The Perceptions of Pregnancy blog, like the Researchers’ Network, aims to reach beyond boundaries and borders, and to facilitate an international and interdisciplinary conversation on pregnancy and its associated bodily and emotional experiences from the earliest times to the present day. This first post of the new academic year is contributed by Naomi Redina who has reviewed the 2015 film documentary The Mama Sherpas.
After being pressured into an unwanted c-section with her first child, director Brigid Maher sought to understand if it is “even possible for women to have a natural childbirth in a hospital.” The Mama Sherpas (2015) — executive produced by Ricki Lake and Abby Epstein — investigates collaborative care between midwives and physicians. Throughout the film, “natural” birth is mentioned as ideal. Aren’t all births that results in a baby exiting the womb via the vagina, “natural?” An inattention to language resulted in the film discussing “natural” birth but really meaning “birth with as minimal intervention as mom wants.” At the end, Maher mentions there are various models of midwifery, including that which supports “natural” birth or the use of an epidural. Epidurals were never discussed in the filmed office visits, and only one c-section was shown. The c-section was sanctioned by the midwives because of health risks to the mother.
Mama Sherpas investigates “collaborative care” between midwives and physicians in hospitals, asking if doctors and midwives can find a middle ground or somehow compromise. Interviews with expectant mothers (including the director’s own birth story), midwifery students, certified nurse midwives, and physicians personalized the documentary while demonstrating a sampling (four) of available midwifery practices in the US. Midwife consultations with patients were repetitive but broken up by explicit birthing scenes. These scenes are not for those with weak stomachs. The filmmakers wanted to show the beauty of childbirth, and the birth scenes provide more distraction than anything. However, it was rather remarkable to witness a woman deliver a breech baby.
This documentary significantly highlighted but did not give significant attention to the structural issues within healthcare policy that make midwife care difficult to obtain. The movie notes that in a few of the areas visited, midwives tend to see immigrant or low income mothers since childbirth under the supervision of a midwife is significantly cheaper than by a physician, state healthcare covers the care. If less intervention is safer for both mother and baby, why are there so many policies, both by the state and private insurance companies, making midwife care impossible? In concluding remarks, a certified nurse midwife (CNM) states that most women in the US give birth in a hospital, and that all CNM provide care within hospitals. However, due to hospital protocol and procedure, CNM are not permitted to exclusively provide care. The Midwives Alliance of North America (MANA) provides a state-by-state overview of the legal status of midwives here, NPR in 2012 discussed it here, and a historical overview of midwifery legislation in the US can be reviewed here.
Mama Sherpas is a fantastic follow-up to Lake’s 2008 production of The Business of Being Born (BOBB) that questioned if the current state of medicalized childbirth in the US is an improvement for maternal and fetal health, or are medical interventions making it worse? The US has the highest infant mortality rate compared to Europe in a 2010 study showing the US mortality rate as 6.1 per 1,000 births. BOBB summarizes cultural shift in the US away from home births and midwives and to physicians in hospitals that occurred just over 100 years ago. This model became the norm to the extent that medical intervention is routine, including the major surgery of c-section. In the last 15 years, even arguably the last 50, women have struggled to reclaim their birthing experience from institutionalized medicine. The rise of collaborative care is a step in the right direction.
The Mama Sherpas idealize birth as an event not requiring medical intervention at all, calling for all women to have access to “natural” childbirth. Mama Sherpas attempts to put natural childbirth against the backdrop of medical intervention by showing that midwife care within the hospital allows for a natural birth to occur, but if complications arise, resources are at hand. Had the documentary spent more time addressing the politics and policy limiting and directing the use of midwives in the US and suggesting a change at the institutional level, there would have been a greater impact. Despite the few minor flaws, The Mama Sherpas does an excellent job providing accessible material to further the discussion of midwives and collaborative care in the US.
About the Author
Naomi Rendina is a PhD student studying the History of Medicine at Case Western Reserve University in Cleveland, Ohio. Her dissertation will aim to examine how consumer culture, feminist activism, and the history of medicine intersect and effect women’s agency in childbirth withinin the United States. Her research interests are the modern US, women’s history, history of reproduction, medical anthropology, and activism in the US. Follow her on Twitter: @NaomiRendina, and a full CV can be reviewed at naomirendina.com. Naomi has previously written for the Perceptions of Pregnancy blog about her time interning at the Museum of Motherhood. You can read that post here.