Roger Ebert Home

The C-Section in American Movies

Remember the last childbirth scene you saw in an American movie? Was it a C-section? They are very common in this country, accounting for 33% of births, a percentage considered either too high (compared to Finland’s 6.6%) or not so bad (compared to Brazil’s 80% to 90% private hospital rate). But even though C-sections are not rare occurrences here, childbirth scenes in American movies are uniformly vaginal: “Juno,” “Stagecoach,” “Knocked Up,” “Baby Mama,” “Apocalypto,” “Nine Months,” “The Women,” and (natch) two in “What to Expect When You're Expecting,” to name only a few. Even far into the future it’s still de facto, most absurdly in “Star Trek” (2009), where the “beam me up” technology that can seize onto a person’s coordinates and transport them someplace else is completely forgotten while Kirk’s mother struggles through a vaginal birth. Luke and Leia are delivered vaginally, too, by a medical droid in “Revenge of the Sith.” (Their mother didn’t know she was carrying twins, which suggests that in the Star Wars universe there’s hyperspace but no ultrasound.)

Twins are not the only kind of high-risk pregnancies that would be a candidate for C-section anywhere in the US except in the movies. In Jason Reitman’s film of the same name, Juno is a teenager, a demographic more susceptible to eclampsia and prolonged labors, and, unless they deliver their babies prematurely (another teen risk factor), their immature pelvises are sometimes not big enough. The petite Juno has a full-term, full-weight, vaginal birth. The teenage mother in “Children of Men” does the same, assisted only by someone who’s not a midwife. In "Precious: Based on the Novel Push by Sapphire," Precious delivers two babies (one off-screen) even though being obese, being a teenager, receiving no pre-natal care, and, to America’s great shame, being African-American (did you know there is a staggering 243% difference in maternal mortality rates between white and Black Americans?). And even though the AMA has no protocol for delivering demonic fetuses, even Rosemary’s baby was a successful (albeit heavily sedated) vaginal birth. At least they delivered pregnant Arnold Schwarzenegger’s baby in “Junior” by C-section. The other character who was expecting, however—the movie’s real woman—didn’t need one.

Vaginal deliveries in movies can be comedic, like the birth scene in “Monty Python’s The Meaning of Life,” or in “Nine Months,” or “Knocked Up,” or “The Dictator,” or “Ace Ventura 2,” or “Big Momma’s House,” or the homebirth in a kiddie pool in “The Back-Up Plan,” or even the birth of a cute little tentacled alien in “Men in Black.” When C-section births do occur in movies, however they’re overwhelmingly horrific. The shock of medical footage spliced into Dwain Esper’s geek-show exploitation movie “Maniac” (1934) was just the beginning of a tradition of hideously gory ones in horror movies like “Prevenge,” “It’s Alive,” “Inside” (performed with scissors), “Devil’s Due” (self-inflicted), and “Mad Max: Fury Road” (post-mortem). Not only does “The Clinic” have a C-section, but the “I” in its movie poster is a (very undersized) C-section scar. Bella has her half-vampire baby by screaming, bleeding C-section in “The Twilight Saga: Breaking Dawn - Part 1,” but even harder to take is the brutal and claustrophobic C-section in “Prometheus,” where a woman subjects herself to an unanaesthetized extraction of an alien fetus inside a futuristic surgery capsule, as automated lasers cut through her belly and forceps shaped like an arcade claw machine grip rip an alien out of her abdomen. (It can be argued that this is more accurately an abortion, but the machine’s surgery sequence, from long cauterized incision to staples, is identical to how C-sections are done.) And what about the aftermath? Rachel the replicant dies from an off-screen C-section in “Blade Runner 2049.” By the time we join the story, there’s nothing left of her except her genetically engineered bones in a box buried under a tree.

Why are C-sections so stigmatized in movies? The stretch of a theory is that directors would prefer to take sole responsibility for how they “deliver” a film, and don’t like to think about how cutting—the editor’s job—is really part of what births a movie. But that’s a laughably tenuous explanation, and the real answer is more obvious. A C-section is a dramatic lead balloon. A protagonist’s response to challenges are the cornerstone of good drama. If a character is pregnant in the first act, then the obvious resolution to her story is to rise to the difficult task of birth by the third, emerging heroically at the end having conquered her challenge. The effort and struggle and noise of vaginal birth looks better on screen than the woman’s anesthetized passivity in a C-section. Most significantly, having someone else (i.e. a doctor) solve a character’s climactic problem is too deus ex machina to make for satisfying drama. These are logical reasons, but to impose these Hero’s Journey conventions as a cultural myth upon real-life childbirth experiences does a disservice to women who've had C-sections. There's no narrative of triumph in the culture where they can see themselves represented, and the repercussions of that lack can be more than just hurtful—they can be catastrophic.

