“Laboring Under An Illusion:” RH Reality Check Talks to Filmmaker Vicki Elson


Childbirth
educator and documentary filmmaker Vicki Elson likes to say, aside from the
typical hospital birth, there are essentially three kinds of births on
television:

"One type is a
pioneer woman or early Native American just pushing her baby out, no problem.
Another type is an accidental birth on an airplane, in a tree, or during a
hostage situation.  The third type is a planned out-of-hospital birth.
These look pretty flaky on TV, like what they call "extreme birth" with
dolphins or in remote lagoons, although in reality planned home birth with good
midwifery care is as safe as hospital birth." 

After viewing
Elson’s new documentary, "Laboring Under An Illusion: Mass Media Childbirth
vs. The Real Thing"
, you
realize she’s absolutely right. It would be hilarious (and it sometimes is) if
not for the absurd reality that we’re talking about society’s visual
storytelling of the single most connecting link between human beings in the
history of all that is and ever was: birth.  Why are we presenting childbirth in ways that repel, scare
and misrepresent women (and our someday partners) and our birth experiences? By
ceding the representation of childbirth to the "oh, it’s just television" mode
of thinking we surrender some of the wisdom of our own bodies, the knowledge
about birth we can pass onto other women, the wonder of the beauty and the
remembrance of the pain in a way, as well.  Elson is determined to take it back.

It is a growing
problem. Elson reminds us in the video "two-thirds of pregnant women watch
reality television shows on childbirth but only one-quarter of these women
actually attend childbirth education classes." What kind of "education" about
birth are women getting? First off, babies can be beamed out, as one was from Deanna
Troi
on "Star Trek:
Next Generation."
Or,
cesarean sections are becoming "the norm" as vaginal birth is being presented
as ‘the other’ option on reality television shows about pregnancy and birth
(view her video to learn more). And, finally, should you find yourself
pregnant, on a beach sunbathing? Elson tells me that one of the weirdest
television scenes about birth she’s witnessed was from the old TV show, Baywatch, where one of the characters gives birth
without taking off her one-piece bathing suit.

I spoke with
Vicki Elson about her video documentary: the "panicky fathers" and "mothers screaming
for drugs" on one end of the media-representation spectrum. And the "orgasmic"
and "unassisted" births on the other. Because Elson has been working with women
and their partners for many years, her answers to my questions and her
perspective seem wonderfully balanced, rooted in a crystal clear concern for
what is best for women, preparing women to have the healthiest birth experience
they are able.

You’ve been
educating pregnant women for 25 years! What made you originally decide to get
into this line of work and what was the impetus for making this documentary?

VE: When I had my
first baby, I was young and clueless and I considered myself a wimp.  It was the hardest work I ever did, but
it was a life-changing joy. 
Afterward I felt like I could do anything – which was great, because
what I had to do next was raise a baby. 
I think it really set the stage for my daughter’s entire life – and
mine.  There were certain elements
that contributed to having such a positive experience – my care providers,
childbirth classes, and support team especially.  I wanted to share that with other families, and all these
years later, teaching classes and watching new parents get born is still fun!

The impetus
for the film was this:
I
was doing a workshop for nurse-midwives at a local hospital when a particularly
ghastly and unrealistic (and Emmy-winning) episode of "E.R." came out.  The midwives said their phones were
ringing off the hooks because moms were scared that they could die like the
lady on TV.  Meanwhile, Murphy Brown
was America’s liberated TV mom who could anchor the news and stand up to Dan
Quayle.  But in labor, she was
wilted and powerless, except when she was strangling men by their neckties.  I wanted my kids and their friends to
grow up with realistic, nourishing imagery about the power of their bodies to
do normal things like have babies. 
I was working with midwives Rahima Baldwin Dancy and Catherine Stone on
a workshop called "Empowering Women in the Childbearing Year," and we started
collecting clips to show childbirth educators what they were up against from
the culture.  It’s still a struggle
to compete with compelling but unrealistic imagery that sticks in people’s
minds.  I expanded on that project
to write my master’s thesis 10 years ago, and when the kids grew up I finally
got around to updating the project and putting it on DVD so it’s more useful
and accessible. 

