Review of Orgasmic Birth

I met the filmmaker Debra Pascali-Bonaro at the Lamaze Conference in October, and she gave me a copy of Orgasmic Birth to review. I’ve watched it three times and had three very different reactions to the movie. This isn’t a traditional film review; I won’t be giving a play-by-play of what happens in the movie. It’s more a written account of the conversations I’ve had with myself and with others as I’ve thought about the film.

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The first time, I watched it alone while sewing. I found myself close to tears during the birth scenes. They were beautiful and moving. The noises and the movements evoked a bodily memory of my own births. When I watched these women move and heard them give birth, my body knew what they were experiencing.

The film follows eleven couples through their late pregnancies, births, and early postpartum time. While they were still pregnant, they spoke of their hopes and fears for the birth. They were interviewed again after their births and discussed how they felt about the experience. The film also features twelve different birth experts, including obstetricians, family physicians, pediatricians, midwives, academics, doulas, and birth advocates. Many of the names are familiar: OB/GYNs Christiane Northrup and Jacques Moritz, Dr. Sarah J. Buckley, Dr. Marsden Wagner, Ina May Gaskin, Elizabeth Davis, Penny Simkin, Eugene R. Declercq, and Robbie Davis-Floyd. Others might be new to some viewers: Carrie Contey, PhD, Maureen Corry, MPH, Richard Jennings, CNM, Ricardo Herbert Jones, MD, Lonnie C. Morris, CNM, Lawrence D. Rosen, MD, Naolí Vinaver, CPM, and Billee Wolff, RN.

Four of the eleven women give birth in a hospital with wildly different experiences: a first-time mom almost gives birth en route, not realizing that her labor is so far advanced. She commented that the hardest part was laboring in the car, when she could no longer move with her contractions like she could at home. A woman who strongly doesn’t want a c-section agrees to an elective induction and ends up with Pit, an epidural, and multiple vacuum extraction attempts. Another woman has a cesarean section for failure to progress. The other women give birth at home, some outside on their decks, some in birth pools, some in the corner of the shower, some on their beds. We see women squatting, kneeling, crouching, standing, swaying, walking, bouncing on the birth ball, hanging from a birth sling, climbing up and down the stairs. We hear them joke around and moan and sing and grunt and scream and cry.

Several of the women explained what they were thinking and feeling during their labors. For example, we saw footage of one woman screaming as her baby was being born. From the looks and sounds of it, you’d think she was in extreme agony. But the film cut to her explaining what was going on internally: It just felt so satisfying to scream, she said. Giving birth was the most satisfying work I’ve ever done. I loved that the birth scenes often included how many hours or minutes before birth. One woman had a very long labor: 38 hours. You see her laboring at 23 hours before the birth, then 18 hours, then 6, then 1, and then finally you witness the last minutes of pushing. Because you see the hours pass by, you understand that birth is a process that takes time and is sometimes just…slow and tedious and quotidian.

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I watched Orgasmic Birth again a second time a few days later. My emotional response was more muted, and I found myself asking more probing questions about the film: What, exactly, was Debra Pascali-Bonaro trying to say with her film? Why did she choose “orgasmic birth” for the title? Might the idea of orgasmic birth set women up for failure when they actually go into labor and feel the rawness and intensity and pain, not just the bliss and the ecstasy?

I found myself particularly troubled with the word “orgasmic.” I think a number of other words describe more accurately what the filmmaker is trying to communicate in this film: ecstatic, empowering, or transformative come to mind. In our society, orgasmic is always used in the narrow, sexual sense. In that sense, orgasmic birth = having a literal orgasm during birth. But that isn’t really what the film is talking about at all. We do see at least one woman literally having an orgasm during her labor (she said it was very unexpected and quite lovely), but the other women experience something else, something more nuanced and more complex than simplistic sexual climax.

I thought about my own labors and births and there is no way I would label them as orgasmic. There wasn’t anything sexual in the experience. Sensual? Yes. Not in the erotic, titillating sense, but definitely sensual in the larger meaning—an experience involving all of the senses deeply and fully. Definitely ecstatic. Definitely painful and challenging at certain moments, mostly during the last hour or two before Dio was born. Empowering, yes. And normal and everyday too.

I wondered if my rejection of the idea of orgasmic birth was just a case of sour grapes. You know—for me birth didn’t feel like amazing sex, ergo it cannot for anyone else either. But I don’t think so. I totally understand how labor and birth can be pleasurable, enjoyable, and even sexually fulfilling for some women. I enjoy giving birth—not that every moment of it is sheer bliss and pleasure—but the totality of the experience, for me, is quite positive. Just not sexual in nature.

