Ricki Lake never set out to be a childbirth activist, but since the release of her film The Business of Being Born
in 2008, she has become the face of a growing movement toward informed and empowered birth choices. And now with her newly released book, Your Best Birth
, Lake and her friend, producer, and coauthor, Abby Epstein seek to help even more women understand their options and, in their words, "take back the birth experience." Mindful Mama recently sat down with Lake and Epstein to talk about their lives in the spotlight, and what's next.
How have women responded to The Business of Being Born?
Ricki Lake: The reaction has been incredible, it really is. Everyday I meet people who have been affected by it. I went to London and we had a screening over there. It is not just women, it’s everyone, even people who do not think they have an interest in the subject matter, are suddenly interested in the story, are sucked in to the personal stories and the statistics that we reveal and what an important issue this really is.
Abby Epstein: I love the stories that we are hearing. Someone was seeing the film and then at 35 weeks dropped her OB and went to the birth center to the midwives. We are also hearing stories about those women who didn’t necessarily change provider or change location but were able to advocate for themselves and talk their way out of a C-section. One of my best friends in the world just had her baby and started with a midwife in the birth center. She had every possible complication and ended up in the hospital, where they kept trying to give her a C-section, but she just kept coming up with alternatives. "Can we try this first? Will you let us try this first?" And the staff at the hospital was really accommodating—they thought she was were incredibly well informed. They ended up with a vacuum-assist but not a C-section. So I love those stories too because I think that is the message of the film. It is not about everyone should have a home birth, everyone should be at a birth center, everyone should use a midwife, at all. It’s really about education, absolutely. Knowing your choices, being a really informed consumer, and not falling prey to the fear that so many women feel that makes them consent to things.
So you are actually changing people’s lives.
Abby: They tell us we are!
Ricki: We are definitely helping to make it a better experience overall and that feels really good.
What stories are you hearing from midwives? How are you changing the lives of midwives?
Ricki: Their practices are definitely doing better than before the movie. In many cases we are hearing that their practices have doubled, they’ve had to take on more midwives, it has definitely helped their businesses. And it has helped to change the perception of them.
How has the movie changed your own life?
Ricki: It is so hard to put into words. I always felt like my life had a lot of meaning—I am a mom and feel really fulfilled in that role, and I love the work that I do—but it really feels that I have given back in a way that is bigger than I had ever hoped. I feel that given my former career as a talk show host, I now have some legitimacy, and I have something to say, and that people want to hear what I have to say. It is just a really good feeling to have done a project that I believed in so whole-heartedly and is from a really good place and that is having this kind of positive effect.
What about the difficulties, what challenges have you come up to around this movie?
Ricki: Day to day I don’t really come up against a lot of opposition to the film. I am sure there are obstetricians out there that still don’t believe in the message of the film, but I don’t know how you can argue with the message of choice and having choices for women. That is ultimately what it comes down to. In the beginning, screening the movie for the hospital and residents and big heads of the hospital, they had a gut reaction that they felt threatened by it. But for the most part, its been pretty overwhelmingly positive. I don’t feel like women walk away feeling judged by the birth that they ultimately ended up having, or are going to have.
Abby: I agree and one thing that worked in our favor in the film, and I don’t want to spoil the film for anyone who hasn’t seen it, but the outcome of my birth really balances the film. Because you see a birth that required intervention, you see a really lovely transfer from home to hospital, and from midwife to OB, and the system working in the way that it could. I think including my birth in the film really mollifies the medical community in terms of saying, “Of course, there is a place for the hospital, of course, there is a place for surgeons and technology when it is needed." So I think that has really helped us balance the film, get more respect from the medical community, even though a lot of people who really don’t agree with a lot of the points we make in the film, on some level they do embrace the message. In some ways practitioners are up against similar issues that consumers are up against right now, so I think that has really helped us.
What do you think the movie is accomplishing?
Ricki: It is raising awareness; it is definitely putting home birth back in the forefront. People like you Maria—you said it took so long—you have been trying to get people to pay attention to this issue for 20 years, but it took someone who has a TV background, who is a high-profile person, to bring this issue into people’s heads again. So it is definitely raising awareness, it is educating people and getting them to fight for their own choices.
What are your next steps?
Ricki: I am continuing to be out there and advocating for choice in birthing. And to hopefully make the system better and safer and give women access to the information and hopefully lower the C-section rate and have the maternal death rate go down. We want all of it. We want better maternity care and for women to have as amazing, empowered experiences as possible.
How has this movie or being a childbirth activist changed your mothering style?
Abby: This whole idea of awareness. Being fully conscious to all the levels of motherhood. Ricki has a quote in the film that her peers just seem to want to “get this baby, acquire this baby, get this baby out,” and that is where motherhood starts. We have just come out with our book, Your Best Birth. When we were writing the bonding chapter, and I think even when you talk about bonding after birth, I think that is something that a lot of women don’t understand. They have never talked about the hormones and the neuroscience—everything that we know about how important birth can be to your entrance to motherhood. I think that it is really a shame that a lot of women are not being prepared, not doing their homework, not getting access to the right information, having birth experiences that are disempowering, depressing, that they are separated from their babies at birth, things that are very deeply wounding. It won’t hurt you as a mother in the long run, but it won’t help you.
Ricki, I know that you are very busy, so how do you integrate mothering into your life? How do you make mothering a priority?
Ricki: Scheduling, what I agree to take part in. I made a commitment when I had kids that any job that I did could not really disrupt my kids’ day-to-day life. I never understood how actresses like Demi Moore could pick up and leave for four months, and make a movie out of town. What do you do with your kids? Do you take them with you and put them on set and get a tutor, or do you leave them? I never understood how to balance that so, lucky for me, I did the talk show thing, which was the same studio for many, many years and shooting three days a week. I passed up opportunities that have come along, just because I don’t want to leave my kids and I don’t want to pull them out of their social environment. We are now doing this follow-up movie, and we work around our schedules, and it’s complicated. For me, to continue to work on this project, it is so personal, and it is an even greater problem to have. The whole thing stemmed from having my kids, the whole idea came out of their coming into the world. So, they understand it, I explained to them how powerful the impact of this movie is having on people. I think Owen, my little one, who is in the film, deep down understands. That his coming into the world is particularly important, and that is the start of this project.
Do you want to tell us anything about your book?
Abby: It is called Your Best Birth and it is meant to be a very practical guide to navigating your choices in the current maternity system that we are in. It is not a pregnancy guide, it is not a What to Expect When You Are Expecting, not telling you what your baby is doing at 34 weeks. It is totally about how to pick your provider, how to build your birth team, whether you should hire a doula or not, whether you want a midwife, explaining the different types of midwives and how they work, what you should be looking for in an OB, what a typical hospital experience is like, things you should ask on the hospital tour, things you should ask on a birth center tour. Very practical, hand-holding guide aimed at women who may want totally different types of births. Definitely not just for women who want natural birth. But for women who want a more empowered, more personal experience.
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Maria Iorillo, CPM, First Vice-President of the Midwives Alliance of North America (MANA), is an editorial advisor to Mindful Mama. Maria has been a practicing midwife serving the San Francisco Bay area since 1986. Maria co-produced It’s My Body, My Baby, My Birth, an educational childbirth film that tells the story of seven mothers in their emotional journeys to natural childbirth. She also contributed to Your Best Birth, coauthored by Ricki Lake and Abby Epstein.