Ricki Lake and Abby Epstein
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Abby Epstein & Ricki Lake’s ‘The Business of Being Born’ Is Free in Support of Expectant Mothers

Daphne Thompson | April 16, 2020

In 2008, Abby Epstein and Ricki Lake released their independent documentary, The Business of Being Born. The illuminating film explored how the American health care system medicalizes child birth and exposed the ways in which those practices can fail to protect the integrity of person’s birth experience. For many, the documentary was a game changer, making the work of doulas, midwives and birth centers an option that had never seemed accessible before.

In 2020, the piece is unfortunately just as relevant. As the COVID-19 pandemic exposes the cracks in the US healthcare system on a daily, full-spectrum support for expectant women who deliver in hospitals has come under threat. Now, more than ever, it is critical for expectant people and their partners to know that there are options, to know that they have the right to advocacy, and to know that, even in the midst of crisis, their birth experience is one that should be protected. Sensitive to the reality that many pregnant women are facing fear and uncertainty when it comes to planning their births in light of the coronavirus pandemic, Epstein and Lake led a Zoom webinar for parents expecting during the COVID-19 pandemic, which can be viewed here.

We were lucky enough to speak to Abby Epstein about the filmmaking duo’s decision to make their acclaimed documentary free to those in need of its guidance. Here’s what she had to say about birthing in the COVID-19 era, and the tools expectant people need to stay confident and in control at a time like this.

In light of COVID-19, many hospitals across the country are limiting or restricting who can be in the room to support a laboring woman through delivery. Is this another example of how birth is seen as a business, and how the American health care system can fail to protect a person’s birth experience? 

“Yes, it’s amazing how many women we are hearing from who are switching from hospital birth to birth centers or home birth because they are not allowed to have more than one person with them during labor. This is limiting the crucial role of doulas during birth who have been proven to lower c-section rates and other interventions… Luckily for New York, Governor Cuomo was able to overturn last week’s ban on labor support as women birthing in hospitals need more support than ever during this stressful time. We hope that this situation will shine a light on the need for more out-of-hospital birthing options.”

How do you hope people will use The Business of Being Born as a tool through the pandemic, and why is having the documentary as a resource more important than ever for birth workers and people who are expecting?

“Sadly, in re-watching The Business of Being Born twelve years after its release, many birth professionals have noted how little has changed. In many places women have less options than they had twelve years ago, as birth centers are closing down. We’ve seen this phenomenon in New York City as the birth center at Mt. Sinai West (where we filmed many of the births featured in in the movie) recently shuttered to accommodate more private maternity rooms. When it comes to birth, the bottom still seems to take priority over the experience of moms and babies. We hope that women will use The Business of Being Born and the More Business of Being Born sequels as a guide to help them advocate for themselves in the hospital – especially if they are not allowed to have their doula present.”

The Business of Being Born came out in 2008 — if you could go back and add anything new to the documentary, what would you want to include and why?

“The documentary has not lost any relevancy over the past twelve years – it still remains one of the most influential and empowering depictions of the history of midwifery and childbirth. We hear weekly from people who attest to how the documentary changed their birth plans and their lives or led them to become a doula or a midwife. It’s truly amazing how revolutionary this film is and we only wish that it became ‘dated’ and that the maternal and infant mortality rates in this country had improved over the past decade. I think if we were to add anything new it would be to show how the doula profession has exploded since 2008, when many people had never heard this term. There has been an awakening amongst birthing women even if institutions are slow or resistant to change.”

The pandemic brings with it a lot of anxiety and uncertainty for all of us, let alone pregnant people. What advice would you give to help them remember to take care of their mental health through their pregnancy, birth, and postpartum?

“This is so important and we discussed this in depth on our Zoom webinar earlier in the week. Pregnant people need to prioritize reducing stress which means avoiding the news cycle as much as possible, especially those click-bait headlines filled with doom and gloom. There are many online resources for prenatal yoga, meditation and great books to keep expectant parents in a positive mindset. And of course spending time in nature – even a walk down a tree-lined city street or in a park can be transformative during this time when we are all cooped up and isolated.”


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