Interview with Cara Muhlhahn: America's most famous midwife tries to sell us on home birth.'s Five Minute Time Out.


If your idea of a midwife is a quirky old lady who’s stuck in the ’60s, than you need to meet Cara Muhlhahn. Muhlhahn is a Certified Nurse Midwife with over thirty years of clinical experience. She is also a mother, a jazz singer, a salsa dancer and a multilinguist. Featured in the eye-opening film The Business of Being Born, Muhlhahn is a vocal advocate for homebirth and for redefining the role of the midwife in American culture. Here, we discuss stereotypes about midwifery, what she takes issue with in the film, and what she really wanted to call her memoir. – Lindsay Armstrong

I heard that since The Business of Being Born was released, women have started scheduling their pregnancies around when you’re available. What kinds of reactions have you’ve gotten to the film?

[Laughs] I haven’t heard that particular fact yet, but all of the homebirth midwives’ practices have pretty much doubled since that film came out – in the New York City area, but not only there. Everybody is busy, busy, busy! Women who had not previously considered homebirth are definitely being inspired by it.

When you first considered taking part in the film, you were wary of how midwifery might be presented. What stereotypes do you usually encounter about midwifery?

People look at me and say, “You’re a midwife?” And just from one look, I know what they’re thinking. The visual stereotype of a midwife is someone who is old and overweight and kind of quirky, not a modern person. That distinction stands, I think, even in the educated person’s mind. The other stereotype has to do with the idea that midwives don’t know how to make clinical judgment calls. It’s very harmful and not true.

The other night, for example, I had a mom at home. She was only in labor for about three hours when she started having some very subtle signs that something was going wrong. I put an IV in, walked her to the car, and drove her to St. Vincent’s Hospital. In fifteen minutes flat she was in the labor room and she later had a Caesarian section. Everything was fine, but she needed the C-section, so I made the right judgment call.

That’s what I was so happy about in the film. There were many midwives in that movie and each of us looked like modern, scientifically and clinically prepared medical professionals, but hopefully ones with a lot of soul! [Laughs.]

The Business of Being Born has generated some very strong reactions, both positive and negative. One of the experts interviewed in the film implies that women who have C-sections may have a harder time loving their children. Many of us at Babble were surprised and offended by that. What is your take on his comment?

It feels like a dis, I think. I’ve never seen anyone who had a Caesarian have trouble loving her child. It can interfere with early bonding, but the maternal/child bond . . . those maternal instincts persist until you die, probably. The person who said that was a man and I respect him in a lot of ways, but he’s never known those exact feelings. I understand what he’s talking about in terms of saying that we need to do everything we can to promote vaginal birth both for safety and maternal bonding, but that’s it.

You know, some of my women have C-sections as well. I have a four percent C-section rate. It’s often hard, especially for moms who have planned to have a natural birth but end up needing a C-section. They sometimes have undeserved feelings of inadequacy. The last thing I want to do is to reinforce those feelings.