One of the Most Talked About and Provocative Documentaries About Childbirth Is Having Its Own Rebirth

One of the most talked about and provocative documentaries about childbirth is having its own rebirth. “The Business of Being Born,” the 2008 film by the former talk show host Ricki Lake questioning the American medical system’s approach to childbirth and presenting the benefits of home birth, will be rereleased digitally in late January, becoming available globally for the first time. The updated version of the documentary, which also spawned a DVD series and a book, will include interviews with celebrities like the actress and model Stacy Keibler who were swayed by the film and, like Ms. Lake, gave birth at home. Doctors, doulas and mothers say that “The Business of Being Born” has influenced childbirth in the United States. But six years after it first came out — and on the cusp of its updated release — the documentary is still criticized by some members of the American medical system who argue that Ms. Lake’s enthusiasm for at-home births does not show how dangerous it can be. The film remains a top-watched documentary on Netflix and ranks consistently in the top 100 for documentaries on iTunes. It has also been screened to thousands of students in schools across the nation, according to the nonprofit Choices and Childbirth. “She is the most accessible media celebrity to women of the childbearing age,” said Tanya Wills, who says she was so influenced by Ms. Lake’s film that she had two home births, became a doula and is finishing the midwifery program at Yale’s School of Nursing. “Ricki Lake is sort of the older sister to all of us saying, ‘I’ve been through this and this is what I learned and this is what it can be for you.’ ” There was a strong reaction against the documentary following its original release. The American College of Obstetricians and Gynecologists released a statement saying it “believes that hospitals and birthing centers are the safest setting for birth.” In a recent interview, Dr. Amos Grunebaum, director of obstetrics at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, noted that while home births still made up only less than 1 percent of total births, there have been more conversations since the film came out about at-home birth, and his hospital has tried to take a more “human approach” to childbirth. He said his hospital has lowered its cesarean-section delivery rates to 32.7 percent from 39.3 percent. This summer, his hospital also hired a midwife to better educate staff about midwifery. But he warned that the United States’ home-birth system was less developed than those in Europe. “If there’s anything we learned from the documentary, it is to teach their pregnant patients to bring their home to the hospital and not bring their hospital setting to the home,” Dr. Grunebaum said. Danielle Repp, a trained doula and a stay-at-home mother who is writing a book about home birth in the United States, says she was inspired by Ms. Lake’s documentary to have an at-home birth. But she ultimately delivered at a hospital because her health insurance would not cover the costs of giving birth at home. Ms. Repp wound up having a postpartum hemorrhage and says she was grateful to have delivered in a hospital. She questions whether the media lavishes too much attention on celebrities who deliver their babies at home, including the supermodels Gisele Bündchen and Cindy Crawford. “It’s the celebrity thing to do,” said Ms. Repp, who says that despite her experience, home birth should remain an option, and that Ms. Lake’s film helps people make informed decisions. Ms. Lake, known for acting in the films “Cry Baby” and “Hairspray” as well as for her talk show, which ran for more than a decade, said the film was inspired by her experience delivering her son Owen in her New York apartment. She said that she made the film because she was contemplating her legacy after the September 11th attacks, and that her only goal was not to lose money. Ms. Lake spent $450,000 of her own money to develop the film, and she says she has not covered her costs. She sold the film to New Line Cinema and Netflix for $300,000. “It was just one of those labors of love that had an incredibly long shelf life,” Ms. Lake said. “I don’t look at it as trying to get women to make the choices I made. I just want them to know they have choices.” The rerelease also coincides with the plan by Ms. Lake, along with her producing partner Abby Epstein, to use the film to build a broader documentary brand focused on health and women’s issues. This year, when they lent their names to a first-time filmmaker for the documentary “Breastmilk,” it became the fourth-most-purchased documentary in the iTunes store shortly after its release. They have raised $350,000 of the $500,000 they need for the documentary “Weed the People,” which explores the use of marijuana to fight cancer, especially among children, and is expected to be finished in late 2015. The following year, they plan to develop a documentary inspired by Holly Grigg-Spall’s birth control book “Sweetening the Pill,” which Ms. Lake optioned in January. And Ms. Epstein is offering support to the filmmaker Julie Marron on her documentary, “Happygram,” about mammograms. “Ricki and Abby have the unique position to grow the community they have built around their films,” said Marc Schiller, whose firm, Bond Strategy and Influence, is advising the women on the film’s digital distribution. “It’s really evolving how we think about documentaries.” Netflix declined to provide figures on how many times “The Business of Being Born” had been watched, but Ms. Epstein said that based on her conversations with the streaming service, the film had “held steady” in its viewership since 2008. Choices in Childbirth, which started screening a 30- minute version of the documentary in 2012, estimates that about 50,000 students have seen the documentary. Clare Friedrich, program manager for “The Business of Being Born: Classroom Edition,” said that about 50 college students and recent graduates had volunteered as regional representatives to screen the film in even more schools nationwide. But even Ms. Lake’s biggest fans stress that trying to mimic the idyllic home birth experience Ms. Lake had in the film can prove difficult and often dangerous. While the film includes footage of Ms. Lake’s successful home birth, it also shows Ms. Epstein’s problematic home birth — she is rushed to the hospital, has an emergency C-section and her baby winds up in the neonatal intensive care unit. Misha Vayner, a 34-year-old mother who gave birth to her daughter, Dru Bella, on March 29th, said that she was so influenced by the documentary that she tried to have an at-home birth. She interviewed 20 midwives to find a match. Then at 36 weeks, the pair of midwives she hired dropped her as a patient and would not give up her medical records. The midwife she ultimately hired showed up at the birth with a broken blood pressure monitor and ate and chatted on the phone through her labor, even though her daughter was asynclitic, meaning her head was cocked to the side. She said a backup midwife ultimately helped deliver her daughter. “Because I had my inner strength, I just rolled her out,” Ms. Vayner said about the birth. “I did go through some hell to get there.” For the new audiences about to see the film, Ms. Lake encourages them to think about their options, not to use her experience as a blueprint. “It’s an entertaining film,” Ms. Lake said. “No one should go into this and watch our film and recreate what they see on screen.”.

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