It's a buoyant spring afternoon, and in a comfortable hotel lobby in Manhattan, actress and former talk show host Ricki Lake is talking episiotomies. "I pushed two and a half hours with my first son, and both my midwife and doctor wanted to cut me, and my doula said, 'Please just give her a little more time,'" Lake is saying, when her friend, director Abby Epstein, cuts in. "And at that point, were you like, 'OK, I'm going to push this puppy out?" Lake nods in grinning affirmation that she had indeed pushed out that puppy, now known as 10-year-old Milo. "And all I needed was two superficial stitches!"
It might sound like too much information, but that disclosure is nothing for those who have already caught a screening of "The Business of Being Born," the documentary about midwifery and home birth that had premiered the night before this conversation at the Tribeca Film Festival. Epstein, who directed the movie, and Lake, who executive-produced it, have included vivid footage of their own labors and deliveries in the project, along with those of several other mothers.
It's the 2001 birth of Lake's second son, Owen, in the bathtub in her apartment, that appears in the movie and has already garnered the film gossip column ink. "On the Internet they've already said, 'Ricki Lake gives birth naked ... Ew, I want to vomit,' or 'I think I just threw up a little in my mouth,'" Lake reported laughingly, as she described her own terror at watching the scene on the big screen the night before.
Indeed, if these predictable online cruelties do not seem to be fazing a newly svelte 38-year-old Lake, who has battled her weight publicly for most of the 20 years since being cast as overweight teenager Tracy Turnblad in "Hairspray," she would like to credit the blessed event that is the centerpiece of her new movie.
"That birth was very healing," Lake said, "both from the standpoint of having been sexually abused as a young girl," -- an event she has recently begun to discuss publicly -- "but also having body issues my whole life and being obese for such a long time. I made peace with my body that day. I was able to pat myself on the back and say, 'OK, so I got stretch marks!' But what an amazing and significant thing my body was able to do!"
Fat jokes, she claims, were the least of her concerns. "I was trepidatious about putting my footage in the film," she said. "I don't want to seem like I'm exploiting it. But I felt like it was necessary." Epstein added, "In the beginning when we were trying to get funding, Ricki putting her footage in there raised the ante. For her to expose herself this way, it confirmed this isn't some celebrity vanity project -- quite the opposite! This isn't Angelina Jolie traipsing through Kenya with an economist."
No. "The Business of Being Born" is most definitely not Angelina Jolie traipsing through Kenya with an economist. It's a magical mystery tour of bodily fluids, sliced uteri, gloppy infants and gaping vaginas. I watched it at a press screening seated across the aisle from Lake's mentor, venerable transgressor John Waters. Waters appeared calm if slightly faint as baby after baby was sloppily disgorged, and had guffawed appreciatively during the discussion of the demand for elective C-sections for those "too posh to push." "I said to John after the screening that I bet that was the most vaginas he's ever seen in his life!" said Lake.
But for all the anatomical infelicities of human reproduction, "The Business of Being Born" includes very little of the screaming, gnashing, clenching horror that is the hallmark of most TLC-style obstetri-drama or, for that matter, of the kind of hirsute birthing filmstrip some progressively educated middle schoolers are shown in sex ed. Instead, Lake and Epstein have made a movie about the pleasures and political importance of natural, midwife-assisted home birth.
The film examines the grim history of childbirth practices in the United States, from the scary twilight sleep of the early 20th century to the newer chemical and surgical interventions. Their take is that as childbirth has become a technologically advanced business, and moved from homes to hospitals, the power and innate wisdom of laboring women (and their midwives) have been sapped by a medical establishment that thinks it knows better. It's not new. Adrienne Rich wrote "Of Woman Born" in 1976; Nancy Chodorow published "The Reproduction of Motherhood" two years later. But like so much learned feminism, the politics of motherhood seem destined to be ghettoized, forgotten and rediscovered again, over and over, until one day, perhaps, they sink in.
In "The Business of Being Born," the unhappy women are those in hospitals, their deliveries sped up and often mangled by drugs that numb them, that make their babies come fast and hard, and that necessitate emergency surgical deliveries with increasing frequency. Epstein's cameras catch maternity wards in which every laboring mother is being induced, in which women are shamed into pushing harder and threatened with C-sections if they don't. She interviews experienced doctors who have never witnessed a natural home birth, though they instinctively reject the notion.
It's not as though the half-dozen home-birth mothers in "The Business of Being Born" are gently expelling pink babies onto bushels of cornflowers. But the experience sure does look a hell of a lot happier through Epstein's lens.
Women in the midwife-assisted births are shown walking around their apartments. They wiggle their hips and squat and groan and bend over and sweat and curse and finally reach between their own legs, often while lying in bathtubs or birthing pools, and pick up the schmutz-covered infants who have just sploshed from their bodies, holding them to their bellies and bare breasts with surprising serenity.
Epstein and Lake met, they said rather poetically, "through vaginas"; Epstein directed Lake in an off-Broadway production of "The Vagina Monologues" in 2000, and they collaborated again for V-Day in 2001, when Lake was carrying Owen and feeling very exuberant about her lady parts. "I was about six months pregnant and I was like, 'My vagina's awesome!'" she said. The women became friends, and Lake told Epstein about her home-birth plans.
"I just kind of thought you were crazy." Epstein said. "I probably told you, 'Oh, cool,' but inside I was thinking, "That sounds terrible!" Lake had developed a fascination with midwifery after Milo's birth, and was reading up on natural delivery. She even considered becoming a midwife herself, until she realized how much schooling it would entail.
