Think Ricki Lake Is Behind Home Birth Popularity? Think Again

Ah, Ricki Lake. She is an easy lady to love. That talk show (I am old enough to have watched it- yikes!), that birth movie (I saw her naked!) and now Dancing with the Stars! She genuinely seems like a nice person to share a cup of herbal tea with. How does this somewhat small-time actress manage to get so much hatred and smear from some of the obstetric/anti-home birth world? Well, the obvious reason is that little movie she made: "The Business of Being Born."

The movie (BOBB) has an obvious pro-home birth slant and covers a few mothers birthing at home (or attempting to) and their journeys, their joys and their disappointments. (One mother -the director no less- has a home birth transport because the baby is too early.) She runs through some common hospital interventions, interviews some fabulous doctors and midwives (on both sides of the fence) and basically makes home birth look like it is not such a bad thing. If the former director of the World Health Organization thinks it is a good idea, how bad can it be, right?!

I love that movie and I have seen people consider home birth after watching it, or at least question some of the assembly line procedures so common in the hospital. So why is a woman who wanted a better birth, and found one at home, being attacked by the anti-home birth people? ACOG- (also sometimes referred to as "the enemy" -well maybe I am the only one that calls them that-) even came up with a whole STATEMENT in which they refer to her and the movie,
"Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre."

I have even heard people say that she has "blood on her hands"! Really?!!! Ricki Lake kills babies? Well, that is reaching...

Maybe people are angry because of the HUGE rise in home birth. (I am being sarcastic.) Home birth has risen 20% in the last few years, it is true but...
"In 2008, there were 28,357 home births in the United States. From 2004 to 2008, the percentage of births occurring at home increased by 20 percent from 0.56 percent to 0.67 percent of United States births. This rise was largely driven by a 28 percent increase in the percentage of home births for non-Hispanic white women, for whom more than 1 percent of births occur at home"

You can read the abstract here. Twenty percent sounds like a huge jump, but we are still looking at only about ONE PERCENT of women in total birthing at home- this isn't exactly mainstream yet.

So, Ricki Lake makes a movie, home birth jumps in the US, it must be her fault, right?

Wrong.

Ricki is an easy target. Especially if you don't want to take any responsibility for the fact that your patients hate you.

Yeah, I said it. Home birth is on the rise because women no longer want to birth in hospitals with obstetricians. Obstetricians, not Ricki Lake, are the reason behind the jump in home birth. Why? What happened to women?

~They thought the pitocin hurt like hell.~
~They wonder why breastfeeding was so hard.~
~They struggled to recover from an epidural.~
~They felt out of control while they were half numb.~
~They felt like a slab of meat on a bed while the nurses came in and rather than actually talking to or looking at them, just looked at a print out of their contractions and their babies heart rate.~
~Over 30% of them birthed via abdominal surgery and they don't even know why. ~
~They were ignored, forgotten, and then they were told that none of that mattered, because they had a healthy baby. ~

What drives women toward out of hospital birth is not a misplaced desire to be more like a former TV talk show host, it is their dissatisfaction with the obstetric and hospital system.

If OB's, ACOG, and angry anti-natural birth bloggers really want women to keep birthing at the hospital (lets be honest- the vast majority still do) they need to forget about Ricki Lake and BOBB, they need to look in the mirror.

It is much harder to admit that people just don't like you or the kind of care you are giving them. Easier and involving much less self-reflection is blaming somebody else. But that doesn't fix the problem. The problem lies in dysfunctional maternity care.

If you really want to see women leave home and birth in the hospital, the answer is actually quite simple.

Respect them.
Talk to them.
Look at them.
Answer their questions.
Learn their names.
Give them good breastfeeding support.
Give them their babies.
Comply with the mother/baby friendly hospital initiative.
Give them a real chance to VBAC.
Only push medical procedures like induction when it is really needed.
Be somebody they can trust.

Many hospitals and care providers already do this. Many don't, but women either don't realize that there is another option, don't care, or are afraid of birthing without pain relief medication.

The truth is that the obstetric model of care doesn't really need to change anything. The vast majority of women already believe that birthing in a hospital with an OB is the best thing they can do. But if they want to keep (or woo back) those women who are dissatisfied with the run-of the-mill care, they can simply do the above. It is often harder, more expensive (if insurance doesn't pay) and less culturally acceptable to birth at home. Making the choice to birth outside of the hospital, is still a rather revolutionary one, no matter what Ricki Lake does.

