A father + husband's critique
I just finished the documentary -- As a husband, father, and soon-to-be father for a second time, I was very interested in it. I've been through the process twice and am convinced that the medical establishment maximizes visits, tests, and procedures to maximize their profits from paying patients, to offset their losses on non-paying or Medicaid patients. I have a certain anti-establishment bias, so I thought the documentary would be preaching to the choir.
That being said. I was disappointed in the documentary and found it incredibly biased and unconvincing. Some of my problems with it...
1. I found the statistics to be incredibly misleading. One of the reasons why the USA has such disproportionately high infant mortality rates is because of the prevalence of neonatal units. An extremely newborn baby in the USA who dies would be considered an infant death, while elsewhere it would be considered a miscarriage. The definition of a "live birth" varies considerably from country to country.
One of the primary reasons why mid-wives have such high success rates is simply because they take low risk patients. This results in an inherent sampling bias.
2. It completely ignored the role of fathers and husbands. Child birth is an emotional and painful time for a woman but she isn't there alone up against the medical experts. It's the job of the husband to be her advocate, motivator, and emotional support in the process. This is the same whether the mother goes to a midwife or a hospital.
3. It focused on the absolute worse case situation with obstetricians. In most situations, the goal is to have the same OBGYN who handled the prenatal care perform the child birth. It isn't an anonymous experience and you build up a relationship over the course of 10 months.
I think the documentary made many important points (as echoed by other posts in this message board) but it felt more like something from a trade show or lobbying group than an unbiased analysis of obstetrician vs. midwifery.