Pregnant in America
The Day the Birth Stood Still

Pregnancy is perhaps the subject least likely to interest me.  I had a vasectomy prior to being married ten years ago, and was even celibate before that.  Due to medical complications, my wife has also had an endometrial ablation, which prevents menstruation.  We are as about as sterile as a couple can get, and a child in this household would be a miracle birth indeed—pretty a propos this time of year.

All of this to explain why I have zero vested interest in following one filmmaker’s tour through childbearing—and why my recommendation of Pregnant in America should be taken fairly seriously.

This decidedly bargain-basement documentary carries the subtitle “A Nation’s Miscarriage,” but don’t be confused: this is not a film about abortion.  It never touches on the catchphrase “pro-life,” and Roe v. Wade is about as far from its agenda as a monster truck rally. 

Steve, Mandy, and Bella, featured in Pregnant in AmericaNo, the thesis of the film is something perhaps more startling: that American business interests really have an awful lot invested in promoting childbirth—and in making it as expensive for you as possible.  The tagline says it all: “Who’s getting rich? Who’s paying the price?”  And the film’s moving answer to the second question is: our children.

One of the producers of the film, Betsy Chasse, serves as a case study for the film.  Having previously delivered a child via Cesarean section, Betsy was told by her insurance company that, given the risks of a second delivery, they would only cover C-section the second time around, despite her wishes to pursue natural childbirth. Potential out-of-pocket costs to Chasse and her husband for pursuing natural childbirth anyway, depending on complications: $40,000.  Instead, Besty and Gordie went to Canada for the delivery—which ended up being by C-section in spite of their best efforts.  Total cost: $10,000.  Do the math. 

Now, it’s truly odd to think that what is completely natural and routine—and expense free—for the vast majority of the world’s mothers can, in America, set you back as much as the cost of an SUV.  But then, it’s odd that so many Americans drive SUVs, and can afford them.

The greatest strength of Pregnant in America, as Steve and Mandy Buonaugurio drive passionately toward delivering their daughter Bella via the most natural means possible (aside from having a movie camera hovering around the whole time, which is far from natural), is demonstrating the way in which Americans tend to take “modern medicine” for granted.  Hospitals are businesses and doctors are, in part, businessmen; but given that we are all so consumed by the business of business, we don’t often stop to think that there are some things—such as human relations, and parent-child connections in particular—that are the furthest thing removed from mere financial transactions.  When you throw in the vested interests of insurance companies, you’ve got the potential for an inhuman scenario intruding on the most human of activities.

Arguably, Pregnant in America is just an overlong commercial for the cottage industry that has grown up around natural childbirth: midwives, doulas, and advocates.  But you don’t have to do much googling around to realize that there’s a lot less speculative dough tied up in that side of the industry than in the other—and director Steve Buonaugurio does a fine job of documenting the many insidious ways in which transactional pragmatism (including the nine-to-five, weekday-only mentality of many maternity wards) drives the childbirth decision-making process.

If you’re planning on having a child soon—and even if you aren’t, but are in a position to become “with child” anyway—you really ought to watch this documentary as part of your “informed consent” process.  There are probably other options than what your OB-GYN and your insurer are willing to share, and they’re well worth knowing about.

On the downside, the film tends to villainize medicine, surgeons, and administrators; but large businesses always conduct themselves in a manner consistent with the demands of their shareholders—and those shareholders tend to be us.  So there’s plenty of blame to go around, and the contemporary practice of American medicine is just a symptom of a much larger problem.  At some point, the world at large is going to have to come to grips with the fact that the scale of health care will become unsustainable.  It’s ultimately not a financial dilemma; it’s a moral quandary—and like the Romanian mother who has to choose between antibiotics for her ten-year-old daughter and firewood for the winter, hard choices will trump entrenched entitlements.

In the meantime, though, if you don’t mind seeing a little too much of Buongurio in his own film, and if you can bear 105 minutes of soundtrack monotony and a bit of really primitive animation, Pregnant In America is not a bad way to spend twenty bucks.  It handles an important topic responsibly, wisely sidestepping political and religious landmines and distractions, and it’s far more personal and warm than a Frontline special report.

Pregnant in America is unrated.  Given that the subject is vaginal birth, there’s naturally a lot of very frank talk about anatomy—but no gratuitous or explicit footage of the same.  I’d say PG-13 would be an appropriate rating.

Courtesy of a national publicist, Greg viewed a promotional screener of Pregnant in America, now available on DVD.