Or, rather than looking in the mirror and actually NOTICING that maybe Ricki Lake was simply a reaction to bad hospital births rather than a rebel promoting home birth for no good reason, they could just point the finger at a small movie and a talk show host. That is much easier than changing themselves.

If "they" really cared about women and babies and really thought that home birth was less safe, they would happily start treating women and babies with respect. Maybe they just don't care about us. Maybe they just care about their bottom line, their schedule, and their convenience.

That is fine with me though- I know a great home birth midwife.

Comments

dia-a-dia said…
Thank you so much for the clairvoyance and courage of this article! It‘s so important what you just summarized here, that I risk asking you permission to translate it into Portuguese. May I? Portuguese women must read this, and many of them don’t understand English. Of course I’d always cite you as author, or, if you prefer, you can publish my translation directly on your blog – this would be a great advantage to all Portuguese and Brazilian women in USA and all over the world. THANK YOU, one more time!
R times 5 said…
This inspired me to write my own blog post which I'm sure my family will not appreciate but oh well. Thank you for posting.
Sabine Lavine said…
I wouldn't say Ricki Lake is singlehandedly responsible for the increase in home births, but she has certainly given it a higher profile and drawn some attention to it.

I wish people would try to reach a happy medium and understand that the vast majority of people (and doctors) fall somewhere in the middle of the two extremes. Plenty of people have positive experiences in the hospital, and some women have bad experiences at home with midwifes. The fact that there are unlicensed midwifes out there giving medical advice and treatment is just as scary as any hospital intervention (even more). It would be nice if the two extremes could attempt to communicate and compromise rather than being at each other's throats.
Anonymous said…
I don't believe that it is solely the incompetence of OB's with regard to normal physiological birth-- though it is a large part of it (as the article states. I think perhaps the fact is that a hospital is not necessary for the vast majority of births, period. OB's can try to win back customers by adopting a base-line of respect for women and the birth process but quite frankly the first and most unnecessary birth intervention is leaving one's home. Perhaps OB's should return to making house-calls and attending homebirths?
Anonymous said…
This comment has been removed by the author.
Jen said…
~Over 30% of them birthed via abdominal surgery and they don't even know why. ~
~They were ignored, forgotten, and then they were told that none of that mattered, because they had a healthy baby. ~

6 years later that pain still gets to me.
Jen said…
I love this post! Thank you so much! Ricki Lake didn't convince me to have a home birth. Having a hospital birth did. I wish I could tell ACOG that some days.

@Andygirl
Just a side note, but licensing status doesn't necessarily have anything to do with a midwife's qualifications. It's more often an indicator of the political climate in their area than of the amount and quality of their training and experience.
Unknown said…
Thank you! Ricki Lake isn't what pushed me towards paying for a homebirth out-of-pocket. What finally pushed me out of the hospital was when I found out every hospital in my area had a c-section rate between 45%-49.5%, including the hospital that supposedly supports "holistic" birth (47.5%). I refuse to believe that almost 50% of all women giving birth truly needed a c-section. I just don't see how those numbers can even be defended. It was to risky, as far as I was concerned, for me to expose myself and my child to odds that strongly against a natural and normal birth.

People have been telling me how brave I am for having had a homebirth (that was absolutely wonderful!). I don't think I was brave, I think they are crazy for trying to go against those odds.

Oh, and all the routine newborn procedures following birth is definitely another of my reasons. It alone wouldn't have been quite enough to push me into paying for a midwife but it strongly swayed me in that direction.
lmnop said…
I haven't birthed at home, I have birthed in the hospitals, but I would never birth with an OB unless I absolutely had to. After reading birth story after birth story after birth story about the pitocin, epidural, c-section cycle there is no way I would put myself at risk for unnecessary surgery. I have had two great experiences with midwives in the hospital, after lots of preparing and research and my third will be at a birth center with a midwife. I would happily give birth at home if it were legal for a CNM to attend one in the state I live in. However, it is illegal, the nearest lay midwife is two states away, and I would have to pay out of pocket for everything, which is not feasible. After my first birth, I watched the business of being born, and it merely reinforced everything I had heard about the OB model of care. I find it scary. I can't imagine being bullied and having fear tactics and a time clock to worry about while trying to be in labor. Thank you for this. Once again, the ACOG talks about women as if they are incapable of reading a book and educating themselves. It must be a celebrity trend that makes women want to stand up for their bodies and their births, right? Gee, I'm glad they are so concerned about the well being of women.
Mama Birth said…
Yes- you can translate it- could you e-mail me a link though and also if you could link back to me and give me credit I would appreciate it! thanks!!!
And you know what's funny? I wouldn't have even watched that movie if it weren't for my HORRIFIC hospital experience (induction turned cesarean.)

