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Bringing Up Baby: My Water Broke! And... Action!

Katherine Heigl in labor in Knocked Up

This is a movie. This is television. This is the formula:

Jane is going about her business when her water breaks. The time has come! Ready the troops! Jane calls husband or big sister or mom or best friend. "We'll meet you at the hospital! Go Go Go!" If husband is present: "Where are the bags?! WE FORGOT TO PACK THE BAGS!"

Cut scene. Arrival at hospital. Frantic. "My wife/partner/friend/daughter is having a baby, pay attention to us NOW!" Cut scene. Delivery. Woman is screaming, sweating, screaming some more—but still looking relatively good. If family and friends are present, they're worried and distressed in the waiting room. They hear her screams. Cut back to woman. She hurls obscenities at doctor or father. She screams about the pain. She demands an epidural. If this is a sitcom, some joke will be made about her anger with the dad, who looks terrified and might faint. Cut scene. Beaming mom/family cuddles baby.

Deviations exist, of course, but this is the norm. (It's even apparent when interspersed with a musical scene, as below on Glee:)


(Is it wrong that this scene made me tear up?)

We must be sensitive about portrayals of childbirth in the media because the United States is in the midst of a maternal health care crisis. Last year, Amnesty International published "Deadly Delivery: The Maternal Health Care Crisis in the USA," a report that categorically condemned our maternal healthcare system. Key information: In 2011, the U.S. ranked 50th worldwide in maternal mortality rates, tying with Saudi Arabia and dropping rank from 44th in 2010. Yet the U.S. spends more money on maternal healthcare than any other country. African-American women are three to four times more likely to die from pregnancy-related complications, yet unusually high death and illness rates cross racial and socioeconomic boundaries. 42 percent of American births are covered by Medicaid.

The reasons for this crisis are systemic and have a lot to do with health insurance, access to care, and malpractice insurance. They also have a lot to do with how obstetrics is practiced. In this post (one of a three-part series) I will focus on the issue of time.

Re-read the formula. You'll notice the pervasive theme is a sense of urgency and emergency. The sense of urgency is portrayed as deriving from the mother's hysteria and the inherent trauma of childbirth. The urgency is legitimized later in the scene, when the birth is shown to occur immediately and with great pain and drama.


(The Look Who's Talking clip is in French and an absolute must-watch.)

But... Why the urgency? Labor can actually take quite a long time, and if anything, women usually arrive at a hospital too early, not too late. (That doesn't make for great drama though, does it?) When women arrive too early, the doctor often breaks their water manually with a hook and then orders Pitocin, a labor-inducing drug. These types of drugs are used in at least 24 percent of American births, and they make contractions more painful and increase the likelihood of an emergency C-section and other complications. On average, women are three times more likely to die following a cesarean (the danger of a C-section depends very much on the specific situation) than following a vaginal birth, yet cesarean rates in the U.S. are now at 33 percent, an all-time high.

In most U.S. hospitals, an obstetrician must be present during the birth of a baby. This differs from policy in other countries, where doctors are present when surgery is required. Our unique policy transforms childbirth into a feat of time management: so many women, so few doctors. It's common today for an OB to place a time limit on a woman's pregnancy; if she doesn't go into labor by a specific date, she is deemed "post-term" and scheduled for an induction or a C-section. The definition of "post-term" has narrowed over time and varies from hospital to hospital. Meanwhile, "failure to progress" places a time limit on how long a woman can labor before her labor is "augmented" with labor-inducing drugs. The definition of "failure to progress" has narrowed as well, from 36 hours in the 1950s to 12-24 hours today. And finally, the episiotomy—cutting the vagina and perineum—is a common part of labor and delivery in many hospitals, yet conspicuously absent from "the formula."

And so "the formula," the urgent scenario that begins with the water breaking and quickly moves to screaming and immediate delivery, legitimizes the urgency of childbirth and firmly places the source of all urgency on the mother. We rarely see women scheduled for a C-section or threatened with impending induction. The homogeneity of birth scenes lulls us into a state of complacency and misguided expectations. It limits the type of questions that women are asking. Scheduling cesareans or inductions for "post-term" babies is now very common, yet the women I interview for my research are always surprised when it happens to them. Emergency cesareans are common as well, yet these scenarios fall outside our cultural expectations of birthing, and therefore are more upsetting when they occur. We don't anticipate that the circumstances of labor and delivery might be outside of our control. Indeed, on TV and in the movies, the demands come from the woman. Usually that she be given an epidural, stat.

