Home birth at its most extreme
by Amelia Thomson-DeVeaux
After I watched The Business of Being Born in my women's studies class last semester, I decided to become a birth doula. I'm prone to extreme decisions, but this was also because The Business of Being Born, a documentary about the home birth movement, is one of the most convincing documentaries I've ever seen - it shows off the midwives of New York City as sane and birth-friendly in a healthcare system that is unqualified and unwilling to deliver babies correctly. There's a profile of midwife Cara Muhlhahn (one of the central figures in TBOBB) in New York Magazine which presents her as perhaps a darker figure - one which I don't necessarily agree with, but which is an interesting counterpoint to the film. The article's author, Andrew Goldman, is distinctly dubious about Muhlhahn's methods - and to hear him tell it, she does sound a little crazy.
Goldman writes, "When you ask Muhlhahn’s many happy customers to recount their birth stories, they struggle a bit; you suspect they feel the way an astronaut might attempting to describe space travel to someone who’s never flown in a plane. 'When you get through that transition, and you experience the birth of your child, you get the endorphins, the best bonding experience, I mean, I can’t even explain how meaningful and important and life-changing an event it was,' says Jeannie Gaffigan, who delivered her second child with Muhlhahn." This is the side of Muhlhahn that the documentary presents - a woman who pays attention to her clients, and refuses to let them feel like they're a number or a small part of a larger system. And she has delivered babies under the riskiest of conditions, in dramatic circumstances - like the picture above, which shows her simulating delivering a baby on the roof of a Brooklyn apartment building.
All of this is exciting, and has helped to normalize home birth so that it even seems glamorous. However, there are points at which it's very possible to question Muhlhahn's sanity, and those Goldman is eager to bring up. He recounts the horror stories that didn't quite make it into the movie's final cut - like the time Muhlhahn left a woman in labor for 72 hours while she went off to deliver another baby. When Muhlhahn returned, the father (understandably worried about his wife's health) asked, "How long is too long for a woman to be in labor?” “Never,” Muhlhahn replied. The woman was taken to the hospital and the baby was delivered by C-section. She remembers her reaction to entering the hospital, which surprised her - "It was a feeling of, ‘Oh my God. Here are people in their white lab coats who know what they’re doing, and there’s equipment and medicine here.’ Then I looked over at Cara with her crazy hair and ragtag clothes and I said to myself, ‘What was I thinking?’"
There are plenty of other stories to make all potential home birth clients cringe, and a few of them ended in tragedy. But there's another side to all this, which obstetrician Jacques Moritz (admittedly, an aficionado of the home birth movement) was quick to point out - "The problem is that we’re talking about the possibility the outcome would be different," he said. “No one who loses a baby in a hospital says, 'Oh, I wonder if this would have been better if I’d done it at home?'"
Goldman is open about his partisanness in all of this - he and his wife almost opted to go the home birth route, but their baby was born in a hospital, through a cesarean section. But I do wonder how much this has to do with the home birth movement, and how much it's about Muhlhahn as a person. There are many midwives who would never dream of attempting the deliveries that Muhlhahn takes on, and that's perhaps the reason why she's taken on a kind of celebrity in the movement. The fact is that there are many good reasons to have a home birth, but there are also times when it's far safer to have a hospital delivery, and the answer is not as cut-and-dried as the doctors or the makers of TBOBB would like you to believe. And Muhlhahn, in many ways the face of the home birth movement, is definitely controversial (I don't know how I'd feel about delivering my baby on the roof of a New York apartment building, for example). But I do think that Muhlhahn's essential goal, to render childbirth more "poetic than clinical," is a beautiful one. Even if she's personally a little crazy, what Muhlhahn - and her fellow midwives - are attempting is something which is brave, and admirable. But I do have to say, after 72 hours in labor, I would be screaming for the hospital too.
Thanks to Aku for the tip!