Yes, that movie inspired me to have my VBAC. Yes that movie helped me discover the wonders of homebirth for my third baby. But did it convince me?

No. You know what convinced me? Watching birth in the hospital as a doula. I always thought that I might be able to make the most out of hospital birth with my third baby, but THANK GOD I became a doula before I got pregnant with her. What I witnessed made me realize that the hospital was absolutely the wrong place for me, and hadn't changed at all since my first two times there.
Mama Birth said…
OK- I just get giddy when The Feminist Breeder comments on my page-
As a midwife of over 23 years I can wholeheartedly confirm that the VAST majority of my clients chose OOH birth BECAUSE of their previous birth experience. Ricki Lake was not the physician at a mother's birth where mom is so traumatized then told the big lie, "at least you have a healthy baby." Talk about blaming the victim!!! These mothers, and there are more and more every day, come into my office, starts telling her birth story, begins to tear up and then APOLOGIZES for being traumatized!! This PTSD of birth or right out birth rape affects the whole family, mom, dad, the marriage, parenting, the list goes on and on... I could go on and on but I have just returned from a beautiful, empowering home birth of an 8lb 4oz baby boy born to a VBAC mom and dad. So goodnight, check out my Facebook page Heaven Sent Births for lots of beautiful pics and stories showing how important birth is to families.
Thank you so much for saying this. My second birth was unassisted at home because my first birth in a hospital (with a midwife) was a horrific nightmare. I finally stopped having flashbacks but I still hate her (the midwife). You are the first person to come out and say the "h" word. I watched BBOB while pregnant with my second and it only served to confirm what I already knew.
"Blaming" the rise of home birth on Ricki Lake--or on any one, single factor--also undermines women's intelligence and the complexity of our decisions when it comes to giving birth.

Is Ricki Lake and The Business of Being Born *inspirational*? Absolutely. But very few women do ANYTHING just because a celebrity says so. Anyone who suggests otherwise is probably just obscuring their (or their profession's) complicity in many women's dissatisfaction with hospital birth.
Kim said…
Pretty much what Gina said. I would have never watched BOBB had it not been for my bad hospital birth and induction.

Ricky Lake deserves some sort of Nobel for birth. She isn't the cause but she offers a solution to those of us who wanted a better birth.

Before watching BOBB I also read Ina May's Guide to Childbirth and those two works of beautiful, birth "propaganda" made up my mind.

October 20 will be my 1 year home birth anniversary. 2 months ago I was able to meet Ricki Lake and thank her in person for her role in one of the happiest, most empowering days of my life.

If only every woman could have the same experience.
Anonymous said…
I LOVE READING YOUR POST. GREAT article, people are looking to be respected not treated like another number. I had two waterbirth at a free standing birth center because we couldn't get any homebirth midwife but It was a great compromise. My baby never left my side and we all my wishes were respected.
Unknown said…
Um, it is TOTALLY untrue about the "more expensive" part in the article about a home birth... I had a home birth after being informed by several documentaries including Ricki's about the assembly line of modern birthing practices in the America. I have no insurance due to high rates, and I make too much to be on state insurance. I called my local hospital, and total birth cost to have my baby at a hospital, providing there be NO complications, was upwards of $35,000.00!!! (And somewhere upwards of $100,000.00 if there were issues! But I had no fear of that since my Midwife is trained to know what is considered normal or not & sent me to specialists and such, so I had no worries about that.) To give birth at home, Midwives in MOST states are totally covered by insurance and if you don't have insurance? Midwife & three assistants total cost? $3,000! When comparing cost when one is uninsured, MIDWIFE is the way to go. She even does births AT the hospital, so if one wanted to give birth at the hospital, she could do it there and you'd have the convenience of being there should you have an abnormal birth (needing intervention). Complications only NATURALLY happen in less than 10% of women... that means a whopping 80% to 90% of women are having unnecessary c-sections in hospital!! ... Go figure that home birthing is on the rise...
KathyMorelli said…
Great blog post. Wondering why they dont say she was the producer of the Biz Of Being Born when she is introduced at DWTS... seems weird to me.
Such a great blog! I love it! Reminds me of the reason people don't vaccinate is because of Jenny McCarthy. Whatever.
Kama said…
I am dye in 2 1/2 weeks w our third child. This will be our first out of hospital, non-medicated delivery. I am so excited to have this baby at home and experience birth differently than I did in the hospital w my other two. I never even considered this before seeing the business of being born when I was 12 weeks along and meeting w my OB the next week. Planning this homebirth, researching and reading has really changed my opinion about hospitals and doctors. I just wish my family and friends would see it too!! :)
newincs said…
I actually posted this on my local hospitals wall. It perfectly describes me and my situation. If we have another child I am considering an unassisted delivery rather than be forced to endure the birth rape and torture I received through the hospital system with my last delivery. I would rather deliver in my bath tub with my husband as my helper then go through that again! Talk about a horrible experience! This post perfectly describes how I felt about the whole experience! :(
Bonnie said…
The success of Ricki Lake...is due to the fact that her message, her movie, speaks to each woman's core truth about her knowledge about her own body and its ability to birth. Not the truth in her head that is muddled with fears and anecdotes. The TRUTH inside her body. The places where we "feel", rather than "know". The places where we "trust" rather than "know with certainty".