Lake said her parents also thought she was nuts for having her second son at home. Her mother had smoked throughout her pregnancies and been knocked out for her deliveries. Her father is a pharmacist. Lake said that she herself is no fan of physical discomfort. "Look, I'm not into hurting myself, and giving birth naturally is painful. But I feel like it's a connection that's really important."
Lake gave Epstein a couple of books ("Spiritual Midwifery" by Ina May Gaskin and "Birth as an American Rite of Passage" by Robbie Davis-Floyd) to persuade her to make a documentary.
"I couldn't believe it," said Epstein, confessing that she had thought of midwives as "crunchy, granola, brown rice people" -- here Lake helpfully interjected, "Birkenstocks!" -- "Yeah, Birks," continued Epstein. "But reading this book it was like, I get it! This is about everything! This is about gender, and oppression of women; this is about art vs. science. There are so many political issues wrapped up in this. I had been involved in women's issues, but didn't know there were any feminist politics in the birth world. Because you think of it just as a medical thing."
On top of the books, Epstein was persuaded to make the movie by watching Lake's home-birth footage. "I still remember the first time I watched it on that tiny LCD screen," said Epstein. "I had an immediate visceral reaction to it. I'd never seen anyone give birth like that. I'd only seen stuff you catch on TV: clinical, graphic." In Lake's movie, Epstein said, "she looked like such a goddess in the bathtub. When you watch the whole pushing stage" -- which is not in the movie, but which Lake said lasted 13 minutes -- "she looks so gorgeous and powerful and it was so sexual, and she's like 'Ooooh, aaaah.' And the baby came out and I was like, 'No wonder men are like tripped out by this. No wonder men are scared of women and try to contain this thing. Because that is a godly act I just saw!'"
According that godly act the respect it deserves is what Epstein and Lake are trying to do. They feel that American doctors cheat women of time -- the time to push a baby out naturally, or to stretch a vagina with oil so it doesn't rip or need to be cut, or to bond with their new babies -- instead electing to cut out infants efficiently, avoid lawsuits and make it home for dinner.
Lake kvelled about her home-birth experience, "We were skin to skin immediately; he breast-fed right away. My husband at the time was next to me. My son was at the park and he came home and met his brother. And after an hour and a half, my midwife, who had been by my side for the whole day, asked my permission to check the baby over. In the hospital, the baby is taken away immediately; the mother has to beg to see the baby. It was so great to have that power and that respect given to me."
Epstein agreed. "The hospitals are very blasé about it. They say the baby has to go to the nursery now, or the mom has to rest, or the baby has to go to NICU [neonatal intensive care unit]. And the baby doesn't have to go to the nursery."
Even more distressing, Epstein argued, is that in pathologizing birth, "the birth process has been manipulated to the point where now it's tipping into being more dangerous. I have so many friends with staph infections, MRSA [methicillin-resistant Staphylococcus aureus] infections, yeast infections, infections from the catheter." Epstein was so convinced by making the documentary while she was coincidentally pregnant herself that the former skeptic decided to have a home birth herself.
Their evangelism for midwifery hits such a fever in "The Business of Being Born" that toward the end it appears to go too far, when French doctor Michel Odent discusses the oxytocin rush women get during the vaginal delivery, and how it leads to bonding between mother and baby. Monkeys who have cesarean sections, he claims, do not get this chemical crush and do not bond with their babies.
Theirs seems a perilously prescriptive attitude, dangerously close to the kind of close-mindedness Lake and Epstein feel the medical establishment shows toward midwifery. "It is a strong statement we're making at the end of the film," said Epstein. "You don't want to shame anybody's choice. But we also felt like the film would get really watered down if we just started to say 'everyone's choice is OK.'" And she stood by Odent's observation that mothers whose babes are not delivered naturally face a barrier to bonding, citing a conversation with one woman who had a C-section with her first child and a natural birth with her second. "She feels like there is always a wedge between her and her firstborn," said Epstein. "That there was a wound right from the beginning."
In the film, this harsh evaluative moment is leavened by the following footage of Epstein's planned home birth getting scarily scuttled when she goes into labor a month early. The fetus is in breech position, and Epstein is rushed to the hospital and delivers via cesarean.
"The truth is, I didn't see my son for 24 hours, and our bonding was delayed, but we did have bonding," said Epstein. "Human beings are going to care about their children and attach to them ..."
"And anyone who has a C-section loves their baby!" Lake interrupts.
But, continues Epstein, "having a cesarean is not an optimal experience and shouldn't be on the table unless it is absolutely necessary. I will tell you from personal experience that it is not a great way to become a mom: You're pumped up on morphine, you're totally out of it. You can't laugh, you can't sit up." Epstein's son is now 10 months old and thriving.
And Lake, who recently shed 25 pounds and is single again after a three-year relationship that followed the end of her marriage to Owen and Milo's father, Rob Sussman, says she has never been happier. Proud of her "reinvention" as executive producer of "The Business of Being Born," she's also still acting. Currently waiting to hear if her pilot "The Middle" will get picked up by ABC, Lake is also in an independent film, "Park," to be released later this year.
Meanwhile, she said, her sons are taking her new level of exposure in stride. Five-and-a-half-year-old Owen apparently asked before the Tribeca screening, "Mom, people don't see my private parts, do they?" but then fell asleep before his big entrance.