What do you think about "the formula" and portrayals of childbirth in the media? Did I get it wrong or miss an important component? Stay tuned for Wednesday, when I break down the birth scene in this week's Parenthood.

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Comments

43 comments have been made. Post a comment.

Look Who's Talking

SO MANY of my misconceptions about childbirth bizarrely come from repeat viewings of Look Who's Talking as a kid.

____________
Kelsey Wallace, contributor

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sexism is at its worst towards pregnant and birthing women....

I really appreciated your piece on childbirth! If there is any time when women are most perceived as women rather than as people or humans I think it would be during pregnancy and childbirth. I think it is at this point that they are most vulnerable any sexism that exists in our society. Here is my reasoning for thinking this.

In some ways it is possible to experience a little less sexism by dressing and acting less girly and working in an less girly field. There has been some discussion about how fields such as teaching started to become undervalued, less respectable and less well paid once more and more women started to enter them. So women in fields with many women may suffer from sexism's effects even more than normal. It's is possible that women working in male dominated fields while still having to face sexism face less of a societal perception that their engineering or math work is not valuable, because although they are not doing something seen as women's work, and thus isn't subject to sexism in that way. Some of sexisms effects are inhibited. Their work is still evaluated as that of a "person" much more than as that of a woman. The more the field you work in is female the more you are probably going to experience a sexist devaluing of your work, and the more you will be evaluated and perceived as a woman in doing it rather than as a person or human being. Anytime women are doing something that men are doing, people are forced to be aware of and reform their sexism and view women as much more as persons and humans, and ask themselves the question "Would I treat a man in this position the same way?" Inequalities in pay and valuing a woman less for the same work that would be valued more in a man is easily apparent.

The more men are doing the same job as women, the more people will be aware of their sexism toward women in this role, whether it's teaching (there's still men doing this), parenting (less men but still there are men), or engineering (lots of men) and stop devaluing the work/job itself.

Giving birth or being pregnant it seems you may as well wear a sign on your back that says "I am a woman." For a woman in this role, none of sexism's effects are inhibited (no men are doing the same job and so nothing is forcing people to rein in their sexism), she is fully vulnerable (perhaps like no other time in life) to sexisms full effects. She can be perceived as totally a woman not as good as a person or human. It seems that anything that can be said about sexism would seem to be especially applicable to childbirth. In terms of sexism that might be stemming from attempts for control over reproduction, well it seems this sexism and these attempts at control would also intensify for pregnant women.

I wanted to say, I liked your tackling this topic and I am interested to read the rest of your series.

Thanks for these comments. I

Thanks for these comments. I actually hadn't thought about that before (women more likely to be respected when playing a role that's traditionally male, ergo giving birth is a situation in which we would expect a lot of sexism). Very interesting.

I definitely feel like I

I definitely feel like I don't trust a doctor or hospital to allow me to have a pregnancy my way.. it's a scary thought and one of the many reasons my spouse and I haven't had kids yet! To be given drugs and rushed along, to be put at risk, to be out of control in such a personal situation.. terrifying!
I have to say at least on reality shows dealing with pregnancy they do address these issues, not to advocate for these shows, but just sayin' that's how I first started learning about all the cases of using Pitocin and how it affected the labor process.

You hit the nail on the head

You hit the nail on the head as far as I'm concerned. When I was pregnant, the older men in my office and some of the younger women were very worried that I would go into labor at work and go through the whole scream/clutch belly/fall over thing. I (and other women who had had babies) explained, calmly and repeatedly, that that was not what actually happened 90+% of the time.

But this bill of goods that has been sold to a great many people, and I think it makes men and women both more nervous and worried about childbirth than they need to be. Men don't have any models for their own behavior other than nervous/clumsy/forgetful/frightened--all behaviors that carry negative connotations and undermine a person's sense of confidence. In terms of tv characters, these characters might have been shown to be competent, intelligent individuals in a wide variety of circumstances, but childbirth and caring for infants turns them into blithering idiots--and almost seems to say, this is your destiny.