I do know some women in real life who have experienced moments of incredible pleasure (including sexual/orgasmic feelings) during birth, including a woman who I’ve known online for a while and finally met in person at the International Breech Conference in Ottawa. She brought her tiny newborn, not even two weeks old. This third baby’s birth was fast and furious, but twice during labor and pushing, she experienced moments of intense pleasure, much to her surprise. Click here to see pictures of her birth, complete with detailed comments. (Crowning pictures are quite graphic.)

I still find myself troubled with “orgasmic birth.” I worry that that particular phrase (though not necessarily the film) sets women up for failure. I can see women finding the idea intriguing until they actually go into labor. Then, as the raw power of labor threatens to engulf them, they will say: “$#@! This hurts! This doesn’t feel anything like sex! Give me the drugs!” Sex in our culture is also debased and commercialized. I don’t like the idea of linking our casual and sometimes crass attitudes towards sex to something as beautiful and sacred as birth (and I think sex should be beautiful and sacred, but it often isn’t in our culture today).

The other day, I looked up “orgasmic” in the dictionary and found that there is another meaning outside “the physical and emotional sensation experienced at the peak of sexual excitation, usually resulting from stimulation of the sexual organ and usually accompanied in the male by ejaculation.” The second meaning, one not in circulation in our everyday language, is “intense or unrestrained excitement” or “a similar point of intensity of emotional excitement.”

I had an “aha!” moment. Debra Pascali-Bonaro is arguing that birth can be a peak emotional, physical, and spiritual experience. And given the right setting and preparation, birth can include moments of ecstasy, transcendence and occasionally even sexual pleasure. Her film explains the hormonal and environmental similarities between making babies and having babies. If we see birth not as just a narrow equivalent of sex, but rather sex and birth and breastfeeding as a continuum of important and inter-related life experiences, then the phrase “orgasmic birth” makes much more sense. Think of it this way: if women were expected to make love in the same kind of setting that they labor and birth in (in a clinical environment, observed by unfamiliar professionals, monitored and tethered to machines, and above all their biological rhythms forced to adhere to a strict timetable), they would undoubtedly have a high rate of sexual dysfunction and disappointment.

Other thoughts I had while watching the film the second time: I wondered who this film is intended for. It’s definitely a film that people in the “birth world” would love (midwives, doulas, childbirth educators, birth activists, etc). But do we need yet another film that preaches to the choir? Would anyone with a more mainstream or medical view of birth even watch this movie? In other words, does the very nature of the film—and the title in particular—deter the very people who would benefit the most from watching it?

Remember the Today Show back in September that accused home birthers of being hedonistic? I had the thought that, while watching Orgasmic Birth, someone could watch the movie the wrong way and find fuel for that argument. Now, that person would have to ignore about 80 minutes of the film in favor of 5 minutes of material (or not bother watching the film and simply make assumptions about the message based on the title).

The hospital births that were decidedly not orgasmic or empowering or transformative (purple pushing, stranded beetle positions, "doctor knows best" mentality, multiple vacuum extraction attempts, cesarean for "failure to progress," etc) were a bit of a distraction. They showed these excerpts without enough time to explain what was going on and why. And the music, at times, was a bit too obvious in the emotions it was attempting to provoke. You know, the happy Enya-like music for the good parts, the stark, dreary music for the sad parts, etc.

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I watched the film for the third time a few days ago with a group of family members: my husband, my sister-in-law Lisa* (mother of five children, the first three born with Pit and epidurals and OBs, and the last two born naturally with hospital-based CNMs), my brother-in-law Ken*, and his wife Mary*, who is 33 weeks pregnant with their first baby. Mary is seeing a hospital-based group of five CNMs. These midwives have a 7% c-section rate and seem very open to doing births in a variety of ways. Mary would like to give birth without an epidural, so we’ve been giving her lots of advice and suggestions with the caveat that she can take or leave them as she wishes. We kept a running commentary as we watched the film: advice, suggestions, reactions, and explanations of what was going on, which Mary found helpful.

After we watched the film, we had a long discussion about everyone’s reaction to the movie in general, and the phrase “orgasmic birth” in particular. Below is my paraphrase of our post-film conversation.

