ITVS Presents "Born in the USA": A Provocative Look at Having Babies in America.

Premiering October 23, 2000 on PBS 

   "Midwifery advocates now have a wonderful tool in `Born in the USA' for
   promoting the midwifery model of care and gentle birthing methods," The
   Birth Gazette.

   "This is the best film on birth in America that I have seen, showing all
   sides, achieving true balance and empowering women and families," Marsden
   Wagner, former director of maternal and child health, World Health
   Organization.

Each year, approximately four million babies are born in the United States, the vast majority in a hospital with a physician in attendance. Three out of every four Americans becomes a parent, yet most of us know very little about the actual process of giving birth until we personally experience it. Until then, most of what we know is based on hearsay, misconception, and TV sitcoms. "Born in the USA," produced and directed by filmmakers (and parents) Marcia Jarmel and Ken Schneider, explores the current state of birthing in America--one that is far more medically-based than many experts think necessary.

"Born in the USA" will air nationally on PBS on October 23, 2000 (check local listings) as part of the second season of the acclaimed PBS series, "Independent Lens." "Independent Lens" is a ten-week series showcasing the best of contemporary independent television, including documentaries, features, and shorts.

The state of birthing in the United States is complex and controversial. While we now routinely use technology that saves countless lives that might have been lost just ten years ago, this technology has also led to one of the highest cesarean section rates in the world: one in five; and more than half of all births involve some type of surgical or operative procedure.

Are all these procedures necessary? How much technology is appropriate for the average, low-risk woman? Can this technology actually create complications? How does the big business of healthcare and the threat of malpractice impact what choices are available? If America, as a nation, spends more per birth than any other country, why do we still have one of the highest rates of infant mortality in the industrialized world? Are the full range of safe options--including midwife assisted births at home and in birthing centers--available to all women?

"Born in the USA" is the first public television documentary to provide an in-depth look at childbirth in America. It offers a fascinating overview of birthing, beginning with the early days of America when almost everyone knew of mothers or babies who died in childbirth. As medicine advanced, maternal and infant mortality rates dropped radically. Hospitals were soon promoted as the safe, modern way to have a baby. By the 1950s, women were giving birth while completely knocked out, while doctors delivered their babies with forceps. With the 60s and the rise of the women's movement, women began to question this practice. Today, many traditional hospitals and physicians are rethinking their policies, midwives are making a slow but steady comeback, birthing centers are opening, and people are finding out that there's more than one way to give birth in America.

The film profiles three caregivers: Joanne, an obstetrician working at a Philadelphia teaching hospital; Heike, a licensed midwife attending homebirths in Seattle; and Jennifer, a certified nurse-midwife who strives to bring the best of both traditions to a birthing center in the Bronx.

Immediate and intimate, "Born in the USA" captures the candid reflections of a variety of mothers, doctors, and midwives, providing viewers with a fascinating inside look into the world of birthing in America.

Little Known Facts about Childbirth in the United States

* Three out of every four Americans becomes a parent.

* Childbirth comprises one-fifth of all healthcare expenditures in the United States.

* The United States spends more per birth than any other country, and yet, has one of the highest rates of infant mortality in the industrialized world.

* African American babies are two to three times more likely to die in childbirth than their white counterparts. The mortality rate for African American mothers is four times higher than for whites.

* Today more than one out of every five American babies (22 percent) is born by cesarean section, despite the 15 percent benchmark set by the Center for Disease Control (CDC) in 1990. Well over half of all American births involve some type of surgical or operative procedure--cesarean section, episiotomy, vacuum extraction, or forceps.

* A variety of technologies have become standard procedure in American births without being studied conclusively for efficacy or risk. For example, electronic fetal monitoring is used in nearly all births, even though medical trials have shown it increases the likelihood of a cesarean section and does not improve fetal outcomes in low-risk women. Doctors cite custom and the threat of lawsuits as reasons.

* A 1998 CDC study concluded that midwives cost less than physicians and have at least as good, if not better, outcomes for low-risk women. In Western countries with better infant outcomes, midwives catch over 70 percent of babies. In the United States, midwives attend only 7 percent of all births.

* Experts suggest that between $13 and $20 billion per year could be saved in healthcare costs by developing midwifery care, demedicalizing childbirth, and encouraging breastfeeding.

* The American medical community has never supported midwifery as an independent profession despite its exemplary track record, and has a long and vocal history of opposition.

* In 1999, the National Organization for Women (NOW) voted for the first time to expand its definition of reproductive rights to include choice of birth attendant and setting. Nevertheless, the conditions of childbirth are rarely part of the dialogue about women's health.

