Monday, March 31, 2008

Big lights going off for me as I revisited the BOBB this weekend

Hey all!
For those of you who saw the Business of Being Born, and were of the mindset that Abby's birth "ruined the film", lets re-discuss, shall we?

Firstly, I will be completely honest and say that I was one of those very people, so I am no stranger to the idea. I too (temporarily, last fall) thought that "the lovely pretty homebirth film ended with a yucky depressing c section" and even joined on the bandwagon of snipey snipe comments like noticing that the baby at the 8 month follow up was drinking from a bottle! See! Bad Mommy! C Sections make you not breastfeed! Yeah! Yeah! (so, so pathetic)

Look, this woman had a 3 pound, preterm, breech baby, and neither her midwife nor her were of the mindset that this was something they would handle at home, and so they transferred. For every person who wanted to leave this out of the film, what the hell are you actually saying--that we just leave out real life? Just leave it out. Pretend it didn't exist. It made you feel yucky? It blew the little dream that all babies are born perfect if only we believe? Maybe she bought wrong fairy dust, perhaps? Didn;t buy the right Pier One cushions for her meditations? Didn't pick up a Birth Works t shirt? What exactly is going on here?

"Just Leave It Out". Well, its easy enough to do with film, but she is real. I am real. You know someone who is real. Whose birth didn't pulse with golden light. Whose baby was extremely small or extremely large or malpositioned, or a thousand other things didn't go right for the homebirth dreams. But guess what, folks, you cant just leave her out, because she is a mother just like you. There is no copy-paste-delete-rewind in life, (and this crap is what Dr Amy FEEDS on, by the way) You cant just leave her out because she isn't just a digital blip, she is a real life mother, a person, with a baby!

(As far as bottle feeding, for gods sake, we don't know what any of those other women did or didn't do as far as feeding their babies because only Abby had the 8 month check-in on film)

I saw the movie this weekend, first time since November, it is out on DVD, with my midwife, KneelingWoman, and I really felt differently about it. I felt and feel ashamed at the things I thought and said when I first saw it. I guess I got caught up in the "sisterhood" of HomeBirth ONLY--but how sad, that I, someone who has been through so much when it comes to birth, could get swept up in that stuff so easily! The power of group can be good and bad, for sure.

I hope Abby is doing well, no matter how that birth was "handled" on film, she is a woman like you and I, who got pregnant, had dreams, and it didn't go as planned. If you have lived this long and never had plans change, never had disappointment, never felt rejection and failure, then maybe only time will allow you the maturity and understanding needed to be a compassionate adult. I have been there. I have been ignored. I have been forgotten. I have experienced exactly what it is to have people avoid you, avoid calling you, avoid dropping in on you, kick you out of their club, their internet group, the Cool Clique, because your current pain kinda clashes with their happy plans that day. It SUCKS, and it takes a long, long time to heal from.

Don't turn away from your friends who have something like this going on. Don't wish Abby's birth wasn't in the film. Ricki left it in there not because she "had to", but because it showed reality, and it showed that yeah, sometimes you gotta transport. Cara her midwife, and Abby herself both knew they had to, and they did. It doesnt matter whether any of us think that the baby "could have made it" at home. It doesnt matter. A documentary was made, and it followed the journeys of several expectant women. The end.


Aidan's mom said...

Hi Joy,

You have been over to my blog and read my birthstory. I actually posted this on another site today wrt a thread on judgement about bottle feeding. Thanks for saying this. I really appreciate it. Here it is:

OK. My first post ever. I have been lurking for a week or so. Some of you will probably poopoo me or tell me you weren't talking about me, but it doesn't really change the silent or voiced judgement I have received for needing to use formula. Here is my sort of brief story.

I had HELLP syndrome at 28 weeks and my son and I almost died in an emergency cesarean. Him from extreme prematurity and me from a nearly ruptured liver and blood loss from the HELLP syndrome. He was only 1.5 lbs at birth and spent 7 weeks on a ventilator. Gratefully most of the rest of his NICU stay was largely "uneventful." I am happy to say we are both not only alive but well. He is now 2 1/2 and against medical odds is doing extremely well. Meeting all of his developmental milestones and ahead in some areas.

