Monday, March 7, 2011

"Pregnant in America": My post-dates reaction

A Facebook friend just watched the documentary "Pregnant in America", and asked me if I wouldn't mind elaborating on my thoughts on the film. Who, ME? Mind elaborating? Have we met?

I'm not going to really do a formal review, per se, of the film because it's been about a year since I saw it myself, so I'll just share some impressions.

No, I didn't care for it at all. Maybe it's because I've been spoiled for all birth documentaries by "The Business of Being Born", which is not a perfect film but it IS a very, very well-crafted one. On top of presenting the information well, they manage to include just enough of the personal narratives to make it relatable without tipping the balance. It's entertaining, it uses humor without going over the top, it's paced expertly.

In my recollection, the couple in "Pregnant in America" - or rather, the filmmaker and father, since he is the central figure - don't achieve that kind of balance in any area. It is about them/him. This in itself could be compelling, as there are plenty of films out there that document a person's life or a particular personal story, but I found the director (and star!), Steve Buonaugurio, to be completely unsympathetic. He's abrasive, contentious from the get-go, and even downright combative at times: he seriously ambushes hospital personnel in the parking lot and tries to interrogate them. He's clearly fancying himself Michael Moore, but with none of the perspective and humor. Say what you will about Moore, he's a talented filmmaker (I happen to be a fan, but I understand if you're not crazy about him or his politics or both).

In one segment, Buonaugurio literally has "The hospital is the enemy" written on a flip chart. Let me take this opportunity to state that he does NOT speak for me, nor for many and I would dare say the majority of the birth advocates I know in real life and online. We have major, major problems in this country's maternity care, but the hospital is NOT the "enemy". I do agree that we overmedicalize many things, including birth, but there are times - yes, including some births - when the hospital is not only not the enemy, but the hero. Most of us know people who have been saved by hospitals in one way or another. A statement like that is an insult both to the people who have been saved and to the many people who work in hospitals and DO care very deeply, and have made their life work out of that caring.

So let's battle about policies with which we disagree, absolutely. But alienating the hospital altogether is a boneheaded, belligerent move. I found him so incredibly abrasive that I found myself wanting to disagree with him on just about everything he said, even though I'm ostensibly on the same "side". And yes, I keep referring back to him and him alone, because his wife, Mandy? Merely a bit player, a backdrop for his big opportunity to create a shocking expose.

There are some positives in the film. I really appreciated some of the interview footage, especially that of Joseph Chilton Pierce, along with mainstays Ina May Gaskin and Dr. Marsden Wagner. And . . . that's about it, really.

I'm most floored by his reaction to his own baby's hospital transfer. The couple did have a home birth that went well, until the baby's heart rate started deviating enough that the midwife advised transfer. The baby is kept for observation, but nothing is ultimately found to be a permanent problem. We're left in the dark as to the details. Buonaugurio is furious about the whole thing, and acts as though he is being persecuted by the NICU stay. I can understand being frustrated and scared, but I will always believe in erring on the side of caution. Can you imagine if the midwife had ignored these signs and it DID turn out to be something serious? The outcome could be tragic. But no, it's all about him.

There are so many other far superior films about the same topic. "The Business of Being Born" is the mack mommy of them all, of course. Again, it has its flaws, but it's worlds apart on a technical level, and it manages to maintain an even-handed demeanor despite coming from a clear bias; some opposing views are represented (even if minimal), and the film's perspective comes from clearly presented facts (some would say oversimplified, and they have a point) as well as from multiple personal testimonies. Buonaugurio just bludgeons you over the head from the start and never lets up. And I think he makes us all look like a bunch of narrow-minded, humorless zealots in the process.

There's a lesser known film called "Born in the USA" (not to be confused with the Marsden Wagner book) that is quite good despite being somewhat dated at this point - overall, though, it's still very relevant. I liked that part of the film focuses on a CNM struggling a bit within the limitations of a hospital setting. There's also a scene where a group of OBs and residents all get together for a peer review session that is quite the eye-opener; I'm actually surprised they allowed cameras in. Give it a watch, just keeping in mind that it's not the most current. I would even recommend "Orgasmic Birth" over "Pregnant in America", despite having some reservations about it.

Finally: Also? WORST TAGLINE EVER. Are you ready for it? "Pregnant in America: A Nation's Miscarriage".

I mean, really. I can't make that kind of crap up.


  1. Thanks for the post! I pretty much completely agree with what you say here. Like I said when answering a friend last night about my thoughts (regarding recommendation) - if you've seen The Business of Being Born, you've seen this, at least in context of the content given here. I don't think I learned a single new thing that I didn't learn from The Business of Being Born.

