The Business of Being Born: A Documentary Film Review

Overview of the Documentary

The Business of Being Born is a documentary that examines the childbirth industry in the United States. The film tackles two fundamental questions about the nature of birth: whether it should be treated as a natural, normal process or as a medical emergency requiring intense intervention. Produced by television talk show host Ricki Lake and director Abby Epstein, the documentary investigates how the landscape of birth has shifted as American social attitudes have evolved. According to the film, the public's view of birth has become clouded by fear, financial incentives, an overreliance on physicians, and a tendency to treat the birthing process as a medical condition rather than a natural life event.

The film presents sobering statistics on birth outcomes in the United States. According to the documentary, the U.S. has one of the highest maternal mortality rates in the developed world, along with the second-worst newborn death rate of any industrialized nation. By contrast, midwives are commonplace in Japan and throughout Europe. Yet in the United States, midwives are utilized in only approximately 8% of births, a sharp contrast that the filmmakers use to question the direction of American obstetric practice.

Midwifery and the Home Birth Experience

The documentary follows Cara Muhlhahn, a New York City certified nurse-midwife, as she attends a series of home births. Muhlhahn shares her philosophy on birth as a normal part of the human life cycle and emphasizes how empowering and gratifying it can be for mothers to trust their own bodies and follow natural physical cues during labor. The film functions partly as an exposé of midwifery, dispelling common myths that portray midwives as little more than bystanders during birth. Instead, it presents trained, educated, and informed midwives as valuable facilitators throughout the labor process.

The footage in the film is graphic and uncensored, making no effort to sanitize or glamorize the birthing process. Viewers witness home births in progress as well as a water birth, presented in straightforward, unfiltered terms. The film clearly advocates midwifery over standard hospital births, illustrating how physicians and surgeons sometimes act hastily in "treating" labor as a condition — often, the documentary suggests, to reduce exposure to litigation rather than to serve the mother's best interests.

U.S. Maternal and Infant Mortality Statistics

An important moment in the film occurs when Epstein herself discovers she is pregnant during production. Because her baby is in a breech position, she is unable to pursue the home birth she had been documenting and must instead deliver at a hospital, ultimately by Caesarean section. This turn of events introduces an unplanned but telling counterpoint to the documentary's central argument.

Conclusion

While medical technologies and hospital equipment are framed in the film as excessive and expensive, many of these same interventions can be critical in ensuring the health of both mother and baby. The United States also contends with population-level risk factors — including high teen pregnancy rates and rising rates of obesity — that increase the likelihood of complications and can raise infant mortality risk. These variables complicate any straightforward comparison between the U.S. and countries with more uniform midwife-assisted birth practices.

Furthermore, not all hospitals and physicians operate in the same way. There are hospitals where intervention is genuinely necessary and is applied judiciously without promoting further unnecessary procedures. There are also hospitals that do not dismiss a mother's requests for a longer labor or a longer postpartum stay. A more balanced documentary might have acknowledged this range of obstetric practice rather than presenting hospital birth as a uniformly problematic institution. Overall, The Business of Being Born raises important questions about how American culture approaches childbirth, but its advocacy stance occasionally comes at the expense of a fuller, more nuanced picture.