As for women, I'm not going to say that this kind of portrayal makes women more likely to seek medical intervention in labor and delivery, because I think we have many, many more influences than that--news and infotainment programs that paint midwives and home birth as non-mainstream, that poke fun at water birth or birthing chairs or other "non traditional" (meaning non-medicalized, non-technology-driven, non-Western) types of birthing. I think the fictional birth stories form only part of a woman's generalized "knowledge" of birth.

i choose the midwives model of care. PERIOD.

this is why i will ALWAYS choose birth center or homebirth with midwives. the midwives model of care is hands down the most evidence-based care you can receive while pregnant. based on the fact that pregnancy and birth are normal life processes, the midwives model of care treats the mother holistically throughout the childbearing year. this woman-centered model is proven to reduce the incidence of birth injury, trauma, and c-section.

Every woman is different

I was ready to deliver my firstborn son vaginally. I had taken two sets of classes (one private, one at the hospital). I read "Pushed." I hired a doula. My contractions started on a Friday morning. Excited, I left work and started getting ready for the delivery. Contractions continued all week with increasing pain and frequency. They were worse at night, and kept me up all night that Wednesday and Thursday. The contractions were never frequent enough to justify admission, but after a week of contractions I went to L&D anyway. Nothing the doctors tried helped in terms of encouraging my labor to progress. Ultimately, my son was born via emergency c-section more than a week after the contractions started. He was healthy, and I was (relatively) healthy. It wasn't the delivery I had imagined for myself, but it all worked out in the end.
My second was born via a scheduled c-section and the recovery time was shorter and the experience less traumatic overall.

laughs

i'm a nanny. i come in contact with women who have recently had children (on playdates or other kid-gatherings) and this comes up more than the weather! someone will ask about a pregnant belly and another will mockingly act out a birth scene, usually the traditional berating of 'the one that did this to me'. it's something that's talked about frequently, i think because of the surprise that births are nothing like what they were expecting.

thanks for highlighting the alarming stats of US births! i can't wait for that parenthood episode to hulu its way to my eyeballs then run here for the followup!

I was pleasantly surprised at

I was pleasantly surprised at the portrayal of birth on, of all shows, the Office. Pam hung out at work while she was in early labor, went to the hospital kind of calmly, and it was implied that she had a natural birth. Meanwhile, yes, most shows are simply ridiculous in their drama. I was kind of hoping for Lily on How I Met Your Mother to have a homebirth in life imitating art, but last week they showed that no, that's not what she did, alas. Also, I feel like most of the medical shows DO have OMGCRAZYSITUATION C SECTION stories, but those do take place in a hospital so I guess that sort of makes sense within the confines of that sort of show.

And I'm really liking this series and looking forward to more discussions of birth on TV!

The Office

Thanks anonymous! You scooped me here because one of my posts will be about Pam's birth on The Office :)
I liked it too. I'll also write about crazybirthsituations on medical dramas, especially Grey's Anatomy. Stay tuned. I have to check out HIMYM, I didn't even know Lily was pregnant!

To add to the list of more

To add to the list of more positive birth stories on TV: Rachel on FRIENDS. Now, there was definitely still the same 'waters broke => labour => hospital', but she's shown going 'overdue' and her doctor not pushing her into induction or a scheduled C section. Then when she gets to the hospital, her labour takes a very long time, she dilates much more slowly than TV characters usually do, and the medical intervention is fairly minimal. Also, the fact that all the other characters continue having storylines whilst she is in labour shows a much more realistic time frame.

(This is me, the Anonymous

(This is me, the Anonymous above, now being less shy and actually using a name... ;) )

I also vaguely remember that Rachel's baby was breech and still delivered vaginally on Friends. And I think there was the implication that Phoebe had her triplets vaginally as well. And there was even a great episode about breastfeeding involving Ross's ex-wife too - I mean, great relatively speaking, but still... Friends. Go figure.

VERY much looking forward to the piece about the Office/Pam's labor and delivery. (And also wondering how they'll handle her second baby/the real first baby for Jenna Fischer.)

