Educational Media Reviews Online

A quote from the introduction of this fine production concisely sums up the main theme of the program: "There's more than one way to think about birth in America." Through interviews with obstetricians, midwives, and patients, Born in the U.S.A. provides an accurate overview of the current state of childbirth in the U.S.

The program points out that what is proven to be best for the health of women delivering babies is often a controversial issue in our society. It explores both sides of the use and effectiveness of epidurals, pitocin, episiotomies, and birth by Cesarean section. Statistics show that 99% of births occur in hospitals, and Born in the U.S.A. opens the door for viewers to realize there are other options. The video shows five actual births, including a Cesarean section, in three different settings: a hospital, a birthing center, and a home birth.

While technology and modern medicine have improved birth outcomes for both mothers and infants, they are not without costs. The increased probing and monitoring required by hospitals and physicians, has resulted in an increase in unnecessary C-sections. The physicians interviewed in the program acknowledge openly and somewhat regretfully that legal considerations definitely influence how they practice medicine. Fetal monitoring may not be the best thing for the baby, but it produces a permanent record of what was happening to the mother and also allows the obstetrician to see more than one patient. The program cites studies from the New England Journal of Medicine and other reputable medical sources, that point to the success of birthing centers as opposed to hospitals in reducing the occurrence of unnecessary C-sections and the use of epidurals for pain relief.

Born in the U.S.A. excels at bringing out the important issues surrounding childbirth in various settings. It includes a discussion about the "meaning of pain", and shows one birthing center where pregnant women take responsibility for some of the routine tasks of their examinations such as urinalysis and weigh-ins. This shift of responsibility results in women feeling more empowered and connected with their pregnancy and their healthcare. Viewers are privy to the discussion at a hospital case review, the decision behind a birthing center midwife to transfer a woman in the late stages of labor to a hospital, and a midwife assisting a home delivery.

Technical aspects of the program are first-rate. Procedures and statements are accurate, though selected, and while the program features physicians and midwives, obstetrical nurses and nurse practitioners seem to be overlooked. The film is a good discussion starter, especially at the high school level and in educational settings for health care professionals. Born in the U.S.A. is highly recommended for viewers high school age through college, and to be part of academic health sciences library collections.

Many thanks to Patricia McCartney, RNC, PhD, Clinical Assistant Professor of Nursing, University at Buffalo.

For other MC Journal reviews on childbirth see: Midwives: A Living Tradition