I began pumping as soon as I woke up from my c section. I don't even remember my first pumping session because I was still on mag. I worked up to pumping 10 times a day while DS was in the NICU. I knew that preemies especially need breastmilk if they can get it. My supply was scant at best. I did everything the LCs suggested. Lots of pumping, oatmeal, fenugreek, water intake, rest. I even ordered domperidone from Canada. The dom actually did increase my output 2 fold which helped immensely.

DS had a decent latch when we began trying to bf at 36 weeks gestational age. But his lungs were damaged from weeks on the vent. He would work SO hard and only get 1/3 of his needed volume. Eventually I had to face the fact that I had low supply, slow letdown, and a slow flow in general. I started giving him breastmilk in bottles. He ate like a champ! We were soon ready to go home as he was accomplishing his bottle feedings like a master!

At home his lungs were still too weak to feed directly from the breast, so we continued breastmilk in bottles. I pumped for a total of 9 months. I pumped up to 10 times a day and then had to turn around and feed him. On top of that, I had a medically fragile newborn home. He was on some medications and oxygen. He slept with an apnea monitor that often gave false alarms. I lived on no sleep for months.

Around the 9 month mark his demand caught up with my supply and my freezer stash. I also got thrush and mastitis on the same breast at the same time. When I went to the OB, she took one look at my tired face and said, "Do you need somebody to give you permission to stop?" I began to cry. Somebody understood what I had been through. I was exhausted, in pain, and suffering from PTSD from my experience. I didn't want to stop pumping but I really did need to.

It was only a couple of weeks later and I was in a mother's room at BR Us. Another mom, who was breastfeeding, gave me a weak smile and said, "Oh, did breastfeeding not work out for you?" I was floored and nearly speechless. Only a month earlier that would have been my breastmilk. I found myself spewing forth the details of my experience. She looked horrified but tried to cover and gathered up her baby and wished me well.

So, what do I mean to tell you with this very long story? You really DON"T know what women have been through to get them to where they are at. When finding the urge to silently judge a formula or bottle feeding mom, maybe remember my story.

It is easy to believe that breastfeeding is always easy and natural. I would love for that to have been my reality but it wasn't.

And yes, you can't make me feel guilty....but if I have guilt (misplaced or not) for my son's early arrival and my "inability" to continue to pump or to b/f at all...are you helping me or hurting me with your judgement?

Food for thought. Thanks for reading.

Sheridan said...

I think the birth should have been in there, I just didn't like the placement of it. I would have preferred it in the middle and ended on a happier note.

I had a medically necessary emergency cesarean. It was difficult for me to watch this scene and after enjoying most of the film, to end with this (yes I know there was a hint of a normal birth at the end... but the main last birth scene was this birth) left me with sadness instead of joy.

So I think yes, it is important to include it in the film. YES it was good they transferred. But I just wish it was in a different place in the film.

jen said...

Yup, I'm one of those "didn't like it" people. However, it's not that I think the C/S should have been glossed over or even omitted. Quite the contrary - I think it COULD have been used as a great "lesson" on why planned homebirth IS safe. I felt that the film didn't actually delve deep enough into Abby's situation. I wanted the film to spell out in black and white, "See: planned homebirth...problems arrise...but look, a hospital transfer is available, possible, and beneficial! Wow, great use of available medical resources!"
THAT was why I didn't like the film.

Also, re. the breast/bottle thing...again, I just felt another "lesson" wasn't really spelled out as well as it could have been. I thought a little more info about why breastfeeding can be problematic would have been more educational than showing yet another bottle...Americans see bottles everywhere, and I was just disappointed that the entire documentary on alternative birthing ended on the same common image we see everyday. Not saying Abby is good/bad/other for her feeding situation...just disappointed that a bottle would be one of the last images in the film.

Andrea said...

