In highly developed nations, the birth process is usually one dominated by medical science — perhaps overly so — with the mother in virtual quarantine conditions. But there’s something to be said for a more communal approach, like the one colorfully portrayed in “Motherland.” U.S. documentarian Ramona S. Diaz’s latest is a lively and engaging glimpse at a Manila maternity ward where overcrowding and limited technological resources have forced some solutions that may not be ideal, but are admirable nonetheless. The docu won a Sundance Special Jury Award for “commanding vision,” a rather odd phrase for a film whose primary impression is one of charm and humor amid challenging circumstances.
The Jose Fabella Hospital boasts what is purportedly the world’s single busiest maternity unit, with as many as 100 births a day. Its patients are a microcosm of the Philippines in general: Mostly poor, Catholic, and already burdened with several children. (No doubt religion is a major factor in many women’s reluctance to use birth control.) Even in the delivery rooms themselves, mothers are often crammed two or more apiece onto beds. Before and after giving birth, they stay in a ward that at first glance seems wildly noisy, cluttered, even chaotic by First World standards.
Yet there’s a compensating sense of community, one that likely echoes these women’s home environments, in which neighbors rely on each other to get along under economic duress. (Many live without electricity or direct water.) Some of the mothers are alarmingly young, while others have already had numerous offspring before reaching their mid-20s. Hospital staff members (which include one flamboyantly larger-than-life transgender doctor) try to encourage good habits for the babies’ sakes, though sometimes their advice falls on deaf ears, as the women are accustomed to deprivation.
The film follows several principal subjects during their overlapping hospital stays, including one young woman who briefly can’t find her baby on the ward (its ID tag is found on the floor, which is no laughing matter); the husband of another woman seldom visits because he can’t raise bus fare on a weekly income of about $10. The most memorable figure is Lerma, a salty-tongued older woman who finally consents to a tubal ligation after seven children. But the sudden sense of responsibility that suggests is undone when she insists on leaving the hospital despite doctors’ advice, her new baby still suffering from pneumonia.
Indeed, there seem to be frequent health complications for the newborns. Because Fabella Hospital lacks funding for incubators, women are encouraged to “incubate” babies themselves via Kangaroo Mother Care, in which they (and sometimes their husbands) use tube tops to press infants against their own bodies for heat — ideally 24/7 until the baby’s weight, temperature, and other vitals have stabilized.
If all this sounds rather bleak, that does a disservice to “Motherland,” which overall is perhaps surprisingly sweet and upbeat — closer to Thomas Balmès’ 2010 “Babies” than a grim report on Third World privation. Rather, the emphasis here is on institutional success at coping with adversity; protagonists’ positive attitudes are not always well-informed, but they’re nonetheless preferable to miserable defeatism. The women certainly leave better-informed than they came in, and you can’t accuse the medical professionals (who often deliver slightly haranguing messages over the hospital loudspeaker) for a lack of valiant effort. There’s also a tangible parental camaraderie that may not extend past the discharging of patients, but is so pervasive that when one new father hands his baby off to a total stranger while searching for a taxi home, you accept his casual trust rather than suspiciously expecting the worst, as one might elsewhere.
There’s an ease of intimacy to Diaz’s observations that suggests her crew was embedded for some time in the ward. The camerawork is crisp and bright, the editorial assembly likewise effortlessly engaging, capturing a sense of lives revealed in the everyday workings of the hospital.