Tori's Blog

Abby Epstein’s Labor

Sunday, February 7th, 2010

Abby Epstein, Ricki Lake’s co-producer in the film, The Business of Being Born, who was also pregnant, had planned for a homebirth with New York midwife, Cara Muhlhahn. Ms. Epstein was being followed closely by a physician during her pregnancy due to her baby being seriously growth restricted (IUGR). IUGR means that the baby has stopped growing appropriately and can be caused by a number of factors, most commonly a problem with the placenta or a medical condition that has developed.

Ms. Epstein spontaneously went into labor prematurely with her very small, breech baby and, although initially not planning to film it, does so. We see Ms. Epstein laboring at home and being checked by Cara Muhlhahn. Disturbingly, she does not call a back up physician (she does not in fact have one) or initially stress the importance of moving to the hospital. Finally, we see them taking a cab to the hospital with Ms. Epstein in very active labor.

In watching the movie, I was stunned at the lack of concern or alarm expressed with her very real possibility of giving birth to a premature, very small baby, outside of a hospital setting that could safely care for him. In her discussion afterward, Abby Epstein expressed disappointment that she didn’t have the experience she wanted and that she had needed to have a c/section.

Of course her emotions are valid but there is a serious disconnect here. Her baby weighed barely 3 lbs. She now has a healthy son who was fortunate enough to be born in an environment where his medical problems were both known and able to be dealt with. Where is the reality check of what is really most important here? Birth truly isn’t predictable, things really do happen, plans do, very much change. I have to ask, “Is labor and birth really just about getting what we want? About what the “experience” is like?”  Is there not a baby? An incredible human being. A gift. A miracle.

Your Comments

  1. Hi Tori,

    Thanks very much for this post and for your respectful and well-informed approach.

    I’ve been teaching a unit on pregnancy and birth in the USA and we got to interview a guest speaker involved in the film.

    I’m trying to understand Ms. Epstein’s intent in putting the film together the way she did. When you heard her speak, did she address the point of why she both revealed and covered-up Ms. Muhlhahn’s failure to diagnose growth-restriction in the film?

    Relatedly, as another comment mentioned, your previous understanding, “followed closely by a physician during her pregnancy” seems to be inaccurate.

  2. Lynn,
    Thank you very much for replying. I appreciate you taking the time.

    Although I understand that the film was limited in its ability to show all the details of each situation, I have heard Abby speak and she clearly has expressed her negative feelings about her experience.

    I have also read a great deal about Cara Muhlhahn and she clearly states (and has been quoted) that she has chosen to have neither a back-up physician or hospital and has been rather cavalier about the necessity of either.

    Having spoken with one of her clients, whose baby died, I have to respectfully point out that Ms. Muhlhahn’s judgement is lacking in many areas.

    I will correct you in the fact that a baby born at 35.5 weeks is indeed “premature” and “near term” does not change the fact that the baby can have significant health issues at birth. Abby’s baby, being clinically undiagnosed as IUGR, is disturbing from a medical management perspective all the way around.

    I apologize for any misunderstandings that I may have. I do not comment on this matter without having researched Cara Muhlhahn, as well as having personal and professional knowledge and long-term experience in the care of women and babies.

  3. Hello Tori,

    My name is Lynn and I am a rep for My Best Birth. I would just like to address some misunderstandings in this post about the birth of Abby Epstein’s baby.

    Cara Muhlhahn of course had a back-up doctor and hospital. In Abby’s case, they actually had two options since her OB/GYN offered to back Cara up for Abby’s birth, as well as Cara’s regular back-up. Cara called Abby’s OB/GYN, Dr. Jacques Moritz, from Abby’s home as soon as she determined that she was in fact in labor and he agreed to meet them at the hospital.

    Cara knew that the baby was very small and breech and that a hospital birth was necessary. You can even hear her in the movie say that “we have to move quickly.”

    Abby was not being monitored closely for IUGR by her OB. He did not pick up on the IUGR and supported Abby’s decision to switch over to Cara Muhlhahn’s care. The IUGR was not diagnosed until after the baby was born.

    In terms of diagnosing IUGR, Abby had only 2 prenatal appointments with Cara – one at 30 weeks and a second at 34 weeks. She went into labor at 35.5 weeks, which is not premature – it is “near term.”

    In the film, Abby does not express disappointment in having a c-section. She expressed disappointment in being separated from her baby after the birth, in missing the moment where the baby is placed on your chest and you get to bond and rejoice. Abby was very thankful for my c-section.



  4. To me, this attitude taken by mothers, that it’s their body and the completion of conception/the birth experience should be a storybook kind of experience they can control is just the same as choosing to end a baby’s life because it is their body and they want to control conception/the beginning of the birth process. I think this way of thinking represents two extreme selfish human attributes opposite each other on a huge paradigm.

    If I were to really put myself out on a limb and reach that point where I love another as myself, every second of every day, I would do everything possible, regardless of how I became pregnant and why, to make sure that being has their grand entrance into this universe and has at least a chance to live, if only for moments. If I were unable to care for the child or give birth to it in ideal conditions, the universe and it’s Creator/Sustainer would make sure, as long as my senses are focused on this being in me and not my needs and wants, that there would be someone loving to care for this being if it were not me.

    Women, get in the way of what their womb was meant to be. It is the portal of life, not some organ to be abused and misused at her whim. It is not at the height of humanity to end a life which comes in peace even if it was caused by violence. It is not the height of humanity to make sure that your birth experience mirrors that of some fantasy that played out, looks like some scene out of a vintage romance novel found at a trendy mountainside retreat.

    Life is precious either way and it is not to be taken lightly, no matter if you are an ignoramus teenager who gets pregnant and doesn’t have a clue or if you are a rich starlet!
    I am done pontificating.

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