Trial of Labor is a documentary about four women seeking a vaginal birth after cesarean (VBAC). The film is a powerful chronicle of their experiences reflecting on their cesarean births, seeking information about VBAC, navigating care provider and hospital policies, healing their emotional wounds and following them through their births with their current pregnancies.
The film opens with the women telling their labor and cesarean birth stories. Some were induced, others had labors which began spontaneously. They go on to describe their surgical birth experience and what it was like to meet their babies for the first time in the operating room. C-sections are shown in the opening segment as well, including one where a vacuum is used. The women then reflect on their experiences and why they had cesareans – concern for the life and safety of their children, failure to progress, failed inductions prior to 40 weeks and fetal distress indications on an electronic fetal heart monitor. Their fear, shame and frustration are evident as they discuss feeling as though they were not listened to or respected. One woman says she felt very misinformed about labor, birth and the risks of interventions. “What do you say when you doctor’s telling you that you are going to die if you do this any other way than he sees fit? I didn’t want to die,” she says. Another describes herself as “foolish” and expresses anger at the medical system because she felt she lacked a voice and options in her birth. The guilt these women carry is enormous. They talk about how they feel that they didn’t put in the time and effort for a natural birth, didn’t stand up for themselves and how they feel they failed their children and themselves. It is clear that attempting a VBAC is key to their emotional healing from their previous birth experience. One woman describes a trial of labor as the ability “to be allowed the freedom to trust your body”.
About 20 minutes into the film doulas are mentioned. One mother had a doula for her first labor and birth and is using a doula again. Another chose to hire a doula for her current pregnancy and planned VBAC for greater support in the labor and delivery room. This mom goes on to say she chose to have a doula to advocate for her, which we DONA International doulas know is outside of our Scope of Practice. While this particular woman says she wants to be able to make informed decisions in labor, her description of what she is expecting from her doula illustrates that we still have work to do to educate families on our role. Doulas, as non-medical support people, do not say, as this mother expects, “No, you know what, I don’t think she needs Pitocin” or “I think she can get through this without an epidural for a little longer.” Doulas are later mentioned as providing key support to partners, allowing them to process their own feelings as a parent and the conflict they may feel in trying to support the mother’s wishes. Childbirth educators and doulas wishing to show this film to families will want to be sure to discuss the role of doulas as important informational, emotional and physical support providers and be clear that we cannot and do not offer medical advice or intervene between a patient and care provider.
As these women continue on their VBAC journeys they encounter many obstacles, including doctors telling them they had no choice but to have a c-section if they wanted to remain their patients, hospitals with VBAC bans and insurance companies that won’t cover birth center or homebirths for VBACs. The physical and emotional vulnerability they experience is profound. It seems that the confidence they gained as they chose and planned for a VBAC is tenuous and easily eroded by their care providers. As one mother put it, “It feels like they just set you up to doubt your decision; start to feel that you are putting your baby’s life at risk, being completely outrageous.” The mothers face looming deadlines for non-stress tests and ultrasounds and pressure to go to the hospital in early labor based on their doctor’s concerns regarding VBACs. The film also includes brief interviews with physicians who discuss the liability risk they feel is inherent in VABCs.
In the end, these four women gain a great deal of healing from their trial of labor experiences even though not all have vaginal births (I won’t spoil the ending for you!). One woman describes her trial of labor as “very healing” and another says she now knows there is a choice. You can see that, despite their very real fears of reprisal, for going against the preferences and recommendations of their care providers, these women, in their own words, feel “strong,” “powerful” and “empowered” by the experience.
One of the final interviews in Trial of Labor says it best when the mother reflects on how it doesn’t matter if a mother births vaginally or via cesarean. As she says, “What matters is the mother you are after that birth happens”.
Trial of Labor is an intense chronicle of the experiences of four women seeking a vaginal birth after cesarean. With additional conversation about the true Scope of Practice of doulas, it can be a powerful film to share with families. Even first time mothers can learn a great deal from the movie about the power of information, self-advocacy, a support network and choice. The film is currently screening across the United States and free viewings via their website are also available for a limited time. Find out more at trialoflabor.com.
— Adrianne Gordon, CD(DONA), MBA