We are mammals. We are females. Our bodies are designed to do this birthing thing from the minute our own genitalia formed inside our mothers. Ricki opens up the option of homebirth to viewers who might not have considered it...by speaking to their truths, as well as the cultural and social truths and realities. Each woman gets to connect her own dots, based on her own fears and willingness to take responsibilty for her own choices.


Ricki gave us the ability and the option to trust birth foremost and not our care providers. She drew the line between what we've been taught to think...and what we believe to be possible.

She calls women out to their own truths.

Ricki Lake's film did not affect my homebirth decisions. My homebirthed babies are 14 and 19 years old respectively, occuring long before she made her film. Discovering the truth about how my "believed to be NECESSARY" cesarean could have been avoided, set me free. My two home births followed my unnecessary cesarean.
jjarse2 said…
In regards to the "Give them their babies" hyperlink: Baby did have skin-to-skin contact with mom after he was born. Doctor was insistent that the cord pumped a bit before he was taken to the radiant warmer for afterbirth care. - DAD
Shari W said…
I was 34 weeks with my OB - 3rd child, second desired VBAC. I saw the wall being built higher and higher, the threats mounting, the "mandatory repeat C" rules being touted. (P.S. Nothing is MANDATORY) Only then did I realize I was not up to another FIGHT to simply give birth. Only then did I look around desperately for options, and found homebirth.

At 40, with gestational diabetes, I SIMPLY stayed home and gave birth with the attention of a skilled midwife.

Ricki's movie, and her new follow-on series "More Business of Being Born" (http://www.mybestbirth.com/) is something I'd love to share with my friends before they reach that level of struggle and stress.

My birth-rights awareness shop: http://www.zazzle.com/lovemychoir/gifts?cg=196873930024520261
SlapItHigh said…
I agree with you. Ricki may have gained media attention and helped the movement but this was going to happen with or without her. I had my homebirth during the height of the BOBB craze so it may have seemed to others that she influenced my decision but she did not. I didn't even see the film until I had already hired my homebirth MW.
Love it! You did a great job pointing out the obvious. :)
Mama Birth said…
@dragonfly- For most women with insurance - it covers the hossy and not the HB, the same is usually true for medicaid. Obviously if you are paying out of pocket this isn't the case, but not a lot of people pay out of pocket
Charity said…
My first and second births were in the hospital. I had a midwife who was great with my care, but my first birth had to prove to her that I could do it. I got pitocin without consent, my son was taken away for hours on end, and I generally hated the experience. I was given the, "why does it matter so much? You have a healthy baby" line so many times! Three years later, she attended my second birth. I fought everything. I wanted no interventions and I refused to even sign any paperwork until after the birth. It was still fairly traumatic because I was treated horribly by the nurses. My third birth was unassisted, at home because my midwife wasn't on call that day and I knew my wishes wouldn't be heard. I hadn't planned the UC, but it was the most empowering and most healing experience of my life... THEN I watched BOBB. :) Ricki Lake had nothing to do with my decision to birth naturally or have an impromptu home birth. Knowing I wouldn't get the birth I wanted in the hospital without my midwife made my decision for me. OBs made it the easiest decision in the world.
Anonymous said…
So you were old enough to see the talk show, but I'm left feeling like you never had a chance to see Hairspray. Please tell me I'm wrong.
Mama Birth said…
I have seen Hairspray- but only once and it was a long time ago- funny you should mention that.
dia-a-dia said…
DONE!