What’s the
film like?

VE: It’s 100 birth
scenes — TV and movie comedies, dramas, real births — plus narration. Birth
films tend to be very romantic or absolutely terrifying.  I wanted to
juxtapose real and fake births and let people make up their own minds, and I
wanted to make it funny, because the subject can be so intense.  And I
have to say that it is pretty entertaining.  It can be really fun to
examine cultural hopes and fears in a new way, and a lot of the clips are
hilarious.   

Do the
pregnant women in your classes (and/or partners) ever come in to class with
visions about childbirth that they got from the media, that are just so bizarre
or unrealistic that is noteworthy for you?

VE: I wish I had
some hilarious anecdote to tell you – but really what’s striking is that women
who are otherwise smart and capable come to class feeling very scared of a
normal physiological process.  It’s
getting worse over time, too, as people are exposed to more and more media, and
more people are watching birth "reality" shows than coming to childbirth
classes.  The reality shows often
take footage of a nice normal birth and then re-contextualize it with a
terrifying voiceover: "The most DANGEROUS journey of the baby’s life…the
four-inch trip…DOWN…the birth…canal."

What are the
usual stories in TV and movie birth scenes?

VE: The mom is
married, white, heterosexual, upper middle class, slender, and about 30. Labor
starts and she needs to be rushed to the hospital – this started with Lucille
Ball.  She hits a traffic jam or a flood or some other drama on the way.
The doctor is rude or maybe incompetent. She was planning a natural birth but
then she dramatically requests drugs. 

What about
fathers and partners?

VE: They’re
panicking and driving badly or getting waylaid on the way to the hospital. Or,
they’re being beaten up or sworn at by the mom.  But I think the same
thing works for moms and for their partners, whether their partners are male or
female: counteract the unrealistic imagery with realistic imagery and solid
information.  Birth does have some
risks, it is painful, it is messy and noisy and joyful and sweaty.  But it’s not the embarrassment or the
catastrophe it looks like on TV – it’s just the hard work that we mammals
do.  Partners can make a world of
difference with nothing more fancy than love and backrubs and words of
encouragement.

There is a film "Being
Dad" that’s been getting good reviews. 
I think it’s important for moms to know what it’s like for dads as well
as vice versa, and this film may help. 
I am also a big fan of women’s groups and men’s groups.  My partner and I have been in our
respective groups for many years, and there is a lot to be said for the candor
and intimacy of gender-specific socializing.  Such groups are also a great safety net when one member or
another hits a rough patch in life.           

One line
really struck me in the video. When a woman says, "Some of my friends feel sorry for me that
I had a c-section. I had a healthy baby and that’s what matters.

How do we present more realistic experiences of women who have c-sections, while simultaneously addressing how important it is not to
treat c-sections as just "another way to give birth" – that it is
major surgery?

VE: I tried to make
the film inclusive of all mothers. 
It is important to acknowledge that cesarean birth is indeed a birth: it
is every bit as meaningful, and it can be every bit as joyful as birth the
old-fashioned way.  There are two
other things we should acknowledge simultaneously, though.  One is that outcomes don’t improve
significantly when the cesarean rate is over 5 or 10 percent, and now it’s 32 percent in the
U.S.  Therefore the majority of
cesareans are medically unnecessary, with attendant risks and costs. The other
thing to keep in mind is that cesarean birth can be harder to recover from
physically and emotionally, and moms will need extra support.  A woman healing from a cesarean may
need to work on acceptance, and people should be absolutely respectful.  She may experience conflicting feelings
from losing her ideal birth and gaining a healthy baby.  She may also wish to investigate
whether her surgery was medically necessary, or to educate other mothers about
making informed decisions, but such activism must come from her.