When I became pregnant for the first time, I had been working the film critic beat for three years, which meant seeing about a hundred movies a year and thinking critically about their subconscious underpinnings. I had many reasons for deciding to try for a homebirth, but in retrospect my career had exposed me to this cinematic myth so much more than it would to a casual moviegoer that it had accumulated in my system like a toxic metal by the time I was ready to deliver. The homebirth midwife who presided over my attempt kept me in labor for 90 hours, all the while telling me this was “a natural part of the process”. (That’s three days and nights. I could have had three babies in that time.) I ultimately had a healthy baby by emergency C-section in the hospital, but by then I was a beaten and traumatized wreck.

The symptoms of PTSD started almost immediately. I was desperately exhausted but could not sleep because I was being battered by flashbacks. I could not walk through the maternity section of clothing stores or attend family member’s baby showers without having a debilitating, shrieking panic attack. Worst of all, going back to work and screening vaginal childbirth scenes in movies I had been assigned to cover only twisted the blade. My fragile mental state and the stress and sleeplessness of caring for a newborn exacerbated my post-partum depression, and finally after five months of this torment I was up in my kitchen at 3 am, putting a knife to my wrist. The only thing that stopped me was knowing it would hurt, and I did not want to hurt again. Eventually I had a nervous breakdown and had to move in with my parents, and the whole ordeal was the beginning of the end of my first marriage. (I never sued the midwife, but I did take satisfaction in hearing years later that she had her license suspended for other acts of gross medical negligence.)

Even now, the words stick in my throat if I say I “gave birth” to my child. Deep down I believe that I did not, that I failed that test in some primal, animal way. I was devastated when I was informed by my obstetrician that the elusive VBAC—the vaginal birth after C-section—was not in the cards for me for my second pregnancy nine years later. But this C-section was miles away from my first experience. The hospital was courteous to my trauma, even when I was shuddering in speechless terror entering the operating theater. A planned C-section is a much more careful and relaxed affair than an emergency one, and I was pleasantly shocked at how it was no nightmare this time around. The movies may have told me that a C-section is synonymous with horror and death, but I can tell you all about horror after being in 90 unnecessary hours of labor for a delivery that should have been a C-section in the first place. And, to my deep gratitude, I can't tell you about death, because my babies survived, and so did I. A C-section can be a good birth. I want movies to see it the same way.

And rarely, sometimes, they do. One of the storylines in “What to Expect When You’re Expecting” is about an (unexpected) C-section, and the screenwriters even find a way for it to be an essential part of the character’s arc, as she triumphs not because she got the birth she wanted but because she grows to accept and welcome motherhood’s unpredictability. And no discussion of this topic is complete without “She’s Having A Baby,” John Hughes’ sentimental drama about a young man (Kevin Bacon) struggling at the liminal crossroads between his exuberant youth and the adult responsibilities to home and family that he’s entered into with his wife (Elizabeth McGovern). This movie’s emergency C-section is discreetly hinted at by one-second shots of a doctor picking up a scalpel and a pea-sized drop of blood hitting a hospital floor, speckled through a montage of the husband’s memories of his wife and their efforts to build a home together, and set against the Kate Bush song “This Woman’s Work.” See, Hollywood, it can be done.

So, what do I want for Mother’s Day? I just want one normal C-section in a movie. Not a horrific one. Not an emergency one. Not even necessarily a climactic one. A matter-of-fact one—maybe even a funny one!—and a mom all sewn up and doing fine and happily holding her baby when it’s done. Like how it happened for a third of all the American moms you know, the women in your life who need to see what they went through as just as climactic and important as any other birth, who need to believe they are heroes of their own story, especially while they’re still sewn up and doped up and recuperating. Maybe they’ll turn this movie on at 2am while trying to stay awake and nurse. I think they deserve something nice, don’t you? I could have used that a decade ago. For the new moms, it’s not too late.


Latest blog posts

Latest reviews

Hard Miles
Under the Bridge
Irena's Vow
Sweet Dreams


comments powered by Disqus