Childbirth is often a communal process, with a team of nurses, doctors and loved ones simultaneously witnessing the miracle of life. In one Philippines hospital, "communal" is an understatement. Ramona S. Diaz's latest film, Motherland, takes us into one of the busiest maternity wards on Earth.
Filled with warmth, humor and heartache, Motherland is a vérité portrait of childbirth--with all its joys and challenges depicted on screen. It is also a fascinating study of a country where conservative Catholic ideas about childbirth and contraception prevail, making the film an ideal starting point for conversations about reproductive healthcare policy.
Overcrowding is the default state of the maternity ward at Jose Fabella Memorial Hospital. The Philippines, one of the world's most populous countries, also has one of the highest birthrates. As a chart on screen indicates, 151 mothers and 115 babies occupy the hospital when the film begins. Patients share not only a large, cavernous room, but beds as well. In the operating rooms, surgeons often attend to four or more women in labor at once. In one nerve-wracking scene, a mother becomes separated from her baby girl while socializing with other mothers and has some difficulty retrieving her child due to a lost tag.
As chaotic as the hospital seems, Diaz finds an attentive group of nurses, caseworkers and doctors who come up with solutions to problems of scarcity. For example, a doctor explains, "If the baby is really small they should be in an incubator. But since we lack incubators in public hospitals, they came up with this alternative program. Here, mothers constantly hold the baby to their chest for warmth. This innovative practice allows mothers to act as a human incubator."
Motherland also discovers a sense of community among the mothers. There are no title cards, and we only learn the names and life stories of the women through the camera's eavesdropping. One woman, Lea Lumanog, didn't even know she was pregnant with twins until she visited the hospital. Another, Lerma Coronel, one of the older patients in the ward, dispenses advice. Having just given birth to her seventh child while her unemployed husband cares for the others at home, she cautions the younger mothers to avoid having too many children with too little money.
Some mothers stay longer than medically necessary. A nurse explains, "There are so many that can go home, but they don't have money." Visits from family members reveal that even the cost of transportation to and from the hospital can be burdensome.
Bills for some patients amount to more than 200 dollars. In a meeting with a social worker, the father of Lumanog's child explains that he makes about five dollars per day and can only find work two days a week. He is told they qualify for assistance through a program called the Philippine Charity Sweepstakes Office. However, the support does not cover the full hospital bill, so they are left to rely on a loan from his sister.
Motherland also illuminates the country's policies regarding birth control and the ambiguous role such birth control plays for a deeply traditional and religious population. Ligation, or elective sterilization surgery, is offered to young mothers who have already had six children, although none of the film's subjects opt for it. During a session with a family planning counselor, one woman is told, "You can't get a ligation because you only have one baby." The hospital offers new mothers with fewer children free intrauterine devices (IUDs). These, too, are usually refused, as the women follow their families' insistence that they not undergo any procedures during their hospital stays.
The end of the film briefly cuts to a press conference the hospital is holding to mark the birth of the 100 millionth Filipino. A doctor expounds on this baby boy's significance: "Over time, we will look at the situation of this baby... in terms of health services, education, employment opportunities. What we're after is the development of the population... Inclusive growth, that's what we want to achieve."
Filmmaker Diaz said, "The joy felt at Fabella is no different from the joy experienced by mothers and fathers worldwide. But because the film takes place in the Philippines, I invite audiences to witness similar situations from the starkly different perspective of a poor, densely populated, Catholic country. I hope that in viewing this film, audiences will discover the connective tissue that binds us all as members of the global community of caregivers."