Written by Malin Evita
On the 41st episode of Making It: Women in Film, midwife, activist, and birth consultant of the movie Pieces of a Woman (2020, dir. Kornél Mundruczó), Elan Vital McAllister, sat down to discuss her work and tell us all about her experience coaching the cast, creatives, and crew on set through the spectacularly chilling and primal birth scene, lasting 24 minutes and captured in a single-shot. The Netflix movie follows the outfall after a home birth turns tragic.
The lead actress, Vanessa Kirby, has been praised for her beautiful and vulnerable performance. One of the things that contributed to this was her commitment to being as truthful and authentic as possible, despite never having given birth herself nor experienced the kind of loss felt after losing a child. To bring truth to screen, she reached out to Elan, a midwife with a background in theatre, for guidance. Here is a snippet of the podcast interview; read more and learn about Elan’s coaching approach and how she consulted on the script to shift the whole direction of the story.
*This transcript has been slightly edited and condensed. Listen to the full interview on Spotify or wherever you get your podcasts: #41 | Bringing Truth to Screen. Spoilers ahead.
Elan Vital McAllister: I was first approached by Vanessa Kirby—the actress who plays Martha; the mother in this film. It was very important to her, you know, that she brings as much truth to this story as possible, and so she had sought me out and we, you know, connected a couple of months before the scene was shot. She was looking for someone to really help her understand what it feels like, what it looks like, what it sounds like. To really be able to embody it as much as she possibly could. And so we started talking in that way and as we got deeper into the process, she sent me this script and I had a chance to read it.
Red Flags in the Original Script
EVM: I have been a maternity care consumer advocate for a number of years, so I have worked on a lot of policy issues on both city, state, and national level. I’ve worked really hard to ensure that people have access to high-quality care in all settings and do everything I can to make sure home birth is as safe as possible, is as integrated into the system as possible, and that we get past the stigma of home birth as this really unsafe option, because it’s not.
I read the script and here is a 25-minute scene of a homebirth, which we never have the opportunity to [show], and then it ends in the baby’s death. And, of course, we are now reinforcing a bias against homebirths, so I had a lot of challenge with that. But I also saw an opportunity to tell a deeper story about how babies, unfortunately, don’t always survive.
If a baby dies in a hospital setting, the assumption is that it was inevitable, that everything was done that could be done, and that that baby just wasn’t going to live. It’s a tragedy, but it’s explainable.
If a baby dies in a homebirth, it is considered to be a crime. Just automatically. The bias is such that the assumption is that had that baby been born in a hospital, they would have survived. It is just assumed.
So there was an opportunity to try and weave some of that cultural bias into the storytelling and I thought that was important and actually interesting.
Here is a family that is dealing with the grief of a baby and also doing so within a culture that blames them for a choice that they made that potentially, to the larger perception, put the baby at risk.
Making Changes — The Day Before
EVM: In talking with Vanessa I petitioned to be connected with the producers because I felt that, rather than just coaching her, they needed to bring me on as a birth consultant for the film because there were some parts of the storytelling that – clearly the writers were not birth professionals or they hadn’t talked with birth professionals. There were pieces that were really problematic and even borderline were malpractice, actually, some of the things that were written in the original script that the midwife did.
So it took some time because the film had just been greenlit, they had just gotten all their financing and they were moving so fast. So I actually was not able to sit down with the screenwriter until the day before the [birth] scene was shot. We had three hours and completely rewrote the scene. Completely rewrote the scene.
The midwife’s character went from being just abrupt, and rude, and harsh to, as you see in the film, being compassionate, and being very sensitive and more reflective of what the midwife’s approach to birth is.
There was just this radical rewriting of [Pieces of a Woman] the day before it was gonna be shot. We got off the call and Vanessa texted me and said ‘can you please get on a plane right now’, she’s like, ‘I’m not doing this without you tomorrow,’ basically.
Malin Evita: You became her midwife there!
