Filmmaker Abby Epstein opens The Business of Being Born, a pseudo-Sicko for the birthing industry, with some man-on-the-street opining on the subject of midwifery. "I thought it meant having a baby in a barn somewhere," one man cracks, wide-eyed. Epstein also finds doctors, however, who either wrinkle their noses at the idea, or become almost hostile, sneering over the "feminist machoism" of women who choose to have their babies at home. Methodical in structure but relaxed and engrossing in tone, Born goes on to explore the merits and the motivations behind both sides of the argument, along with the genesis, if you will, of this country's thoroughly modern (i.e. backward) attitude toward giving birth.

Recruiting piles of experts, authors, doctors, midwives and mothers, along with Ricki Lake (who had her first child in a hospital and her second at home) and finally herself (Epstein became pregnant over the course of shooting), the director is clearly biased in favor of home birth, but that doesn't make her case any less square. She constructs a history, beginning with the turn of the last century, when the overwhelming majority of women gave birth at home; through the rather torturous contraptions women were strapped into to give birth through the 1920s; to the 1950s and beyond, when the "twilight drug" convinced women that giving birth could be nothing more than a bad dream they had; to today, when unnecessary c-sections, over-drugging and complications are the norm. Epstein argues this is mainly because doctors like to have something to do -- and to do it on their schedules. Despite all of this glorious medical advancement, the United States has an infant mortality rate higher than that of some third-world countries.

Epstein doesn't overdo the hippie posturing because she doesn't have to: the e-word comes up, incanted by glassy-eyed moms and midwives alike, but it is the footage of women being treated like burdensome cargo, or condescended to by weary doctors during their most vulnerable moments, that makes empowerment sound anything but softheaded. Giving birth, after all, is a pretty definitive human event, and yet the whole shebang has been increasingly ghettoized, stigmatized (suffering through childbirth was considered "the sin of Eve," and circumventing that pain via drugs was presented as the prerogative of the modern woman) and executed through an increasingly sloppy -- even by medical standards -- and dangerous set of protocols. While it may set off all of your sensitive, new-age alarm bells to hear Cara Muhlhahn, the New York City midwife whom Epstein follows as she deals with various expectant mothers (and then hires for herself) tell a client that she is "the guardian of safety and the witness of your process," compare it to what a haughty doctor offers in the way of reassurance to a clearly terrified woman in labor: "They all come out, one way or another."

Yes, there is footage of a number of women giving birth (most of it not terribly explicit, if pornographically intimate) and the pendulous breast count is off the charts, but The Business of Being Born is remarkable for the way it handles those difficult scenes with a mixture of delicacy, gravity and humor, capturing the exultancy of a moment so human it is almost mundane, yet so transcendent that it is almost more than human. Epstein is not a trembling husband with a camcorder, in other words, and proves an expert and witty editor, particularly during a "midwife, deliver thyself" sequence in which footage of an extremely reluctant Muhlhahn giving birth is intercut with Muhlhahn's own account of the events.

Animations, decent music selections and the birth skit from Monty Python's "The Meaning of Life" mix up the talking heads and home birth footage, and Muhlhahn is an easy, sensible presence; after the struggle of labor, most of the deliveries she facilitates take place with barely a whimper, which may be the most surprising thing of all. What is most intense are the quiet, matter-of-fact moments after the birth, and how conditioned we are to assume that, without a doctor present and much fuss and slapping of asses, anything and everything can go wrong; even the doctors themselves believe it, the vast majority having never witnessed a natural birth.

Former talk show host and current incredible shrinking woman Ricki Lake is the film's other dominating presence, and having given birth on both sides of the picket fence, offers one of the most convincing arguments. The Business of Being Born becomes the ultimate in personal filmmaking when Epstein's own pregnancy comes to term and she delivers several weeks premature. I won't spoil the outcome of that birth, except to say that it is an unlikely triumph not just for her film (drama-rama!), but the argument it presents.