About ITVS 

Unique in American public television, the Independent Television Service (ITVS) was established by Congress to fund and present programs that "involve creative risks and address the needs of under-served audiences, especially children and minorities," while granting artistic control to independent producers. ITVS has funded more than 375 programs for public television since its inception in 1991. For information contact ITVS at 51 Federal St., First Floor, San Francisco, CA 94107; e-mail: [e-mail] or visit the ITVS website at http://www.itvs.org.

"Born in the USA" is available for rental or purchase from Fanlight Productions, 800-937-4113; fax: [phone]; e-mail: [e-mail]; or through their website at http://www.fanlight.com.

What You Can Do

* Encourage your public television station to broadcast "Born in the USA."

* Watch "Born in the USA" with neighbors, co-workers, family, or friends, and talk about what you have seen and how it affected you.

* Visit the website for background and resources about community work using this film (http:// www.itvs.org and use the search engine to find this program).

* Set up a screening of "Born in the USA" at your local community center, clinic, library, place of worship, or at your workplace to celebrate woman-centered birth practices and educate the public about informed choice. Collaborate with other groups (don't forget prospective parents, youth, midwives, medical professionals, insurance providers, women's groups, women's health advocates, women's studies classes, health education classes, childbirth specialists, and the general public) in your community that might share a common interest in childbirth or women's health. Invite speakers and encourage local press to attend. Call, write, or e-mail ITVS for a discussion guide and other materials that can help create a dialogue about the issues.

* Seek out organizations to support you in your efforts.

* Initiate local dialogue in your community newspaper(s) and on your local talk radio stations about birthing options and optimal mother/baby health. Contact ITVS for resources to do this, or look to your local library for background material. Personal stories are usually the best "hook," but editors may also have their own ideas about a story on these issues. Send ITVS clips of stories that illuminate the issue.

* Invite midwives or childbirth educators to speak to your group.

* Contact one of the organizations on the ITVS Resources list (available by calling ITVS or on their website) and find out how you can help make mother-friendly birth choices a reality in your community. Contact the Coalition to Improve Maternity Services (also in Resources) about rating the mother-friendliness of birth services in your area.

* Volunteer to staff a table at community health fairs, state fairs, or other events where women learn about issues that affect them. Contact one of the organizations on the Resources list for materials and information.

* Call and thank your local PBS station for airing "Born in the USA." Let them know that there is an audience for programs about childbirth and women's health issues, and that you appreciate their effort to show diverse points of view.

RELATED ARTICLE: Tips for Working with Public Television

American public television is a network of autonomous local stations that make independent programming decisions based in part on their community, the national schedule available from PBS, local and national events (such as "pledge" and "sweeps week"), and other factors.

Some reasons to contact your station might include encouraging the station to air the program, to encourage them to partner with community organizations to build audience for a broadcast, and to let them know that there is an audience in their community who is interested in these topics.

To reach the station, you generally can find them on the web or you can call them. If you don't know how to reach your station, visit ITVS's website at www.itvs.org/pbssearch. You can also do a search at the bottom of this page using the word "Born" and then clicking "Broadcast" to see if your station's broadcast may already be listed.

Before you call or write your station, think about why this program is important to you and/or your community. Stations are not interested in hearing about nationally coordinated "campaigns" to get a show on the air. They are interested in serving their communities. Think personal and local. Think about how you might help them get the word out about broadcast to people who care. These are the reasons to relate to your station, which will help them make an informed decision about programming which will actually serve your community.

Different personnel at different stations handle public information such as this. Ask to speak with whomever has information about the upcoming broadcast schedule.

If "Born in the USA" is scheduled, thank your station. Provide them with information about reaching your community on these issues. Offer to help, if possible.

If "Born in the USA" is not scheduled, thank your station anyway. Provide them with information about reaching your community on these issues. Offer to help, if possible. By remaining responsive, helpful, and interested, you'll be building bridges that will last beyond this broadcast.

Unfortunately, the reality may be that your station will not broadcast this program. Not all stations put every show on the air, for a variety of reasons. Try not to take it personally. Look into ways in which you could better inform station personnel about how these issues affect your community. Organize a screening for your local public, and then invite the station to come. Accentuate the positive, and work at building better relations. Most importantly, do not attack the station with a letter-writing campaign or negative editorials in the paper, and so on. They are people too, trying to do their job, and can benefit--like all of us--from outreach, education, and inclusion. Future efforts to program this kind of work will benefit from your patience and your courtesy.

For any additional information about working with public television, or to organize a screening, please let ITVS know if they can help. See the Contact List for the appropriate person to contact.