(And yes, please check out HIMYM - I think they're handling Lily's pregnancy very well, but a flash-forward to the birth was...interesting. It was played for laughs and I don't actually know what to think about it - that show does a lot of "oh, but we'll get to that later" and then gets to "that" a season or two or four later. ;) )

Hospitals are a safe place to have babies

I felt that I received wonderful care in a hospital while I was on Medicaid. I came early, was instructed to walk around, and after 10 hours when the contractions were nearly unbearable I requested an epidural, which I got. My water was manually broken and I gave birth a few hours later. It hurt, I tore (but not horribly), but my fetus and I were both monitored the whole time and we were both healthy afterwards. I then stayed in the hospital for 3 days. At no point in the process did I feel rushed or forced into anything.

I am white, but I gave birth in an urban hospital with mostly black and Hispanic moms, who I assume received similarly attentive care.

Having heard horror stories of home births that went wrong, I trust hospitals more than midwives. I know that is an unpopular opinion to voice these days, but if I had needed emergency care, I'm glad I was surrounded by doctors and surgeons who were trained to give it.

This post is not

This post is not anti-hospital. The standard narrative trope for birth in the media is one of crisis. While standards of care in the US are problematic, it doesn't mean that some hospitals are better than others, or that birth experiences don't vary widely. What is problematic is the inaccurate trope.

Thank you

I am always alarmed by the tendency of people to generalize hospital births, doctors, and modern obstetrical medicine as unsafe. Sure, there are abuses and problems -- but If it weren't for modern medicine, hospitals, and pitocin, I could easily be dead right now. Like about 20% of women, I developed pre-eclampsia toward the end of my recent pregnancy. And no, I am not obese. It runs in my family -- in fact, my cousin has developmental disabilities and my aunt nearly died because of undiagnosed pre-eclampsia in the 1980s.

To prevent me from getting sick, my doctors made the choice to induce me at 37 weeks. Pitocin was used, as was a cervical balloon, and everything came out great. (Literally! I have a healthy 5-week-old son now. )

Sure, women gave birth without modern medicine for most of civilization. But women also used to DIE DURING CHILDBIRTH a lot more than they did before Pitocin, C-sections, and neonatal intensive care units. I don't hold it against anyone who chooses to pursue a more natural birth -- but I'm glad I took advantage of modern medicine and certainly hope no one judges my pregnancy and childbirth as being lesser because of it.

"I trust hospitals more than

"I trust hospitals more than midwives"

False dilemma.
In the US, 97% of births attended by certified nurse-midwives occur in hospitals.
Midwife-led care (ie, physicians only called in when needed) produces safer outcomes for moms and babies, lower c-section rates, and higher patient satisfaction.

Oh how the formula needs to change

So many women are afraid of childbirth and don't really know what natural childbirth looks like because of how the media portrays it. Even when your water breaks, that doesn't mean an asap trip to the hospital. It does call for informing your careprovider, but most women's labors don't start right away after the water breaks and still the labor can be quite a while after that. The woman can actually labor at home for quite sometime before heading to the hospital (if that's where she's chosen to give birth). That's another part of the formula that needs to be changed. Not all women deliver in hospitals. Home birth and birth center births are on the rise. Sadly, if home birth is portrayed in the media, it seen as something strange and abnormal. The Netherlands has an 80% home birth rate and their maternity care is far superior to the US. Oh to learn from those who have better outcomes rather than to think that just because we're in the US that we're better.

Thank you!

Thanks for posting your thoughts and speaking so eloquently! I wish that the US would quit being so arrogant about what it thinks it knows.

I think you're spot on

I think you're spot on overall. I'd just add to the absurdity of the whole situation that it's roughly 10% of all pregnancies where one's water breaking is the start of labor, and is in no way a medical emergency or even urgency.

The Business of Being Born

There is a documentary that I recently posted on my own blog about called The Business of Being Born. It contrasts the medical system in the US with midwives. It gives a fantastic portrayal of natural birth, the women were calm and taught to trust in their own bodies rather then to be afraid of them. It also compares the United States take on the birthing process with the way other countries approach it. It made me as a woman fee comfortable with birth instead of afraid of it. I watched it through the Canadian Netflix, if you have not heard of it I would highly recommend it based on your post. I think you did a great job of helping to show how problematic media can be when it comes to the birthing process and women's ability to trust in their own bodies instead of being afraid of them.