I just watched this! I thought it was really good that the birth was there. I watched the special features, and in a Q&A at the premiere Robbie-Davis Floyd (I think) stood up and thanked them for showing how homebirth was wonderful, but also showing the necessity of the hospital in some situations. I agreed with her, and I think it's one of the misconceptions about homebirth -- that you're not ALLOWED to go to the hospital or something. The only thing that bugged me a little was the implication that breech=c-section. But maybe it really did in that situation, and there was somewhere I think that Abby said, "he could have been born vaginally, but he had a lot working against him." I guess the whole issue of breech=c-section was beyond the scope of the film.

I have to admit early on in my career as a mother I was judgemental about bottles. I think I was huffy (for months!) over a situation where I was nursing my homebirth newborn in the hospital waiting area (dh was getting blood drawn) next to a mother feeding her baby a bottle. A hospital employee
oohed and aahed over that baby and then started over to ooh at my baby. When she realized I was nursing, she apologized all freaky like she had walked in on me sitting on the toilet. So I felt icky, and I lashed back out with my judgement.

I'm over it, though. I think I've realized that we all do what we have to to survive while we try to be the best parents we can.

Rixa said...

Yes, I agree that it was good to show Abby's story, and I think it gave the documentary a lot more credibility, especially for more mainstream moms who perhaps hadn't ever heard of or thought of home birth. I do agree that it was more the way in which they edited that sequence and how the film ended, kind of like it got cut off too quickly. Well it's late so I am not sure I'm typing in sentences any more. Ciao!

Lynette said...

I think Jen nailed it when she said "Americans see bottles everywhere." Americans see cesareans everywhere too. I guess my fear is that, in including the cesarean, some of the audience will nod their heads and point and say, "See, things can go wrong so you'd better not ever do something as silly as a homebirth."

I think there's something very complicated here -- being able to tell ALL truths while struggling for the survival of ONE truth that is often dismissed, disregarded, and disbelieved. I guess birth advocacy needs an ecumenical movement.

SarahPerdue said...

I think Abby's birth was an important part of the film but needed more information. I had to watch it twice to figure out that he had IUGR (Intra Uterine Growth Restriction). I think the safe transfer should show how medical technology makes modern homebirth even safer especially with a cooperative doctor like Abby's. He was wonderful. Perhaps Ricky and Abby could have done a better job presenting that in the film.

Some explanation about the bottle feeding could have benefitted the film as well.

My second son was full term but had nursing problems, and my breastfeeding story was similar to aidan's mom's without the complications of a premature baby. Finally after 4 months of insane pumping, ordering domperidone overseas and talking to lactation specialists from Maine to California and even exchanging email with Dr. Newman in Canada. I found myself having a really tough time with his "every baby can breastfeed" attitude. Maybe if it had been realistic for the baby and me to fly to Toronto mine could have, but ultimately, I ended up accepting that he could not get the milk out. I pumped for a year and bottle fed him allowing him comfort nursing only at nap and night time because he'd nurse for a hour and get less than 1/2 ounce.


Judit said...

Before I go into BOBB analysis, I just want to say up front right now: dear Joy, FEAR NOT!!! that I would ignore or shun or forget or abandon you or play armchair obstetrics if your dream birth, or even acceptable birth, doesn't happen. What a terribly painful thought! You know what my fear was of the aftermath of a difficult, complicated, traumatic birth? Ridicule--that people would just think "she thought she was all different but now she's learned her lesson" :( The mere thoughts were gut wrenching. I'm sorry you have felt actually excluded, after a real birth really gone bad, with babe in arms... that's awful.

Now, BOBB. The DVD is great because you get to see more of Abby's story. Did you see this on my blog, Joy? I wrote I was really happy to see more of her on the DVD. I'm joining Sheridan, Jen and Rixa: the movie was edited really awkwardly. Presentation *is* everything. I don't think I am rewriting history by saying that we basically all said at the time (well, not Sheridan, though I wish you could have been there!) that IF they're not gonna explain more about a transfer like that, they MIGHT AS WELL leave it out. After viewing the DVD, I'm really mad they didn't PUT IN more of the Abby's birth footage. Goodness, yeah, that was frustrating and disappointing. The fact that they put in her two sentences about how Matteo was born the way he needed to be born, but not the two sentences when she says she's still glad she had a midwife! That's maddening, and I stand by that!

