BORN IN THE U.S.A., produced and directed by filmmakers (and parents) Marcia Jarmel and Ken Schneider, explores the current state of birthing in America – one that is far more medically-based than many experts think necessary. 


Documentary from October 23, 2000 on PBS, now available for online viewing for $7.99.

Each year, approximately four million babies are born in the United States,the vast majority in a hospital with a physician in attendance. Three out of every four Americans becomes a parent, yet most of us know very little about the actual process of giving birth until we actually experience it. Until then, most of what we know is based on hearsay, misconception and TV sitcoms. BORN IN THE U.S.A. was aired as part of the second season of the acclaimed PBS series, “Independent Lens.” “Independent Lens” is a ten-week series showcasing the best of contemporary independent television, including documentaries, features and shorts.

The state of birthing in the U.S. is complex and controversial. While we now routinely use technology that saves countless lives that might have been lost just ten years ago, this technology has also led to one of the highest C-section rates in the world – one in five — and more than half of all births involve some type of surgical or operative procedure.

Are all these procedures necessary? How much technology is appropriate for the average, low-risk woman? Can this technology actually create complications? How does the big business of healthcare and the threat of malpractice impact what choices are available? If we as a nation spend more per birth than any other country, why do we still have one of the highest rates of infant mortality in the industrialized world? Are the full range of safe options – including midwife assisted births at home and in birthing centers — available to all women?

BORN IN THE U.S.A. is the first public television documentary to provide an in-depth look at childbirth in America. It offers a fascinating overview of birthing, beginning with the early days of our country when almost everyone knew of mothers or babies who died in childbirth. As medicine advanced, maternal and infant mortality rates dropped radically. Hospitals were soon promoted as the safe, modern way to have a baby. By the 1950’s, women were giving birth while completely knocked out, while doctors delivered their babies with forceps. With the 60’s and the rise of the women’s movement, women began to question this practice. Today, manyraditional hospitals and physicians are rethinking their policies, midwives are making a slow but steady comeback, birthing centers are opening and people are finding out that there’s more than one way to give birth in America.

The film profiles three caregivers: Joanne, an obstetrician working at a Philadelphia teaching hospital; Heike, a licensed midwife attending home births in Seattle; and Jennifer, a certified nurse-midwife who strives to bring the best of both traditions to a birthing center in the Bronx. Immediate and intimate, BORN IN THE U.S.A. captures the candid reflections of a variety of mothers, doctors and midwives, providing viewers with a fascinating inside look into the world of birthing in America.

The film is available for purchase through FANLIGHT PRODUCTIONS, or 1-800-937-4113. Ask if you qualify for the community organization/independent professional discount.

About the Filmmakers

Marcia Jarmel’s (Director, Co-Producer, Writer) recent film, “The Return of
Sarah’s Daughters,” has screened at the American Cinematheque, The International Documentary Film Festival, Women in the Director’s Chair and festivals around the U.S., Canada, and Australia. It won a CINE Golden Eagle, a National Educational Media Network Gold Apple and First Place in the Jewish Video Competition. She was co-editor and associate producer of the Academy Award nominee “For Better or For Worse,” and assistant producer of “Berkeley in the Sixties” and “Freedom On My Mind.” She is the mother of two boys, 4-year-old Mica and his new brother, Jaden.

Ken Schneider (Co-Producer, Editor) has edited numerous PBS documentaries, including “Regret To Inform,” “Ancestors in America, Part 2: Chinese in the Frontier West,” and “Making Peace: Rebuilding Our Communities.” He was first editor of Frontline’s Columbia-DuPont winning “School Colors” and co-edited Jarmel’s “The Return of Sarah’s Daughters.” He has taught video production and editing at the City College of San Francisco. He was sound and assistant picture editor for the national Emmy-winning “Last Images of War” and is Dad to the aforementioned sons, Mica and Jaden.

The film profiles three caregivers: Joanne Armstrong, MPH, MD, was an Assistant Clinical Professor at Jefferson Medical College and ThomasJefferson University in Philadelphia at the time the program was made. She directed both the Obstetrical Quality Assurance program and a program for drug-addicted pregnant women. She is currently Regional Medical Director for Women’s Health, Aetna USHealthcare and Assistant Professor of Obstetrics and Gynecology at Baylor College of Medicine in Houston. During medical school she spent time in a midwife-run clinic in Tel Aviv and delivered babies in rural Kenya. She has been in practice for 9 years and has helped to deliver more than 3,000 babies.

Heike Doyle, LM, CPM, a licensed midwife in Seattle, who has been practicing for eleven years. Born in Germany and trained in the United States, she is a graduate of the Seattle Midwifery School and has attended over 500 births. A mother of three, Heike catches babies both in client’s homes and at the Puget Sound Birthing Center. Heike is an active member of the Midwives’ Alliance of North America (MANA), has been on the board of the Midwives Association of Washington State, and is a member of the Clinician Workgroup to Integrate Complementary and Alternative Practitioners, a task force mandated by the state of Washington to ensure cooperation among diverse groups of health care

Jennifer Dorhn, CNM, is Director of Midwifery Services at the Childbearing Center of Morris Heights (the first birthing center in the United States to serve inner-city women of diverse backgrounds). In the 10 years since the Center opened, more than 2000 babies have been born in this out-of-hospital birthing center run by nurse midwives. Jennifer also is Program Director of the Nurse Midwifery program and Assistant Professor of Clinical Nursing at the Columbia University School of Nursing in New York, and works internationally, particularly in South Africa and Nicaragua, to develop health care options for women. She is also the mother of three wonderful children.


  • Three out of every four Americans becomes a parent.
  • Childbirth comprises 1/5th of all health care expenditures in the U.S.
  • The U.S. spends more per birth than any other country, and yet, has one of the highest rates of infant mortality in the industrialized world.
  • African American babies are two to three times more likely to die in childbirth than their white counterparts. The mortality rate for African American mothers is four times higher than for whites.
  • Today more than one out of every five U.S. babies (22%) is born by cesarean section, despite the 15% benchmark set by the Center for Disease Control (CDC) in 1990. Well over half of all American births involve some type of surgical or operative procedure — cesarean section, episiotomy, vacuum extraction, and forceps.
  • A variety of technologies have become standard procedure in American
    births without being studied conclusively for efficacy or risk. For example: electronic fetal monitoring is used in nearly all births, even though medical trials have shown it increases the likelihood of a cesarean section and does not improve fetal outcomes in low-risk women. Doctors cite custom and the threat of lawsuits as reasons.
  • A 1998 CDC study concluded that midwives cost less than physicians and have at least as good, if not better, outcomes for low-risk women. In Western countries with better infant outcomes, midwives catch over 70% of babies. Here in the U.S., midwives attend only 7% of all births.
  • Experts suggest that between $13 and $20 billion a year could be saved in health care costs by developing midwifery care, demedicalizing childbirth, and encouraging breastfeeding.
  • The American medical community has never supported midwifery as an
    independent profession despite its exemplary track record, and has a long
    and vocal history of opposition.
  • In 1999, the National Organization for Women (NOW) voted for the first time to expand its definition of reproductive rights to include choice of birth attendant and setting. Nevertheless, the conditions of childbirth are rarely part of the dialogue about women’s health.

PatchWorks Productions
Ken Schneider and Marcia Jarmel, Producers
430 Steiner Street #8 San Francisco, CA 94117
(415) 626-9902 (voice) (415) 626-4767 (fax)