 

http://informalfeminism.wordpress.com/2011/08/21/the-business-of-being-b...

Before this movie was made ...

Naomi Wolf wrote a book called "Misconceptions" that addresses much of these issues regarding pregnant women and how are treated through childbirth and beyond in what I would refer to as the medical industrial-complex. I know she has been a touchy subject in the feminist blogosphere recently, but I know many mothers who have found this book invaluable in prompting them to take better charge of their health during pregnancy. If anyone must read a Naomi Wolf book other than The Beauty Myth, it shoudl be this one.

Thanks for the tip! I've

Thanks for the tip! I've already bought the DVD but haven't yet watched it. I've heard really wonderful things about it.

Katherine Don

I also watched that same

I also watched that same documentary a while ago. Because of it I, too, feel much more comfortable with the idea of childbirth. I highly recommend watching it to anyone, because it contains some valuable insights that explore the profit side of birth in the U.S.; and since time is money, are women in hospitals really recieving the absolute best care there? And I'm not saying hospital birth is a bad idea, but the more armed you are with information going in, the better off you will be.
I loved this post about birthing in the U.S., because without the right information, facts and media representations women are left to fear childbirth and see hospital birth as the only option. But there are so many options, and I hope more women begin to look into working with midwives--whether they choose to birth with a midwife or not, it's important they know it can be a safe alternative. I also hope more women come to understand that childbirth is not necessarily something to be feared, but the opposite.

The first feeling that comes

The first feeling that comes to my mind after reading this post, is slight shock. I have been told by my own mom and other mothers how the way birth is depicted in movies and TV shows is utterly inaccurate, and it is truly a long and arduous process. Out of three kids, my mother’s water broke only once before going into labor. I am glad to see someone take interest in pointing out the realities of birth. What surprises me as well as frightens me were the facts about the still present dangers of childbirth, which I had thought were very rare in this day and age. The U.S. is really 50th for maternal mortality rates? That is sad and disappointing. I, personally, know I definitely want to have kids in the future, but this post reminded me that it is an actual dangerous process. Most young mothers and teen moms of recent times seem to take this all lightly and literally PLAN their child’s birth down to the day and time using induction and C-sections, also commonly in the hopes of keeping their "figure", which just seems ridiculous. Childbirth is becoming less of a natural process and more a planned date, like a plastic surgery operation. Ridiculous.

Thanks for your thoughts. I

Thanks for your thoughts. I was also very shocked when I first learned about these statistics. But I hope the take-away message isn't to be afraid! I've never delivered a baby either, and I can tell you in all honestly that educating myself about the dangers and the options has made me less afraid, because it becomes quite clear what situations are riskier and what situations are safer.

Katherine Don

Birth is not a crisis

I think this needs to be taken further. Yes, demand comes from women, but it's clearly in the context of Crisis. The time frame fools women and their partners into thinking that as soon as labor starts and/or the waters break birth is imminent. And it's not. We don't get to see the 6, 8, 12, 24 hours of walking, waiting, gradual progression of contractions, etc that are a part of normal, healthy birth. Every birth is a crisis. This isn't The Woman Choosing, this is the woman at the mercy of an event from which only a doctor can save her. She isn't equipped for the crisis; her body can't handle the pain. These two things are patently false in most, normal births.

These scenes don't lull women into scheduling c-sections, because the women and partners in standard tv and movie birth scenes are always unprepared. I would argue that birth is pictured as outside of a woman's control, but not outide of control period. Doctors have it all under control. The bored maternity ward nurse has it all under control. But birthing women? Never. Birth IS outside of our control, but not because birthing woman can't handle it or are clueless, but because it's an act of nature (or an act of God, if your vocabulary works that way). There is no set 'cooking' time for babies - 40 weeks is a base line measure, not an exact recipe.

I could go on and on! Birth isn't a crisis. I'm really excited about this series. Thanks for writing it!

