Wednesday, January 27, 2010

Interview with Debra Pascali-Bonaro, filmmaker of "Orgasmic Birth"

I had the pleasure of interviewing filmmaker Debra Pascali-Bonaro about her recent documentary Orgasmic Birth (please see my review of the film if you haven't yet watched it). After you read the interview, please leave comments, questions, or thoughts about the film, the issues it raises, etc. I'd love to hear from you!

Rixa: Please tell us more about yourself and your background. How did you become interested in childbirth?

Debra: I have always had a fascination with childbirth, even from a young age. I was fortunate to have the birth stories of my great grandmother, grandmother and mother all being very positive. At 16 years old, I volunteered to be a candy striper at a local hospital with the hopes that I could see mothers and babies in labor and delivery. They never let me in, and I would always pass the double doors to labor and delivery and linger, hoping I would get a glimpse of a birth. I first went to Villanova University to be a nurse, thinking this would surely allow me to have time with birthing women. I became very disillusioned when I learned about all the techniques and medicalization of birth, and I transferred to education. When I had my own birth experience, I was shocked how hard I had to fight to have the birth I wanted in the hospital, and this began my journey becoming a childbirth educator, doula, doula trainer and international speaker in maternity care.

Rixa: What prompted you to produce this documentary? 

Debra: The vision to produce Orgasmic Birth: The Best-Kept Secret came to me in a dream. I was consciously very upset with the way the media portrayed birth: always an emergency waiting to happen! I had never considered using the media to give a more accurate message. I didn’t know anything about cameras or making a movie but I awoke one night with a vivid dream of making this film. What I needed to do was clear and my quest began to find the people who would work with me to make it happen. I knew I had only six degrees of separation from the right people. I asked everyone if they knew anyone in film. I took some courses and held my vision strong. The right people began to appear, each bringing their time and talents, and Orgasmic Birth was born. There are so many magical stories about how this happened. This experience has literally taught me to follow my dreams.

Rixa: How have your own birth experiences influenced the way you understand pregnancy and birth? 

Debra: I feel very blessed that I have had three wonderful, challenging and rewarding birth experiences. They surely have contributed to my passion to share about all that is possible in birth so that women and men can make informed decisions: where, with whom, and how they want to birth.

Rixa: I would argue that the title “Orgasmic Birth” does not accurately reflect the film’s core message. I also know that the title has kept many women from seeing the documentary. Why did you choose that title? 

Debra: The title has definitely both helped and hindered; but the overwhelming global awareness of the film is largely due to its controversial title. I really appreciate your review; I feel as you do: that the dictionary definition in the broad sense is how the word “orgasmic” is used in our title. Orgasmic is defined as the “intense or unrestrained excitement” or “a similar point of intensity of emotional excitement.” If you Google the word “orgasmic,” it provides examples such as, “a show reaching an orgasmic peak,” and “the chocolate was orgasmic.” People are using the word “orgasmic” in the broad sense and it is used by the media, but the use of the word “orgasmic” with the word “birth,” has created the greatest challenge. I question why we are so comfortable talking about pain and difficulty with birth. Yet we are uncomfortable to discuss that birth could bring feelings of emotional excitement, pleasure, and bliss. Why does this create such a challenge?

Orgasmic Birth was not our original title; our working title was “an ordinary miracle” and our second title was “ecstatic birth.” But these titles were “safe” and would not have created the media coverage or the great discussion that Orgasmic Birth has created. We do realize that there are some people who have not seen the film because of the title. To them we say, “Please, keep an open mind about what is possible during labor and childbirth.” The title has generated an important awareness on the hormones and sexual nature of birth along with the many alternatives to typical cookie-cutter hospital birth plans. It has also brought an increased awareness among women who are pregnant about the services of doulas and midwives and the many benefits they offer to the process.

Rixa: Would you ever consider changing the title?

Debra: To change the title now, in reaction to those who may be offended by associating the words “Orgasmic” and “Birth,” would be caving in to the uninformed. We need to up the discussion about birth in a new way. If we talk about birth the way we always have, we get the same results. And it is evident that our outcomes are getting worse, not better. I heard someone say that the definition of insanity is doing the same thing and expecting different results, so I don’t want a title that fits our current paradigm. I want people to explore their pre-conceived notions, to take risks, and to see the fullness of what birth can offer. I don’t want to offend anyone; I want every person to have all the information they need to make the best possible choice for themselves and their babies. As Roberta Scaer says, “If you don’t know your options, you don’t have any.”