Here it is - this fabulous post in Portuguese!

http://www.malmequer.org/news/quando%20o%20abuso%20obstetrico%20convida%20%c3%a0%20fuga%20dos%20hospitais/

If you want, I may send it to you in pdf.

Thamk you!
Enjoy Birth said…
Love it! She may have helped given women the idea, but indeed if the OBs were more supportive to women and their desires, not so many would choose homebirth.
MissUnderstood said…
As a Doula and Childbirth Educator I was so happy to read this post! Keep it up. :)
Shanna Freeman said…
Thank you for this post. I was induced a week before my due date due to high blood pressure, given Pitocin, magnesium sulfate and catheterized. In other words, bedbound. There went my plan. I used hypnobirthing techniques and delivered vaginally without pain medication. I got so tired of people telling me that all that mattered was that my baby and I were healthy. I also could not breastfeed despite the support of a lactation consultant, and I still cry over that loss...my daughter is a toddler. I am tired of being made to feel like I am not supposed to have these feelings. It was not what I wanted and why am I not "allowed" to grieve for that loss?
Lisa said…
what a great post! I had the bad hospital experience first, too, then saw BOBB (and cried because seeing it earlier may have helped prevent that bad experience), and had my second baby - my VBAC baby - at home. I'll never go back to the hospital because of the birthing climate there. I might consider a birth center, but most don't take VBACs. What a sad state our country's maternal healthcare is in.
Dr. Vicki Danis said…
I find it a little funny. All the reasons given in this post were NOT the reason I chose to deliver at home. With my first, I had a great experience at the hospital with an unmedicated vaginal delivery.

I chose to have my second at home because I wanted my first child to be able to feel comfortable with her surroundings. I was surrounded by my family and friends - Just as I had envisioned it. I will surely be having my third at home too.

It is so unfortunate that women are scared of having babies. We are so much stronger than we thing!!
Wendyrful said…
I love that Ricki Lake and the BoBB documentary film has helped bring the idea of birthing at home into the mainstream a bit more. Women, and families, even if they still choose to birth in hospital, are becoming more informed. Yay! I have had 4 OOH births, and became a doula after my 5th baby. It is so hard to watch what many women are put through at hospital births with so many interventions and 'policy's' to deal with! I had a young friend who had a baby, who later became an OB in order to help mothers have better experiences than she had as a teen mother. When she was about to begin her OB rotation she asked my advice. I told her over all, to respect women, listen to them… She is known as the natural OB in her area. I'm glad that I have had at least a small impact on a few mothers in my lifetime.
Mom said…
Thank you for posting this. I have four children, all born in a hospital, with less then stellar conditions. All of my doctors were phenomenal but couldn't remember my name without looking at my records. The nurses (all but two) were rude and condescending. They all thought I was odd to want to go through childbirth naturally, they all pushed for a C-section although there was no need. My last child was 12lbs, 1.5oz at birth and I had him completely natural, no drugs or anything. He had no broken or displaced bones and was a big healthy boy. If they had known he was that big, it would of been a C-section. Women need to know that home birth is a viable option. I wish I would of looked into it more. Thanks for the article, I will pass it on.
Bex said…
Maybe I'm the dissenting voice here but I was in a high risk pregnancy and birthed at the hospital. My OB knew exactly what I wanted and what I didn't. She tried to spare me from every thing I did not want to happen. I was induced and less than 12 hours of labor had my beautiful baby girl. The epidural didn't work on me though, which is my biggest complaint. But I'm so glad we did things the way we did and everything turned out all right. Some of us HAVE to birth at a hospital and that doesn't make our birthing experience worse than a home birth. I had people to take care of me, to clean me up, to give me supplies for my bleeding, to bring me meals and to make sure that I had the necessary medications to keep my illnesses in check while putting my body through an extremely demanding experience.

I just cannot stand extremes on either side. There is no right way to do ANYTHING in life. Not every home birth is going to be an amazing, rewarding experience. Not every hospital birth will be a horrific, awful thing either. If you don't trust your OB, don't settle for him or her. Don't have a home birth just because you hate your doctor. Have a home birth because it's something you really want to do.
Anonymous said…
You're a dumbass.