Thanks Niki! I totally agree

Thanks Niki! I totally agree with your comments :)

Katherine Don

So apparently my mother, a

So apparently my mother, a nurse, was in labor with me (her first child) for something like half the day before she noticed. Actually my dad noticed. I think her water had even broke but it wasn't apparent for some reason? She thought the contractions were normal cramping, but my dad noticed that she seemed to be having pain at regular intervals. He timed her and they were a few minutes apart (I don't remember what they said, but it was shorted than when they were told to go the hospital. So if they were told to go at ten minutes, she didn't leave ntil they were at 5 or something). As a result she was in 'labor' for a much shorter period of time. Still 12 hours I think. I don't remember how long it was with my younger sibling, but there were complications (umbilical cord tangling) so that was a csection.

I'd like to do a home birth, but I've got issues that mean that all my births will be high-risk. Therefore I'm really interested in knowing how to make sure that you've got as much control as possible during birth.

retaining control of birth at a hospital

two resources for you: Natural Hospital Birth: The Best of Both Worlds is a GREAT book about exactly this and oneworldbirth.net so you can learn why a doula really makes a difference!

chicken or egg?

I had never thought about how media contributes to challenges in this area, so thank you for the article. I had great birth experiences with my doctors, in a hospital, but I am Canadian and for the most part I think I just lucked out. They were professional and very much of the "monitor and wait things out" method... I was in labor over 47 hours with my first and delivered naturally.

I think there's also a "cult" of "my perfect birth" from the other side of the fence that contributes to the challenges that we face as women in labour. There's the media "OMGWTFBBQ" hype, the "let's just schedule this so I can go golfing" mentality and also the crunchy granola "home birth and drug free is the only real birth" on the other side of the fence.

Neither represents the average experience (which varies widely but rarely hits any of those extremes), and if you are blinded too far either way I think your chances of feeling you are empowered to make good decisions in collusion with your health care provider (doc, nurse or midwife) is in danger.

We've made amazing strides in maternal health in the last couple of decades. It's terrifying that we can't seem to leverage that for more positive income.

good book on the topic

There's a good book that is supposed to help women get what you say you had: a natural hospital birth. I think it's clled "Natural Hospital Birth: The Best of Both Worlds." Instead of a war between two "sides" this book tries to bring the best of everything together. I recommend checking it out if you are not ready for homebirth but also not ready for a medicalized birth.

Birth as a crisis is a pervasive myth

I blogged about this topic recently too http://www.shininglightprenatal.com/2011/05/27/pregnancy-and-birth-in-th...

We can't leave out the news media too. Every time there is a birth on the parkway, or a mom who had an unexpected homebirth (otherwise known as precipitous labor) the news is all over this. So, even the 5:00 news dramatizes the one case of an emergency.... even though these births usually turn out just fine.

The OBs and nurses often support this birth as a crisis phenomenon too. See, the medical model of care is pathology - looking to prevent problems before they arise. Rather than the midwifery model of care - watchful waiting and intervening when necessary. So, the very act of practicing pathology with a normal birth is fear inducing - "If we don't do X, then bad thing Y will happen."

Yes, we do need better, more realistic images on screen and in books. However, we need to move away from pathology and towards midwifery if we are to support a normal process like birth.

While I take your point,

While I take your point, drama is based on, well, drama: conflict, emergencies and unusual and/or heightened situations, so film and television are primed to always portray the most extreme versions of any life-event. We don't see realistic relationships, weddings, marriages, sexual activity, deaths, or trips down to the basement very often either. I don't know anyone who thought birth would be like it is on tv, so perhaps the question is why some people are foolish enough to believe media presentations present truthful experiences.

I think you're actually trying to talk about something quite different and more interesting that what you have written. There is a real problem of the over-medicalization of birth, but on the other hand, the backlash against medical support at birth is equally ridiculous—yes, women have been giving birth for centuries, but they have also been dying of it in large numbers for centuries (I and my twins would have died had I not given birth at a hospital). But over-medicalization and its backlash were not caused by tv; nor will they be solved by changing portrayals of birth on tv. Also, despite the very real birth horror stories, women are in a hell of a lot more control of their birth experiences than they ever have been before—they have the option to give birth at home or in a medical setting, their partners and families (and often doulas or midwives) are allowed to be with them, and most hospitals expect to get and do their best to honor birth directives from mothers-to-be. I wonder what you thought of Betty and Don Draper's labor and birth experience in the um... 3rd season(?) of Mad Men. There was an interestingly and appropriately weird portrayal of a time when no one but the doctors had anything to do with a birth and served as a great reminder of how far we've come.

and the reality shows...

