MANA Vice President Sarita Bennett, DO, CPM, recently talked with Gavin Banks, one of the two filmmakers responsible for creating and producing The Face of Birth. MANA is excited to be able to offer the first American screening (of the 54min version) of the film at the annual MANA Convention, "The Spirit of Midwifery", in St. Louis, Missouri, this week. Their conversation, like the film, spanned topics that included the personal and the political.

Sarita: What brought you to your interest in the topics of homebirth and midwifery?

Gavin: Years after experiencing the births of my own two children, I met a midwife who had developed a birth stool to facilitate upright birth. She wanted to produce a film about how to use her stool, but also, more importantly, wanted to impart her philosophy of one-to-one care. While making the film I was staggered to learn the divide between evidence-based practice and what was actually happening (culturally-based practice) in our hospitals. I started looking into how to expose the wrongdoings that result from prioritizing the system's needs above the woman's. Then, in 2008, I met Kate Gorman, another filmmaker, who had returned to Australia from the UK after the home birth of her second baby. She was expecting to find the same availability of birth options in Australia. Because of proposed legislative changes, which would regulate childbirth providers and included a requirement for indemnity – malpractice – insurance, home birth was about to become illegal! What was being made illegal in Australia was being endorsed in the UK. We saw the opportunity for this film and a coming together of our visions.

Sarita: What statements were you hoping to make with the film?

Gavin: We wanted to address the main issues of misinformation around homebirth – and physiologic birth - in general. We wanted to show how wonderful birth could be, without being prescriptive about how women should do it. We were interested in dispelling myths about home birth and talking about what "safety" really means. That a mother intact emotionally, and in a good mental place, is an element of that definition of safety - and not just a live mother and baby, which is, of course, should be a given. In our experience of making and marketing the film, we have seen a stark contrast between women who were well-supported in their births, regardless of how it went, and women who didn't receive that kind of care.

We wanted to stress the importance of informed choice and not just informed consent. The film is deliberate in its construction to reflect different ages and groups and to address major stumbling blocks. The Face of Birth is gentle enough to even be appreciated by women who have had multiple elective c-sections.

We knew these issues were international, so we wanted to make a film that could travel. Until women are put in the center of the discussion, globally, nothing will really change. Everywhere it is a fight to define birth as a normal physiologic event instead of a medical emergency – shouldn't it be the other way around?

Sarita: You have included some eloquent global experts and there are so many words of wisdom woven into the film. How did you choose who to include?

Gavin: We wanted the film to affect people emotionally but with the backing of full scientific fact. Our experts were chosen to address the main issues we had identified as stumbling blocks. Sheila Kitzinger brings an understanding of the psychological impact and potential trauma of failing to respect women's rights or needs in birth. Michael Odent cautions us against unnecessary intervention and encourages us to look to scientific research to understand the implications of current (non evidence-based) medical practice. We interviewed Ina May Gaskin and Robbie Davis Floyd, to understand the impact of US birthing culture on global trends and the implications. And, we included published, Australian experts, aware of the situation in Australia, who were doing research that had global significance. We wanted to emphasize that all around the world we don't really follow evidence-based practice, because if we did, birth would be the same everywhere. What we have, globally, are systems based on professional (culturally-based) preferences.

Sarita: Tell me about the aboriginal midwives that were included in the film.

Gavin: Our trip to the Northern Territory in 2010 was funded by one of the researchers in the film. Because of the relationships formed by some remarkable midwives we were introduced to a number of indigenous elders as well as midwives/educators who worked with indigenous women. While in East Arnhemland, I was privileged to witness (and film) a sacred women's ceremony – something that other men never get to see (but you can now in the movie, with the elders' blessing!) The elder's interviews were just as inspiring.

We then travelled to Utopia in the Red Centre. Communication there is very difficult because it is so remote. We arrived unexpected - the local private health service had gotten the dates of our visit wrong, so nothing was organized! They quickly rallied to our side and introduced us to a local midwife with some connection with the community. We drove to an indigenous women's camp where the midwife introduced us to the traditional midwives and the interview began. The interview was over when the women said "That's enough – you can go now". Life out there is so different; the people's generosity is astounding - the poverty unbearable.

Sarita: What drew you to work with MANA?

Gavin: We are trying to get the film out to as many people as possible and appreciate MANA's mission and vision. Our focus is affecting change and we love midwives and doulas. The childbirth culture won't change until women (and those who care for them) stand up and make noise together. When a finding against natural birth comes out, it is immediately taken as gospel by the media. But when something positive comes out, it's justified away: "that applies to a different people than us, and is not relevant in our case". As a man, I understand that men have had so much negative influence on birth; I want to stand up for change –not to be telling women what they should do – instead, to be highlighting the need to support and respect a woman's right to choose how, where and with whom she gives birth.

Sarita: Tell us about the two videos that are accompaniments to The Face of Birth and about any plans for sequels or future work.

Gavin: In making The Face of Birth, we accumulated many hours of interviews, with both our global experts and the women we filmed. Much amazing content couldn't be used in the film (or it would run too long!). We cut these extra, in-depth interviews into two DVDs/ downloads. One features 3.5 hours of expert interviews, which can be selected by topic, and is called "Meet the Experts". We also made another DVD called "Birth Stories" which is made up of nine short films focusing on the extended stories of nine women, including the women seen in The Face of Birth. The trilogy of the three films has significant educational and emotional value, and allows you to explore the issues more fully.

If there is a sequel, I'd like to go into traditional cultures and talk to indigenous midwives from around the world about the how / what / why of what they do. I'd then find scientists who can explain the physiology of why it works. There is an example of this in The Face of Birth (that is more fully explained in the Birth Stories DVD) - the reeds used in the indigenous 'baby smoking ceremony' actually have an antiseptic property, so the ceremony provides a cleansing for the baby and mom and heals infection.

I'm also interested in episodic TV. Once you have an audience, you can continue to build it. One idea would be to base a series around a modern-day midwifery clinic.

Sarita: Is there anything you want to tell women?

Gavin: Some people think only strong women give birth at home. I believe, as Noni Hazlehurst from the movie states, "All women are strong".

All my life I have been surrounded by strong women - whom I love and respect. Supported well in birth, these women have empowering births. Poorly supported, they, their babies and families suffer unnecessary pain.

Childbirth reform isn't a women's issue, it's a human rights issue. Childbirth culture can change but it will take women (and men) around the world to stand up and demand it together. Please use The Face of Birth to spread the word - to get people excited about what birth can be if (and hopefully when) we support women to birth how, where and with whom they choose.

Learn more about the Face of Birth here.