Bottom line on the title though: the film has actually only been out for one year. Looking back, it’s been a challenging year in some ways, but we’ve also had a year of tremendous strides in the field of childbirth education and awareness. As “Orgasmic Birth” becomes more established as an authoritative resource tool, the recommendations and support continue to grow. The increased awareness and familiarization has helped to dispel many of the original negative title-related impressions we experienced. Not that they don’t continue to arise, but we’ve progressed from the common initially posted feedback of “WTF?!” to where virtually all postings are informed, curious and/or complementary. We believe this positive awareness will continue to grow in the years ahead and negative impressions will continue to diminish as recommendations increase from each wave of new moms.

Rixa: Some women have argued that a focus on orgasmic birth is inherently flawed—that what makes birth so rewarding is overcoming an incredibly challenging experience. For example, one blog reader commented: 
My two births were incredibly, incredibly painful from start to finish—and frankly, the pain is what made my births so meaningful. I was incredibly proud of myself for getting through that kind of pain and not giving up and giving in to drugs. If I'd had a pleasurable and/or orgasmic birth experience, I don't think birth would have been as meaningful, empowering or transforming. Kind of "I'm a woman, and I am STRONG!"
How would you respond to her question?

Debra: I would congratulate her and agree we each need to face our challenges. These rites of passage are what help us define our strengths and ourselves. I could not agree more that is the gift that birth holds for us. I would ask her if, with all her challenges/pain, she had a moment of pleasure — would that have really diminished all of it? Could she not have, as many women do, pain and pleasure at different times and still feel a great sense of pride and accomplishment? If another woman faces her fears and challenges and has pleasure too, why can’t we hold both and honor that each of us has a unique journey? I am always surprised how birth becomes a competition among women. Why do we want to hold other woman to our values and experience? This does not honor our unique abilities. Even with one woman giving birth several times, each birth experience will be different and unique. I would like to see us honor all women’s birth experiences: medicated, undisturbed, c-section, and orgasmic. To acknowledge the full spectrum of possibilities and respect each woman’s decision and journey. That was my goal in sharing many different birth stories in Orgasmic Birth as I know when women are respected, supported and allowed to experience birth in the fullest way they want, there is a sense of pride, strength and wisdom that is attainable by all. As Trisha says in our film: "I am so proud and I don’t mind telling the world I am so proud of myself." This is what I hope all women feel.

Rixa: What would you say to women who did not have an orgasmic or ecstatic birth, especially when it’s something they prepared for but did not experience? 

Debra: I would say that you cannot “plan” for any specific aspect of birth...but rather you create preferences, a vision, and wishes. Do your homework. Has your provider supported births like this before? How often? What are his/her rates of interventions? Is you provider offering the experience you are looking for? Many times we have wishes for birth: it is like going out for Italian food, but finding yourself at a Thai restaurant. Find out what things will help you achieve an easier, orgasmic birth – water, a doula, massage, privacy, darkness, touch, etc. – and make sure these are available to you. Birth does not always go as planned, but I hope with support, respect and nurturing it still can be a special, memorable experience. Birth is stepping outside the confines of ordinary knowing, and allowing ourselves to experience the fullness of the moment. I love this quote:
An Ode to Faith
-by Patrick Overter

When you have come to the edge
Of all the light you know,
Into the darkness of the unknown,
Faith is knowing that
One of two things will happen,
There will be something solid to stand on,
Or you will be taught how to fly.
Rixa: Would you say that orgasmic birth is what we should have, or just something that women can experience?

Debra: I think it is a part of the spectrum of possibilities…something that some women experience. As women are reporting to me, orgasmic births can range from 10 – 20% of all undisturbed births. Add to that, descriptives such as pleasurable, blissful…and that number goes higher. I wonder how many more women would have pleasurable births if they knew it was possible, if they were in a safe, secure environment, and if they hired supportive providers. I would never say any woman should have a specific type of birth experience; this is for her to define for herself and her baby.

Rixa: If there was one thing a woman could do to prepare to make her birthing time orgasmic/ecstatic, what would that be? 

Debra: Have confidence and trust in yourself, your body, and birth. Relax and allow yourself to surrender to the sensations just as you surrender to orgasm. It is in the totally letting go that you can find your way to a pleasurable place, an ecstatic, orgasmic state.

Rixa: What role does the location of birth play in facilitating orgasmic or ecstatic births?

Debra: As Ina May Gaskin, the famous midwife says: “the energy that gets the baby in gets the baby out.” I would agree that an environment that you would find safe and satisfying for a romantic evening is the same environment you will open up easiest for birth…so having said that, each woman must choose the place she feels safe, private and can release her fears and give birth. Many women find this in their own homes, or in a birth center. Sadly today, it is the rare hospital that provides this type of environment to help make birth easier. Hospitals focus on controlling and knowing what is happening every minute so they can intervene. This approach to intimacy would not work. If they were observed by strange people and machines, how many women would relax and enjoy their sexuality? It is possible to create an intimate, safe space in a hospital, and I hope that more hospitals look at what they can do to change the atmosphere and approach of birth to one that honors that birth is a normal, healthy function. Providers should be like a life guard: there when needed, but silent and not disturbing when all is normal. Until this happens, it is rare to have an ecstatic/orgasmic birth in a hospital. Many providers who have seen our film are talking about changes they can make in the hospital to help make ecstatic/orgasmic birth possible.