    I was sort of entertained by the family's progression through pregnancy, but I too was bothered by how everything was made to be about him, not his pregnant wife or the baby growing in her belly.

    It bothered and angered me that he decided to take it upon himself to approach his sister-in-law's former OB/GYN to let him know that his SIL had in fact given birth to a healthy baby vaginally, despite his diagnosis that she wouldn't be able to.

    It also upset me the way he approached the hospital administrator of the hospital (I believe) where his SIL was staying, and his condescension toward the security guard for asking him if he had a college degree (THE NERVE OF SOME PEOPLE. Of COURSE I have a degree and how dare you ask, you lowly SECURITY GUARD!).

    Wow. There was a lot more about this film that bothered me than I thought. I can think of at least 4 more examples of things that irked me, but overall I think it was just his attitude in general, in that he acted like his stance was 100% right for every situation and that people who choose differently must be stupid for it. (That's just what I got from him. I don't think he ever went as far as to actually say that.)

    Anyway, thanks again for elaborating your thoughts on the film. I was really curious after you posted that you didn't want to say until I was done watching as not to taint my perspective on it. HAHA.

  2. For us birth junkies I think it felt like it was just another day at the office, ya know? Parents being passionate and emotional about something really important. A baby gets born. There were no real surprises for me.

    And they had a chance to really spread the good news when it came to the non-birthies out there...but instead tried squeeze ahomebirth experience into the A Baby Story format and do a sensationalized controversial spin which just made homebirth look radical and irresponsible. Not on my list to recommend to first time expctant parents at all.

  3. "He's clearly fancying himself Michael Moore, but with none of the perspective and humor."

    THAT. Hit the nail on the head. The entire movie I was like "Um, that part COULD have been compelling if the director had an ounce of talent." And seriously worst tagline ever.

    BoBB has just set the bar for modern birth movies as far as I'm concerned. I literally still cry every time I watch it, and it's been 3 years since I first saw it. A self-involved director trying to be a poor man's Michael Moore will never compare to what Ricki and Abby were able to do.

  4. To each her own I suppose. I liked it. My husband watched it with me and I think it was very helpful to have the mandly point of view. My husband was already supportive of my decisions, but this was far more eye opening for him than anything else.

    As far as him feeling like he was being "punished" for having a home birth? Happens every day, and I'm surprised you can't sympathize with him for that.

  5. Sorry for the typo, that should read "manly" point of view.

  6. I saw that come up in my new movies queue on Netflix the other night. Adrian was scrolling through and said, "Oh, there's a movie you'll like." I wasn't paying attention and said, "What is it?" "It's about miscarriage." "WHAT?? Why would I want to watch that??" "I dunno, that's just what it said." So I had him scroll back and saw what it really was. I haven't had a chance to watch it yet.

  7. TFB, I still cry too, and it's probably not an exaggeration to say I've seen it a dozen times now.

    Maria, I agree that a male perspective is very much needed! I'm really looking forward to finally seeing "The Other Side of the Glass" for that very reason. I just don't know that I liked this particular male's perspective. But it's a very good point.

    You're also right that families do sometimes get 'punished' by poor treatment from hospital staff after transferring from a home birth, and that's abhorrent. But I just didn't see any evidence of that intent here. That doesn't mean it didn't happen, of course, BUT, this is a film. We only know what we're shown. If this was the case for him, I think he needed to find a way to depict that more clearly. But from what I could tell (and this is where I get into trouble, because as I said, it's been a while), his experience was colored by his determination to be a victim of the hospital, IMO.

    For example, I recall him getting bent out of shape because some staff was holding the baby when he and his wife weren't present. I'm inclined to think he'd have been just as bent if they had left the baby lying in an isolette with no contact. Know what I mean? Again, very much just my opinion, as a viewer with limited information at that, but it really seems to me that he went in with a huge chip on his shoulder.

    Jill, that's hilarious AND facepalmy.