Judit said...

P.S. re: the bottle on TV, or elsewhere.
You met me when I was still exclusively bfing baby M, but two months later she was completely weaned. It wasn't despite some enormously heroic battle against medical odds like you read on the MDC bf support forums either. I still often feel compelled to explain myself, to prove that I'm still pro-breast. I hate to bring a bottle with me on outings, because I feel like I'm giving the wrong impression? Being a bad role model for future or potential moms, ya know? I guess I have BIP (bottlefeeding in public) hangups, LOL!

All this mental gymnastics, enough to make a person totally neurotic Haha.

Aidan's mom said...

I think this is one of those been there done that things. But I knew immediately that Abby's baby was IUGR. One look at him and I leaned over to my friend and said..."Aha, IUGR". I think when you have been there it is so easy to recognize.

I was not at all surprised to see her bottlefeeding. SO many NICU babies have weak sucks or the mothers have scant supply and poor letdown.

Honestly, after doing a lot of research on the topic, I believe I have come to a ocuple of conclusions. In a lot of IUGR babies the placenta is malfunctioning somehow. Removal of the placenta is crucial to giving the signal for lactogenesis. Well, what did my body think about the removal of a placenta that was barely functioning? My body probably barely noticed. It didn't get the full signal. I firmly believe this.

And secondly (and I don't mean to be a downer here) but I think my body felt like there wasn't going to be a baby to feed. Like my body on some level knew that nursing wasn't going to be needed. If not for the intervention we had baby and I would both be dead.

I wonder if there is any truth to that?

Housefairy said...

Hi, everyone!

Well, I am prone to getting very worked up about stuff, but today I am feeling calmer, so after hearing what you all have said, I think you are right. I think that Abby's birth story was really hastily slapped on there. I guess I keep forgetting that I have seen the movie five times, now (and read/debated about it for 1/2 a year, too)

I need to look at the extra footage (left my copy of the DVD with the midwife for her to borrow for a few days) but yes, it shouldnt have been the last thing we see, and they should have explained afterwards what exactly happened so that nobody thought that Homebirth was Tomfoolery or Crazy, etc. That would be really the best answer.

So, I am glad she wasnt left out of the movie, because beleive me, planning a homebirth and then transferring is one of the Birth Scenarios that really, REALLY doesnt get much coverage in any kind of media, and it carries with it a different set of dissapointments, questions, sadnesses.

I stand by my irritation that we are all assuming any of the other mothers exclusively breastfed those homeborn babies--and thank you Aidan's Mom and Judit for reminding us that after the birth, there is a whole lifetime ahead with its own unforseen parenting challenges.

Glad for all the input, maybe we should write to Ricki? Hahaha too late I guess.

Anonymous said...

Much of it has already been said. It seems like the last 1/4 was very quickly put together... not edited with as much care as the earlier parts. I didn't have one issue with Abby's birth being in there, but ENDING the movie with such drama drags the whole message of the wonder of homebirth and midwives down the tubes. As someone else said, folks can easily say, "See? If THAT can happen, why bother trying at home in the first place?" I think a lovely, LONG homebirth sequence would have better served the movie.

And as for the bottle feeding thing. That baby was EIGHT MONTHS OLD! Abby could have *easily* taped when the baby wasn't sucking on a bottle. We see the things *everywhere* (and not meaning one iota of offense to women who HAVE to use them because I know PLENTY who have had to)- why, in a natural birth, baby-wearing, midwife-supporting movie do we have to see another one? Aargh!!!!

That so many of us had issues with the bottle is extremely indicative of the audiences watching. I have wondered if "mainstream" audiences would even bat an eye about the bottle. Perhaps if there were 20 women in there nursing, the bottle might not have been so offensive.

I've seen the movie 16 times now (I can quote lots of it!) - haven't seen the dvd yet, though, so look way forward to seeing backstory.