Rixa: Do you feel that the presence of male partners contributes toward or detracts from women's ability to have ecstatic or orgasmic births?

Debra: This depends on the woman and her relationship with the male partner. In our film, you see many very connected men who, by protecting the space, nurturing and caressing, help the women to have pleasurable, satisfying births. Yet I know of some women who shared their orgasmic birth experiences with me and they were alone or with other women. So I don’t think there is a specific way; it is what a woman feels comfortable and safe with. I believe there are many benefits of a genuinely involved male partner in all phases of pregnancy, from the moment a woman discovers she’s pregnant through childbirth. More and more studies are showing a direct correlation between involved pregnancy partners and involved husbands and fathers. Connected partners create stable families together. That connection doesn’t just happen. Partners need to learn how to grow together into effective parents as they transition from being just a couple into becoming a family. Just like motherhood, fatherhood begins at conception too. Thankfully, there are many emerging resources to help prepare men and couples, as well as resources to help women better understand men.

Rixa: Have you witnessed births in which the mother and her partner come away with wildly different perceptions—perhaps the mother felt it was very empowering, while the father thought it was traumatic and scary, or vice-versa?

Debra: With my role as a doula, I find that if this is happening during birth, I can address the woman and her partner/father’s concerns in the moment, support them, and help them with tools so that in the end they are both more likely to feel positive about their experience. Doulas allow everyone to participate in the way that best serves them, while ensuring they have good information and positive communication with the whole care team. So I have to say, I have not had this experience where after the birth they would feel so differently.

Rixa: Here’s a question from a family physician: “What can a birth attendant do to help promote an ecstatic birth for her clients? When interventions are needed (or, as in my fairly mainstream practice, merely wanted), how can we preserve a woman's ability to feel in control and in charge of her birth?”

Debra: Birth attendants can help by creating as much privacy as women want. Knock before entering the room, so that it is her space. The Lamaze Healthy Birth Practices are important to incorporate for having a pleasurable birth. Allow labor to begin on its own, use freedom of movement to labor in positions that are comfortable, give birth upright and avoid unnecessary interventions like IV’s and continuous monitoring. I would also encourage the use of warm water and doulas as an addition to the team.

I would encourage women to submit their birth preference and to discuss them ahead of time so they have realistic expectations of what is possible and what your style of practice is like. We know that when women participate fully in decision-making, they feel more positive about their birth no matter how it unfolds. I would encourage you and your colleagues to provide the time for women to fully understand their options, including waiting, and all the alternatives. Give women time to discuss their choices whenever possible. Providing women a full range of choices in an environment that supports active, passionate birth is a great start in having an ecstatic birth.

Share your confidence in birth and women’s’ ability to have an ecstatic, orgasmic birth. Providers' beliefs can be felt as women in labor feel the attitudes of all around her. How can she believe in herself when a provider she respects appears nervous, cautious and doubtful?

Rixa: What was your favorite part about making the movie? What is your favorite part *in* the movie?

Debra: My favorite part was filming the births and being a part of birth in this new way. As a doula for 25 years I had attended hundreds of birth, but filming and seeing the whole team and birth in this new way was very special for me. I don’t know that I have a favorite part in the movie. Each person and scene has a very special story and place for me. I would have to say the story that I felt was so important to include that I could not have finished the film without was Helen’s. As a survivor of abuse, her story of how birth transformed and healed her is an important part of our film. Birth can be transformative for every woman. For women with a history of abuse, the way they are cared for, respected, supported and nurtured can offer a special opportunity for healing.

Rixa: What kind of issues/surprises did you run into during the film’s creation?

Debra: Not knowing anything about making a film, the whole process was a learning process and one I really enjoyed. It was full of surprises, most good. The hardest part for me was when the film was finished and I realized I had to learn how to market and distribute a documentary.

Rixa: Did you have a clear vision for the film’s narrative and organization before you started filming?

Debra:  No, I wish I did. But in a documentary you don’t know what the film will be until you film and see what you capture. This truly was a film that was created before our eyes as the stories were born. Of course once we had the stories we did have a vision for the overall message we hoped to weave in, and I feel that came through.

Rixa: How do you feel that your crew and equipment, however discreet, affected the births you filmed?

Debra: Since I filmed most of the births myself (and/or another experienced doula), there was just one person present and she really knew birth. I did everything I could not to disturb the birth in any way. I felt we did not affect the births much if at all. I was called a doula by one couple; you may have noticed that in the film. So, by smiling and offering words of encouragement, by expressing my own belief in the magic and sacredness of birth, I feel I did all I could to honor their experience and not let the camera alter the experience.