Lisa (mother of 5, last 2 born naturally): “The title didn’t really fit the film. The overall message of the movie was that birth is normal. The film showed really what giving birth was like for me when I gave birth naturally. And even how they showed those hospital births and how clueless people are and how they just do what their doctors say. That kind of behavior bothers me, and that’s how it was with my first three children. Now I know that my body does know more than what a doctor knows, and that I need to trust myself. If I were in Mary’s situation, I think this is the best movie you could watch. I like this film much more than The Business of Being Born, which was really Hollywood-ized. There’s more nudity in this film and more of the noises of birth—it’s really what birth is like.”

Mary (pregnant with her first): “It was invaluable to watch this movie with all of you, since you've already had several children. I liked hearing your multiple points of view during the movie.”

Lisa on Pitocin: “Pitocin is awful. If someone offers you Pitocin, RUN! Run away from that person. That’s why I got epidurals with my first three because I could not handle the pain once I was on Pitocin. It felt like I was being turned inside out. With my fourth baby [first natural birth] I was really scared because I didn’t know if I would be able to do it naturally. But really for me, the contractions didn’t hurt at all. Pushing did. I pushed my fourth out in a kneeling position, leaning over the back of the bed, which was raised up all the way. The nurse had never seen a woman give birth like that before. The only thing I didn’t like about the movie is that I don’t think birth is a sexual experience. The kissing thing doesn’t make any sense.” (A few of the couples kissed a lot during labor.)

We talked about the less commonly used definition of orgasmic (as a peak emotional experience), and they both totally agreed that that’s the meaning the film is trying to portray.

Lisa commented that orgasm [in the narrow, sexual sense] has nothing to do with birth to her. Linking it to sex, for her, didn't work. Mary agreed. Lisa commented that sex was often talked about as this “dirty” thing when she was growing up. They weren’t allowed to say the words "sex" or "orgasm," let alone have one. Mary commented that sex is often not what it should be and that it has too many negative connotations or implications in our society, so using the phrase “orgasmic birth” almost contaminates the birth. Lisa was pleasantly surprised to find that the film was different than she thought it would be like because of the title. The first few minutes are a montage of women in labor, making very sexual sounding noises (because, let’s face it, labor and birth often sound like that!) and she was thinking “oh boy, what am I getting myself into?!” They both felt that the title “Ecstatic Birth” more closely described the movie’s message. Still, Mary felt the title should stay the same, even though it’s not exactly the right fit for the movie, because it made her think.

Eric commented that he was most moved by the women who found that giving birth was a transformative experience—particularly Helen, who was a survivor of sexual abuse. (Helen was molested when she was 6, and raped when she was 19. She wanted to have her baby in a way that was safe, that was the opposite of her experience of sexuality in the past. She was worried that labor would trigger flashbacks, but giving birth became the most powerful thing that has happened to her body. She said, “I felt myself go away, and this woman who knew how to birth a baby came in. I felt transformed.”)

Lisa: “I now have complete trust in my body, myself, and my womanliness. The film did a great job of showing how birth is naturally. There’s a plethora of emotions in the whole process, from the excitement of first finding out you’re in labor, to impatience when it keeps going on and on.”

Mary particularly liked one husband’s comment about the birth, that “it felt like God was in the room.” She liked that the film communicated that it’s okay to be scared and it’s okay to cry or scream or whatever you need to do.

Towards the end of our discussion, Lisa commented: “Mainstream people aren’t going to watch the movie because of the title, and that’s a shame. How could I tell someone they should watch a movie with that title, especially some of my more conservative friends?”

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It turns out that "Orgasmic Birth" was not Debra Pascali-Bonaro's first choice for the documentary title/concept. She pitched several other titles to media executives, including "Ecstatic Birth," but only "orgasmic birth" stuck. This makes sense of a title that is intriguing and controversial and memorable, but that doesn't exactly fit the content of the film. Her interest in the topic also comes from her own experience giving birth. From the Times Leader of NE Pennsylvania:

The birth of her own third child, 19 years ago, “was an orgasmic experience in the way that dark chocolate is,” Pascali-Bonaro says. “The release, the absolute release, as I felt his body slip from mine, was orgasmic.”

In sum: the birth scenes are incredible and the movie is worth watching for that reason alone. They're not overly romanticized or sanitized. I found them incredibly realistic, in all their variety, about what giving birth normally is like. I'd like a different title, because I think that it will keep many people from watching it, but I also understand the rhetorical power of "orgasmic birth."

* Not their real names. You know who you are!