EVM: Very much so. I took a red-eye that night and went straight to the set. She was already in her prosthetic belly when I got there and within a half-hour, we shot the scene for the first time. And again it’s a 25-minute single-shot scene and we never rehearsed it! We never rehearsed it.
I was down with the monitor and taking my notes and I think we did it maybe three or four times the first day and twice the next day. After each take, I would run upstairs and go to each actor and give them my notes as quickly as I could because we were doing it just over and over again! And [the actors] were remarkable. Just remarkable.
Especially Vanessa, [who] has so much stage experience. She just takes and lives a note. So quickly. I was so profoundly… just in awe of all of them. The work that they did and how we went from one script one day to a completely different script the next day!
And here it is! This really pivotal scene for the film, you know, it’s a really important scene and they did such a remarkable, remarkable job on it.
ME: Yeah, Vanessa… During the whole movie, she is just so moving. There is not a second where you doubt her; it is so profound. I was sitting at the edge of my seat, I almost couldn’t watch it because of how raw it was.
EVM: Yeah and the questions that she asked. The fact that she just recognised, she’s like, ‘I have never had a baby. I have never seen a birth. I haven’t even thought about birth, and now I am supposed to completely embody it in a home birth where I am not even on an epidural!’
And in this scene, we go from early labor to—and I had to choreograph like, how do we get, in 25 minutes, the full arch of a labor? Which for a first time mom typically takes 24 to 36 hours. How do we capture all of these different stages in 25 minutes?
So going from being light, I would just kind of describe the different qualities of each stage of labor. In the first stage of labor, it’s early labor, and you are just starting to get some contractions and it’s exciting, ‘cause you know that the baby is coming. You also maybe have some nesting feelings. You just have this sense of the baby is coming and it’s really exciting.
Then in the film, we have her water break. In TV and film, that water breaks and you rush off to the hospital, right? That’s just not the way it happens. Quite often, the water doesn’t break until quite late in labor. It’s not the first thing that happens.
But for the purpose of the storytelling, having the water break, that often makes the contractions be stronger, be more intense, because now the baby’s head is right on your cervix without the padding of amniotic fluids so we can often speed things up. So just to keep things moving, we have that happen so labor gets more and more intense.
Coaching Vanessa Kirby
[Vanessa] took everything that I shared with her. Like this is how you are going deeper and deeper. As you go deeper into labor you are leaving your neocortex, which is where your language is, which is where your ability to have cognitive thinking, to have conversations – that. You are dropping out of that part of your brain and into a more primal place. All of a sudden, you are not tracking time anymore. You are not tracking the things around you. You are going deeper and deeper and deeper. That is what happens during labor.
You go from this light-excited place to where it starts getting deeper and deeper. Your contractions are starting to become more intense and it’s taking your full focus and you go into this animal place where you want to be in the dark, you want to be in the quiet. You want to be in a place where you are not being observed; where you are free to go into a very primal place.
We tried to capture that in the bathroom, in the bathtub, where you just see her go so deep inside of herself and there is a sense of time flowing. She is in her own world there and it’s a really deep place.
And then suddenly there is the urge to push and the whole energy of birth changes when that urge to push happens. Now you are actively working. Every muscle in your body is working with you to bring this baby out into this world. It is this really dynamic energy. Shifting into that…
It was really fun to see how those descriptions, the words and the descriptions I was giving to [Vanessa], how they were filtering through her as a person, you know, Vanessa Kirby learning all of this and then applying it through the lens of this character, Martha, and how Martha would embrace things.
It was just such a beautiful thing to see how she brought it all in and brought it forward.
Listen to our full interview with birth consultant Elan Vital McAllister, available now on all major podcast platforms.
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Written by Malin Evita
Evita is the host and producer of the podcast, Instagram curator, and a writer focused on script, cultural commentary, and film analysis. She is a Vocal grand prize winner and currently studies Professional Writing at college. Through storytelling, she aims to amplify empathy and human connectivity.