Rixa: I am intensely curious about what more “mainstream” audiences thought about your film. Please tell us more about the range of people who have come to screenings, and how they have reacted to your film. 

Debra: Our film has shown in 40 countries now and we have had a very broad range of people who have seen the film, from young teens to great-grandparents. Of all the screenings I have attended, I have had so many positive comments and feedback, with very little criticism. Audiences laugh, cry and feel they have witnessed something they have never thought of or experienced. Many people stand up and share their birth stories, both positive and yes orgasmic. Others wish they had seen the film and known more before giving birth so that they would have made different choices. I find it is those who have not seen the film that offer criticism about the title.

Rixa: What has been the most surprising response to the film?

Debra: Most surprising was a room of physicians who cried. They had a long discussion after about reclaiming ecstatic, sacred birth, as that is what drew them to obstetrics and they feel they have lost in the over-medicalization of birth.

Rixa: What is the most common reaction?

Debra: It is hard to find the most common response. I would have to say it is thankfulness for creating a film that challenges our ordinary beliefs about birth. There is always a thank-you for having so sensitively included Helen’s birth story (she is a survivor of sexual abuse). It is a surprise that many people did not expect in the film and yet that moves them deeply. And lastly the question "what is next?" We are scripting our next film and it is not Orgasmic Birth 2. It is about reducing disparities in maternity care, improving outcomes, reducing costs and increasing satisfaction. We are currently fundraising to begin filming in the U.S, Canada, UK and Mexico. If you would like to donate to our next project, please contact me at

Our book, Orgasmic Birth: Your Guide to a Safe, Satisfying and Pleasurable Birth Experience, is available now for preorder. Coming soon we will have a 52-minute version of the film that will be broadcast in many countries around the world. I am dedicated to continuing to bring our message out to help women and men reclaim birth, to let the secret out that birth can be safe, satisfying, pleasurable even orgasmic.

Thank you very much for your questions and for taking the time to share your thoughts and ideas so that together we can improve care and create awareness of all that is possible in birth.


  1. Well I will say that after reading your review and reading this interview, I really, REALLY want to see this film!

    I also have always loved the title because I, too, find it provocative. The title forces a "double-take" if you will, gets people thinking and challenges our perceptions about birth and what is possible. I also appreciate the versatility of the word "orgasmic". I did not have an orgasm during any of my births but I would definitely describe my last birth that way. It so far exceeding my expectations based on my previous births that it was unreal. I could NOT stop laughing and smiling when he came out. I still grin ridiculously just thinking about it. It was, in fact, a delicious experience. One of the beautiful things about our language is that it's a living language: always changing a little here and there. I fully support broadening our definitions of orgasm AND "labor/birth".

  2. I really loved Orgasmic Birth a lot. What is really great is the contrast shown between a hospital birth and home births. It really shows how much more relaxed and pro-active the women are when they're birthing at home not pressured by anyone to do anything but be in labor.

    Before seeing the film, I don't know if I was really buying the sexual/orgasmic side to birth, but now I can see now how it can be sensual if you let it be. It just requires the right setting!

    My favorite part about the entire movie was the woman laboring with her husband on her lawn. It was so peaceful - quiet, sunlit, and surrounded by trees.

    Orgasmic Birth lets us know that birth can make you feel powerful and proud and accomplished! That it can be enjoyed, not frightening, and you can feel empowered.

    This was a great interview; Thank you, Rixa!

  3. I loved the film, and this was a great interview, Rixa!

    My only complaint about the film was that it seemed short and could certainly have gone into the idea of orgasmic birth a bit more than it did. But then again, I'm a birth junkie so maybe it wouldn't have felt thorough enough, no matter what. :)

    Great interview.

  4. I saw the film before the birth of my son and it was very encouraging to me!

    Great interview. Thanks for sharing!

  5. I saw the "call for stories" or whenever the site had just went up, about 6 weeks after the birth of my first child (hospital birth, very "standard" and for me, traumatizing). I was quite intrigued because I had, in spite of the numerous unecessary interventions and distractions, experienced something I did not quite know how to feel about - a birth orgasm. It was odd, I felt ashamed, and for weeks I was internally embarassed that my body reacted the way it did to birth - especially under the circumstances. Just READING the future title of this movie, opened my mind and started taking away alot of the secrecy, shame, and confusion of my experience. It's been almost 4 years since my son's hospital birth and in that time I've made a quantum leap in knowledge of birth - partly because of that simple title - "orgasmic birth" and concept that women CAN feel "good" during labor and birth. Thanks for this post, and that was a GREAT interview!!

  6. What a beautiful interview. Thanks so much for the interesting questions. I especially loved the reflection from Debra about a room of physicians who cried after seeing the film! Yes!


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