  8. I watched this for the first time night before last. I have to say I was THRILLED to see some light being shed on the risks of c-sections, induction, and the drug Cytotec. Those risks NEED to be common knowledge to anyone who is planning to give birth. I might have been put off by the director's anti-hospital agenda had I not been seriously mistreated by the hospital I gave birth to my third child at just 6 months ago. Long story short I was planning to VBAC and all was well until my water broke at 38 weeks and my OB was out of town. The on call OB absolutely refused to do a VBAC under ANY circumstances and threatened to have social services get involved and take the baby away if I didn't consent to surgery. In my case the hospital really was the enemy and I still ache deeply over my birth experience. The Dr who bullied me into surgery has been sued for two uterine ruptures and simply didn't want his insurance to go up because he allowed me to deliver vaginally, even though it's statistically safer and my specific case was ideal for VBAC. Really, the babby and I were NEVER in any danger unless you count the Dr refusing to leave my room while he lectured me on how my "ignorants of the REAL risks" were going to "KILL" me and the baby. I actually handed him a print out of the ACOG recommendations for VBAC and he LAUGHED and told me ACOG was just a bunch of researchers who don't actually practice medicine. This Dr also routinely uses Cytotec to induce labor.
    Anyway, back to the documentary:
    Yes the director got on my nerves at times but then I thought, if MY husband had been that passionate, if he had been as rooted in having a non hospital birth I would have never gone to the hospital for my third, I would have never had to choose between loosing my child or having a surgery I didn't need and had already left me with PTSD once.
    I don't blame my husband at all, I know he was scared and just wanted us to be alright, but with the way our country's obstetrics system is at this point in time you really do have to be an activist to have a natural birth and you need your partner to be a warrior for you so you can focus on having the baby. The director certainly wasn't perfect but I was so glad to see him be the champion his wife needed.

  9. First and foremost, I am so sorry you had such a horrible experience! That doctor is a menace, and embodies everything that is wrong with our system. Ugh.

    I'm glad to hear that the film resonated for you! It's out there, after all, so I'm happy there are some who have had a positive experience with it. And I do agree that the male perspective, including how to be a real advocate for your partner, is very important. I do still hope "The Other Side of the Glass" fits the bill.

  10. When I watched the film (granted, it's been about a year for me too), I was also struck by this thought: "Well, he's only preaching to the choir. This film isn't going to change minds, and if it does, it just going to make pregnant women scared shitless."

    BoBB, however? I can't tell you how many times I've talked to women (and men too, for that matter) whose perspectives on birth and maternity care have literally been transformed by that movie. You're right, it's not perfect, but it is *inspiring*.

  11. @Anon - I'm SO SO SO SORRY for your experience! That sounds just AWFUL!

    @Kristen - I'm one of those people whose entire perspective on birth and maternity care was completely transformed! My best friend was pregnant at the same time I was and she had a midwife. I thought she was CRAZY. I thought it was like back-country, up in the hills and mountains, jerry-rigged medicine because I was completely uninformed on what midwifery really means. Shortly after giving birth to my daughter, I saw BoBB and it literally turned my life around. I'm in nursing school now working on becoming an RN so I can eventually become a midwife! :)

  12. Great minds, Erin, great minds!

  13. Unfortunately, just wasted my time watching this "documentary". Everything you said was right on. Nothing about his wife or his baby, it was all about him. And part of me wonders if they did get a diagnosis, but just refused to state what it was - after all, no one but the parents would be privy to such information, so there's no way to say what is true or not. As for the hospital stay, at the beginning, he said there would be no prenatal testing, no nothing just about. So I don't blame the hospital for doing their job and observing the baby and running tests to make sure all was okay. If not they'd have sued the hospital for negligence. Ugh. Just hated the movie, hated the guy.

    Bottom line: I feel like he was one of those abusive husbands who dictates how everyone else is going to live. His wife had to defer to him before he would allow the hospital transfer. He didn't want this, he didn't want that. Focus was entirely on him...never upon the actual pregnant woman and child.

    1. For someone without a medical background he certainly likes to act as though he knows more than medical staff. I wonder what kind of "managing" he had to do in the NICU. His personality unfortunately diminishes what may otherwise be an interesting perspective on birth. From a medical perspective someone should clarify for him that there are different shaped uterus' and some are much less likely to be able to have a vaginal birth. And often times it is the shoulder, not the head, that gets stuck. Also, I am guessing that while his baby never got a "diagnosis" her differential diagnosis probably included sepsis, transient tachypnea and hypoglycemia (which can cause neurological issues in the infant). Sometimes medicine is about treating symptoms, not providing a diagnosis for the know-it-all dad. Business of being born is a much better and enlightening perspective on this topic. Some of the expert interviews and other stories that did not involve Steve were good, but his egomaniacal attitude is just too overshadowing.

  14. Agreed, husband was horrible. And, I would have liked some explanation or answering to the statistics showing infant mortality in the Netherlands (which he idealizes)as being one of the highest in the western world and further analysis linking the bulk of the infant deaths to the trip from home to hospital. Anyway, it was just over the top. And, since he was protected by those HIPPA regulations he mocked with his sister in law, he is free to never disclose what the hospital found. Obviously "diagnosis" or not, there were findings and abnormalities and he refused to mention those. If he stood by his claims, why not publish the hospital records on his website?

  15. The director was an idiot, pure and simple. Showed no gratitude towards the hospital staff who SAVED HIS CHILD'S LIFE. I feel bad for his wife.

    1. Ha ha ha! His child DIDN'T NEED SAVING! You seem to be making stuff up for your own agenda now!