June 25, 2009 08:00 AM

Former talk show host Ricki Lake drew praise and criticism for her documentary, The Business of Being Born. Now, together with Abby Epstein, her documentary partner, the mom of two is releasing a book, Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience.

In part 1 of the interview, Ricki and Abby spoke to us about their film and their new book. In part 2, which runs tomorrow, they spoke to us about the accompanying new social networking site, mybestbirth.com, their next film and answered CBB reader questions!

Celebrity Baby Blog: Tell us how The Business of Being Born came about.

Abby Epstein: [The film came] out of Ricki’s passion for shedding some light on this childbirth information that’s sorely inaccessible and unavailable to most women. I actually thought we were pretty tame in the film considering some of the information we found, because it’s pretty horrible what’s going on now in a lot of hospitals.

Since we released the film, we’ve had so many upsetting emails from women all over the country who are so traumatized by their experiences giving birth. A lot of them don’t even realize they were abused or disempowered through the experience in some way until it’s long over. Something sparked it, and all of a sudden they realized they didn’t even know they had these options.

We started doing screenings all around the country, and it was clear how much misinformation there was, and how much more the cause needed to be illuminated.

Ricki, The Business of Being Born has really given you the reputation of being this gung-ho pro-homebirther. Would you say that’s a fair assessment?

Ricki Lake: My documentary was very much about my personal journey and the women we followed, and it weighed more heavily on natural births, and midwife-assisted births. I think it was balanced in that Abby ended up having an emergency, necessary C-section with an obstetrician, so it had a point of view.

I don’t want anyone to think I’m judging them for choices that they make. I’m not God or pretending to be anyone who knows better than anyone else. I’m the lay person who had this experience herself, and had the need for people to start the discussion about the issue. I consider myself to be “pro-choice” in this deal, not even “pro-natural birth.” That was my choice, but it’s not the right choice for a lot of people and I recognize that, and don’t judge anyone for making any choice they make in this area. I don’t want anyone to walk away thinking I have expectations of anybody.

Abby: There’s a gray area: lots of people saw the film, had the epidural and had their OB, went with their birth plan, but avoided a C-section after seeing the movie. They weren’t afraid to speak up about methods, timing, or the baby’s health. That’s a big part of this.

The great thing about having a midwife in the hospital is that she can recommend other options, like an epidural. Then the epidural becomes just a really helpful extension. You have care with a provider who’s coming from a philosophy where they believe in you and your body, and your ability to give birth on your own – and that is so huge! A lot of OBs don’t believe women can give birth without epidurals and that the process is dangerous and requires intervention. So having a provider whose general philosophy is that this is a physiological natural body process that most women can do unassisted, is a huge place to start.

I can tell you that the book and films have changed my life, and I’m sure you’ve heard that from so many people!

Ricki: I never get tired of hearing that. I feel like it started a little movement, and I never imagined that would happen. I really feel that when I started my own research in 1997, and saw Ina May [Gaskin, who is known as the pioneer of modern midwifery] speak for the first time, I didn’t think anyone cared – or that my friends cared – about giving birth as drug-free as possible. But to see that people are interested and passionate about it, and want to do it differently next time, it’s really a great feeling.

Abby, you became pregnant while shooting the film. Where were you on intervention-free birth and homebirth before you started filming?

Abby: I was absolutely not interested in it, would never have explored it, had no idea what a midwife was. I knew Ricki because she was my friend – I knew she had the homebirth – but I was really uninterested in hearing about it, and I thought she was crazy. So for me, it was completely shut out. Then she gave me Ina May’s book, and then I was like, “Oh okay, well wait a minute. This is an empowerment issue.” So that’s how I came into it – as a filmmaker interested in women’s issues and empowerment issues. So when I read the book and realized there were all these other levels to it, then I started getting interested as a filmmaker.

For me, one of the turning points was attending people’s births. The first birth that I went to was a homebirth, and I was kind of freaking out – it was hardcore! I’d never seen a birth in my life, and the first was in someone’s apartment and I don’t really deal well with blood. But it was such an incredible experience, so simple and so natural.