I appreciate the point above that TV drama is about, well, drama. Yes, so true. And so are reality shows, though we pretend when we watch them that these are more "real" than TV shows. But if you watch the formula of "A Baby Story" you see that they show birth in precisely the same way every time... down to the minute.

Of course over-medicalization is not caused by TV exactly, but it is a two-way street. TV reflects our reality (to a certain degree) but it also teaches us what is "normal." In 2011 mainstream America, most first-time mothers have NEVER witnessed another woman give birth and while some young women have seen their mothers or sisters or friends breastfeed, this is still an area where most first-time moms are seriously lacking in personal experience.

I teach medical anthropology at a university that serves a diverse student body. I am always shocked at how often TV and movie birth scenes are the ONLY birth experiences that my students can remember (unless they themselves have had children.) Every so often a student can talk about a sister's experience with some detail, but otherwise the only visualization they can access is from the media. When I tell them about ways of giving birth across the globe, they are shocked.

SHOULD the media portray birth differently? Well, of course, I wish they would because I think it could have a positive impact on our collective vision of birth. But I also see it as a HUGE failure of imagination on the part of Hollywood. Birth is about as dramatic as it gets! In this case, life is better than TV. There are SOOO many interesting stories in birth stories and it seems like the Hollywood writers are missing out on the really great stuff by sticking to cliches. I tune in to shows that are cutting-edge and interesting. I think the American public could get really excited about shows that portray "alternative" birth scenarios. Even if a pregnant woman is watching who wants a "classic hospital medicalized birth," wouldn't she be interested in seeing a character make a different decision from her? By setting it up as "natural" versus "medicalized" we miss out on all the nuances and human stories that make birth so interesting. At least to me.

Absolutely. And how dramatic

Absolutely. And how dramatic is it, really, if it's such predictable formula? We know from watching TV and movies that each of these formulaic steps will be met, and it's really no surprise when the mother's cursing the father of the baby and screaming at the top of her lungs.

I also think that the way the mother is physically portrayed during labor in media is a major problem. I had a med-free hospital birth and labored there for over 15 hours. I spent very, very little of that time laying down in the bed. Showing women with a freer range of motion would go a long way toward giving back some agency and change the view on what labor "has" to be like.

And this is why I read Bitch.

And this is why I read Bitch. Thank you!

Bones

Bones had a funny episode where Angela starts getting contractions. Cue Hodgins running around, panicking because he can't find his keys. He finds his keys, they leave for the hospital. Cut to them sitting in the car discussing how embarrassing it was to go into the hospital panicking only to find out it was Bradson-Hicks contractions. Also nice because it was the father who saw it as a crisis, and most of the urgency came from him.

It is nice to see this topic

It is nice to see this topic being discussed, but is the topic only going to entail how the media portrays pregnancy and birth? I myself am 4 months now and living in France. I can't necessarily compare, since I haven't had a child in America, but I can say the more I read about the system back home the more relief I feel living here. I asked my initial question because this topic could be explored on so many interesting levels just to eventually get to the media aspect. I have been living here for two years and my French husband still makes fun of me for being afraid to visit the doctor, though on every occasion they have been the kindest most reassuring doctor I could ever imagine. I have a deep deep scar from growing up in the US, first from the financial point of view and second from the cold stainless steel "compassion" I received every time I found it completely necessary to go to the doctor. I can't imagine having my baby in America at this point, even though France has its industry standards and is also a very patriarchal medical system. I feel that more and more in the US, if the issue at hand is serious and deserves attention, the more the media and general society laugh at it, make jokes, or ignore it completely. Also, I will be doing hypnobirthing and I have to say my practice for it so far has changed my entire notion of what I though birth is...totally influenced by "look who's talkin".

HELL YEAH.

