birth for posterity. She never envisioned the footage would be seen outside of her immediate family.
Fast forward to January, when Lake’s documentary, The Business of Being Born, premiered at the Tribeca Film Festival. The movie, which celebrates midwifery and natural birthing methods—while scrutinizing how some hospitals deliver maternal care—is Lake’s baby in every sense of the word. The film shows Lake birthing Owen at home with the help of a midwife. “There I was at 195 pounds, naked and giving birth to my son in the bathtub,” says Lake, who turns 40 this year. “I was hesitant at first to include the footage in the film. It’s very intimate but it’s also a beautiful moment.”
Lake had vastly different birthing experiences with her two sons. Milo, who is now 11, was born in a New York City hospital where Lake’s childbirth experience deviated from her birth plan. Although she had a midwife present, the hospital had certain protocols, and after a long labor she eventually had to be induced. Although she received exemplary care, Lake wondered if her son’s birth might have been different without all of the medical interventions. “I was in labor for almost 36 hours, tethered to an IV that was dispensing [the labor-inducing drug] Pitocin,” she says. “I didn’t feel as if I was in control of my body or that I had many choices.”
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After reading the classic Spiritual Midwifery by midwife Ina May Gaskin, Lake decided to birth Owen at home, in water, surrounded by her midwife and family. “With my second son the delivery was nine hours long and I was entertaining friends and family at my home the next day,” says Lake.
Lake decided she had a story to tell as well as the background and resources needed to explore the notion of an ideal birth experience. She approached friend and director Abby Epstein with the idea of filming a documentary that would examine the politics and history of birthing in America, while also attempting to answer some tough questions, like why the U.S. spends twice as much per birth as any other industrialized country but still has high mortality rates for infants. Lake also asks, “Why are one in three women having C-sections? Are they really medically necessary?”
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Lake wanted to advocate for the rights of expectant mothers and for better maternal care. So she bankrolled the project and served as its executive producer. To capture a variety of views and experiences, Lake and Epstein interviewed doctors, nurses, medical anthropologists and midwives while also following several women through their pregnancies and births.
While some critics say the film advocates natural home births, Lake says her only goal was to educate pregnant women about their birthing options. “The film doesn’t advocate anything other than choices,” she says. “I’m not recommending that all women have a natural home birth or forego having an epidural.”
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During her own pregnancies she grew tired of movies and television shows that depicted pregnant women lying in hospital beds screaming; she wanted the film to show birthing in a positive light. The film includes a number of women giving birth; these scenes have been praised for their mixture of delicacy and humor. “Books and movies can scare the hell out of pregnant women,” says Lake. “I want women to realize that giving birth isn’t an illness that needs to be numbed but rather a miraculous event that should be experienced.”
When Epstein learned she was pregnant during the filming, her experience also became part of the documentary. She originally opted to have a home birth, but after learning her baby was in a breech position, Epstein was admitted to a hospital where she delivered her son by Caesarean section.
Although the surgery was unexpected, both Epstein and Lake say the experience illustrated why women need to be educated about their options. “We don’t want women to feel bad if they have a C-section,” Lake says. “Our belief is that C-sections are fine as long as they are only performed to guarantee the health of the mother and baby. They shouldn’t be the first choice of delivery for healthy mothers.”
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Lake is especially passionate about the role of midwives in birth. She cites national research demonstrating that midwives achieve the same outcomes as physicians but with fewer disruptions to the natural process of birth. Midwives have also been shown to reduce Caesarean section rates by more than 50%, and their patients have significantly lower rates of episiotomies, induced labor and forceps births. Today’s certified nurse midwives are professional healthcare providers and registered nurses who have graduated from one of the advanced education programs accredited by the American College of Nurse Midwives.
Midwives assist women in all types of birthing situations and facilities; Lake had midwives present for both of her sons’ births—even during her first son’s hospital birth. “I’m not anti-doctor or anti-hospital,” Lake says. “I think it’s important for women to know what the statistics and risks are—for both a natural home birth and a hospital one.”
To date, the film has been well received. By April it had already been rented or reserved by 85,000 customers of the online movie company Netflix. Another 14,000 subscribers opted to watch the movie online. “We’ve had obstetricians tell us that the medical community is embracing our film as a very important tool,” says Lake. “Midwives have thanked us for promoting an awareness of their profession, and women are telling us that in some cases they have switched care providers and left the film with very different ideas about their birth plan.”
Lake and Epstein are continuing their journey to empower expectant mothers with a new book, Your Best Birth, slated to hit bookstores next spring. “The book covers everything from questions to ask a midwife to having a vaginal birth after Cesarean,” Lake says. “I am so excited about both the movie and the book. I truly feel that these projects give my life meaning.”
The book will also feature the experiences of other celebrities, including supermodel Cindy Crawford, who birthed her two children at home. “She was a fantastic person to interview,”
Lake says. “She was very open about both of her children’s births and how the experiences changed her.”
Lake says that being a mom has altered her own life for the better. She revels in watching her sons grow up. “Both boys saw the premiere of the documentary with me,” Lake says. “And Owen gave me a beautiful handmade card that said, ‘Thank you for letting me be born in our bathtub at home.’ ” And for that, says Lake, he is very welcome.
Healthy Mom& Baby has many articles to help you through your pregnancy, and keep you and your baby in good health, written by the nurses at AWHONN, see our Healthy Moms and Healthy Pregnancy and Healthy Baby sections.