Me watching Ricki give birth in her bathtub on camera, that was a huge part of me wanting to make this film. Back in the day when birth was really something that women got to see all the time, you attended your sister’s birth and people were around and there. Those were the doulas; that’s who got you through. And now that we’ve kind of lost that connection and women don’t see birth anymore, I think that’s a huge piece of why we’re so afraid of it – we only see it on television in this very frightening way.

So as soon as I started attending births and seeing other women do it, I thought to myself, “Wait a minute, I could do this. Ricki could do it, I can do it!” So it just changes you completely.

Abby, you mentioned on The Today Show that your partner was more into natural childbirth than you?

Abby: He was sure I could do it – I didn’t change my mind until about 32 weeks. I was going to be in Roosevelt Hospital with my OB. I was thinking a hospital or birth center. So I didn’t switch to homebirth until the end. He was shooting the film, so he was there for all the births with me, filming them. He was having the same experience I was, seeing how amazing the homebirths were.

He’s from Brazil, and it’s one of the worst countries in terms of birth systems. We filmed there for both movies, and if you can believe it, Rio de Janeiro actually has a 93 percent C-section rate. So in Brazil it’s like, if you have money you have a C-section, period.

Even if you’re planning to have a hospital birth with drugs and typical interventions, some of the doctors in the film come off as very arrogant.

Abby: The Business of Being Born was just tame compared to what we could’ve put out there. We have some really, really damning footage and some terrible quotes. A lot of these doctors don’t even care that they’re being filmed, or that they have anything to hide. This is the way they do birth, they’re proud of it and believe in it.

You can even see some of it on A Baby Story. Once you’re enlightened, then watch the show, you see how arrogant and condescending these doctors are to the women. But if you don’t know the other side of it and you watch those shows, you just think, “Oh the doctor is right! She must really need that C-section right now.” But if you know your stuff and watch those shows, it’s horrible! Half the time these women don’t need to be induced and who knows why they are. Then the doctor comes in and says they’re not progressing or dilating, like it’s the woman’s fault. Well, she wasn’t even ready to give birth! You are trying to put her into labor. So all those shows, if you really know what’s going on, you’ll see it.

There’s such a power disparity. The medical world has so much power that you don’t question or challenge – you only do what’s right for the health of the baby. They can use cervidil in hospitals because it’s cheap. When we were filming at one hospital in Brooklyn, I remember the nurses said, “They’re just pushing us to use the cytotec, and we don’t like it – it’s really powerful.” It’s not like a drug you can tone down in an IV – it’s a pill that dissolves. So once it’s in your cervix dissolving, you can’t scale it back. It’s just a very crude drug. You should never let anyone induce you with cytotec, ever.

And how did the book, Your Best Birth, come about?

Abby: So we decided to write the book and make it non-controversial, but a must-read for every single woman who is going to have a baby. It doesn’t matter if you already know you want to have a C-section, or are looking for a natural or homebirth, but it’s just a book of what every woman needs to know about how to get her best birth. That’s how the book came about. It’s a topic I think so few people are really talking about it publicly, and there’s so little advocacy going on in a public way, so we thought we can’t really get off the birth train just yet because we seem to be having a really big impact.

How is the book different from the film?

Ricki: The book is more about empowering women to make sure they make the best decision for them, whatever it is. I want to be very clear that I’m not telling people what to do.

It’s really encouraging to meet these doctors – both old and young – who have a really great philosophy that’s much more midwife-friendly, and not even natural-birth-focused, but treating women in a way that they’re not just a doctor. They don’t train young residents to learn the art of birthing. They don’t train them to do forceps delivery anymore, so it’s really based on a C-section, which is what you’re going to do anytime there are complications.

As far as turning the baby, and those kinds of things, they’re not being taught like they were when others went to school. We’re losing natural birth in the hospital system. But once you get to these residents, even those that aren’t planning to be OBs, and you show them the film and they see a natural birth, for some the first time, it can help in forming their skills and show how important it is to have that kind of positive experience.

I feel like at this point I know of more celebrities who have had homebirths than friends who have done the same.

Ricki: A lot of celebrities are happy to talk about it now! It seems that there’s a resurgence of people who’ve done it. Cindy Crawford has been incredibly generous with her time, and speaks candidly about her experience [with her homebirths]. Christy Turlington Burns gave birth in a birth center, and Laila Ali and Kellie Martin [had natural births] in hospitals.

— Danielle

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