I'm glad so many of us "see" the same things. Nice to be on the same page sometimes. :)

Aidan's mom said...

I guess you would probably label me a "mainstream" mom if you met me. Not all my choices fall into what you might think of as a mainstream mom, but some do. I was definitely very pro breastfeeding when I got pregnant. I had a lot of counseling after my son's premature birth. One of the many issues we dealt with was how desperately I had wanted to breastfeed to keep one piece of normalcy about an otherwise very traumatic birth.

I noticed the bottle immediately. And I felt a strange sisterhood with Abby. A narrative in my head saying to her, "It's OK. Sometimes birth just hands you this stuff. He was early. It's tough to breastfeed under these circumstances. You did your best."

I really identified with the fact the bfing often doesn't work in the circumstances of a premature birth. I don't think Abby should have had to hide the bottlefeeding any more than I had to. And who knew when they were watching it if it was breastmilk or formula? Almost the entire time my DS had bottles, they were all breastmilk.

Andrea said...

I'm wondering who was involved in the editing. I agree, it wasn't as fully developed as it could have been. But was it Abby? Her partner? Ricky? It seems like there was a lack of objectivity. Abby didn't set out to make the film about herself; her own accidental pregnancy just kind of took over. And I don't think she meant to make herself a poster-mother for anything or to be an activist. She wasn't a hardcore homebirth clique type, she had a back-up OB just in case, she mentioned a couple times about "what if I change my mind at the last minute." This was her path -- she's not the heroine we might want her to be, she's just a mom who the best she could.

But anyway, I think the film might have lost its way a little because her own birth got in the middle of it. But at the same time, there was value in it being there. I'm not finding the way back to what I was trying to say, but
I think in light of her own experience, it was probably very difficult to edit for the message she may have set out to champion (as a filmmaker, not a mother).

I think ultimately this film laid groundwork for more films, more writing, more exposure for the homebirth movement.

Jennifer said...

This made me cry.

"I have experienced exactly what it is to have people avoid you, avoid calling you, avoid dropping in on you, kick you out of their club, their internet group, the Cool Clique, because your current pain kinda clashes with their happy plans that day. It SUCKS, and it takes a long, long time to heal from."

I am in this place and does hurt. And it does take a long time to heal from. Thanks, the tears needed to be released.

Ooops! I posted this on the wrong entry initially!

Rae said...

Transfer should have been involved in the film. It absolutely was perfect, especially the way it was handled. (Like most transports, very little sense of emergency..everyone kept a great sense of humor, the membranes rupturing in the taxi-cab...totally awesome.)

Jill said...

I actually thought Abby's segment was a great inclusion to the film, (a bit of a downer to end on, however) because it showed that yes, sometimes things go wrong, and when that happens, you take your happy butt to the hospital and get it taken care of, and although it wasn't the perfect shiny "good birth experience" you hoped for, things did turn out okay in the end and it's ALL GOOD. Yes she was bummed, a little, and had a right to be. But she, along with the midwife (whose name I've forgotten) helped prove that not all homebirthers are ninnies who will sit at home meditating to flickering candles and Enya CDs in the face of something going wrong just because they are selfish twits who don't care about their babies.

I think they should have included MORE about what happened, in fact. I feel like they left a lot out and raised more questions than ought to have been raised. I've heard the director's cut includes a lot of things that were left out, and would like to see it someday.

Brooke said...

Thank you for reminding us to count ourselves back in - those of us who tried or wanted or dreamed of a certain birth and got something drastically different. You are right, no class or affirmation or pristine diet or prenatal yoga or chanting can guarantee us the birth we wanted. The journey is painful but also a gift in its own way.

CNH said...

Oh gosh Joy, I hear you! I've been saying since the beginning that I really "got" WHY her birth was included, and at the end as well. They needed to 'say' that while c-sections/transfers are absolutely necessary and right and needed that they are no walk in the park like the 'c-tuck' generation would have you believe. Something you already knew though. (((HUGS))) Don't be too hard on yourself. It was just your knee-jerk reaction to seeing your pain on screen.