In the video,
one woman asks:

"Are these my only choices? An unnecessary cesarean or an orgasm in a hot
tub?"
I think, for women who are set on having a natural childbirth,
sometimes the pressure to think they have to have the most wondrous, orgasmic
birth is another level of perfectionism for women. Do you think more realistic
images of birth in the mainstream media can help women on this end of the
spectrum as well?

VE: Absolutely.
Imagery can be overly romanticized OR overly medicalized. From the beginning,
childbirth education has run the risk of giving the impression that there’s a "right"
way to give birth.  I love the
orgasmic birth films because it’s great to know that birth is not necessarily a
medical event that’s all about pain – birth is, in fact, part of the continuum
of a couple’s love life.  (Hey, if
I’d known orgasmic birth was a possibility, I might have had more kids!) But
just because a few women have such pleasure doesn’t mean the rest of us should
compare ourselves to them.  No two
women give birth alike, and even the same woman will have different experiences
with each baby. Yes, the media should be more realistic, AND women need to take
responsibility for filtering what they take in.  Each of us needs to own and honor our own unique experience.  And our friends and care providers
should support that.

Are you
promoting home birth or natural birth?

VE: I tried to make
a film that doesn’t propagandize any particular way of giving birth, because
everybody’s different and there can always be surprises no matter what kind of
birth you’ve planned.  The film has a wide variety of births: real,
imaginary, fast, slow, simple, complicated, natural, surgical, orgasmic…

We see
virtually no images of childbirth doulas in mass media. Do you show your
childbirth students images of doulas at work with their clients?

VE: I can think of
only one or two doulas (non-medical labor support providers) who appear in my
film, but I agree that it’s an extremely important topic that should be
emphasized wherever possible.  I’m
a doula myself and I loved having doulas at my children’s births.  Doulas help moms and partners and
siblings through labor, and often provide more continuity than doctors,
midwives, or nurses can offer.  The
reassuring presence of a doula – even one who doesn’t speak the same language!
– has been shown to shorten labor, decrease intervention rates, and improve
maternal-infant bonding.  There is
a related profession called post-partum doula.  These fabulous people cook and clean and massage and support
breastfeeding in the early weeks.    

It seems
obvious why the mass media portrays birth in the way it does – it’s
traditionally, like most cultural institutions in this country, been a
male-dominated institution, on the whole. So, how do we go about changing these portrayals?

VE: I think that
it’s not just a problem of patriarchy – it’s a problem of profit. 
Hollywood is under the impression that what sells is danger, speed,
indignity.  To remedy this, we have to start with media literacy – making
ourselves less vulnerable to media imagery.  If we have to wait for
Hollywood, we might wait a long time.  I’m giving it a try, though – I’m
starting up an Authentic Birth Clearinghouse (www.authenticbirthclearinghouse.com
will launch soon).  It will offer assistance to mass media writers,
producers, actors, and directors.  There will be guidelines, connections
with expert advisors, links to websites that offer realistic birth imagery, and
workshops in Los Angeles, New York, and elsewhere. 

Who is this
documentary for?

VE: It’s great for
childbirth classes, high school health classes, and college courses in media
studies, medical anthropology, or women’s studies.  It’s a good film to
screen as a fundraiser for childbirth or media literacy organizations. 
It’s a good resource for libraries.  And it’s an offbeat gift (or
activity) for baby showers! 

 

You can view the feel good trailer below but one word of warning to all: have a box of tissues nearby because birth, when it’s shown in all its glory, is a beauty to behold:

For more information on the video or to order a copy, visit Birth-Media.com

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  • crowepps

    Those new babies are all just great!

  • amie-newman

    It’s just spectacular to view birth and I would hope that everyone in this country (around the world!) has an opportunity to see a real, live birth in person or via the media, that presents birth honestly and authentically. Thanks for commenting, crowepps!

     

    Amie Newman

    Managing Editor, RH Reality Check

  • melgarvey

    Great interview, Amie! ACNM showed this at our annual meeting last May. I really enjoyed it.