This this and more this. I've had three kids, and all three births were wildly different. My first one was an out of control nightmare, largely because I was uninformed and ignorant. I'd never even heard of back labour (um, ouch.) My second was many years later, and was with the world's worst midwife. Buddha on a basketball, she was bad. If the labour nurse hadn't quietly said to me, "This is your birth, not hers. You do what YOU want" I don't know what would have happened. God bless that nurse! The third was a planned c-section. My maternity doc didn't love me much, let me tell you. I told her how it was going to be. I refused to let her check my cervix (there's no need for that shit except to help her plan her week). I told her there was no way in hell my kid was getting the antibiotic drops in his eyes after birth because I know I don't have an STD because SHE FREAKIN' TESTED ME! etc, ad nauseum. Every damn thing was a fight. I'm very glad to be done with pregnancy and childbirth. Very glad.

Some thoughts

I have a lot of thoughts about this post and the comments and will respond in more depth later. I think childbirth and maternal care is one of the most under-recognized areas of activism when it comes to the feminist movement. There are so many fantastic women advocating for choice in what is quickly becoming a choiceless area of women's rights. Ina May Gaskin comes to mind, a natural and homebirth advocate. She is interviewed on the documentary previously mentioned, The Business of Being Born. Which, by the way, is getting ready to release four all new documentaries going into more depth on the state of childbirth in the US.

It's Never Too Late to Overcome that Scripted Fear...

I appreciated reading this very much - the idea of an unmedicated birth seemed almost crazy to me at one point in my life - I dismissively thought 'why would someone WANT all that pain?'. I went full speed ahead, young and uninformed into my first pregnancy/delivery. Even as they scheduled my appointment to come in for pitocin two weeks prior to my due date "because baby is too big", I didn't question the system or the doctors providing my care. They were the doctors and if they said the baby was 'too big', I believed them. That day my baby was born, but not because I gave birth to her, I felt like a bystander in the process. Four months of screaming and unexplained 'colic' led me to question whether two additional weeks in the tummy would have made for a less turbulent entry into the world.

Then, I had baby #2 and 'tried' for an unmedicated birth, but was still not informed enough. I knew I didn't want a repeat of my first experience, but I failed to do the research to truly find out how to accomplish that goal. I got to 8 centimeters when the hospital staff basically said, "it's now or never" and I accepted the epidural. Again, I felt something was missing.

Thankfully, I read "Natural Hospital Birth: The Best of Both Worlds" (Cynthia Gabriel) which gave me the roadmap I needed to overcome the culture of fear that I hadn't realized until pregnancy #3 was so prevalent. This book helped me achieve the natural birth I'd wanted and I will be forever grateful to the author for empowering me to take a leap of faith and believe in myself. My child, my husband and I experienced what birth was meant to be.

Hollywood, you've got it all wrong.

Thank you! I literally just wrote about this topic on my blog yesterday: http://blogalacart.com/2011/10/hollywood/

I'd love for fellow moms to weigh in and add to the list I'm generating about the realities of birth for women!

I'm thrilled to see the topic of birth in the US being covered in this way and you are hitting on such a crucial issue in your analysis of time.

With my 1st baby, they wanted to induce me and I had to fight to stay on bed rest - and then when labor started I went to the hospital far too early and had a hell of a time getting the nursing staff to support my wishes for an intervention free birth. They popped my water eventually when I'd been in labor for 12 hours and were panicy because the baby was over 9lbs. I fortunately delivered her very shortly after having my bag broken or I fear they would have convinced me to have a C.

With my 2nd, I knew to labor at home til the very end. And even though I walked through the hospital doors only 40min before I delivered the baby after a full day if laboring at home, it was a relaxed and non-urgent process. I wish more women knew to approach birth in this way. We need more writing like this to let them know the possibility exists!! Thanks again.

Anthropology Undergraduate Thesis Topic

This is phenomenal, I am currently writing my anthropology undergraduate thesis on this topic. On how visual media (television shows and film) represent childbirth. This has been an amazing find, and I will undoubtedly be quoting Katherine Don in my thesis. It is really exciting that after a frustrating time trying to find literature in this field, I am finally beginning to find a rise in this discussion. It proves the point that I have been trying to argue with my professors for a while now, that this is indeed a very important topic. Thank you so much for publishing this! And anyone is more than welcome to contact me about my research!