Fleishman Is in Trouble, based on Taffy Brodesser-Akner’s 2019 novel of the same name, recounts Toby Fleishman’s (Jesse Eisenberg) frustrating search for his ex-wife, Rachel (Claire Danes), who drops their two kids at his apartment in the middle of the night one summer soon after their divorce and then disappears. We follow Toby as he goes over and over what went wrong in their marriage—Rachel was selfish, status-obsessed, cared more about the theater clients at her agency and fitting in with her rich friends than her husband and children. Toby cannot reach her, despite leaving increasingly belligerent messages on her voice mail. His kids are suffering without their mother, and he doesn’t know what to tell them.
Eventually, we see what he missed. In the penultimate episode, when we finally understand her own experience of her marriage, birth, early postpartum days, career, and life with Toby and their children, it’s because she is the one telling her story. She repeats many of the same stories Toby told, but we see how each one is refracted through one specific trauma—the trauma of childbirth.
The series revisits one pivotal scene in particular, when Rachel is in labor with their first child in the same hospital where Toby is a hepatologist. He briefly leaves the room to usher out his colleagues who have arrived to congratulate him and Rachel before the baby is born, and reenters to the sounds of Rachel screaming at the on-call ob-gyn, “He did something! Get him out!”
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“I think we might need to get psych in here,” the doctor says to Toby and the nurse. To Rachel he says, “Are you planning on being a baby or delivering a baby?” Toby finds out later the physician had intentionally ruptured Rachel’s membrane and broken her water without her consent. Later, when Rachel narrates the story, the violation is more pronounced, more violent. “It was the worst day of her life,” the narrator explains.
I watched that scene through my fingers, in tears, remembering my own delivery, an occasion that should have been celebratory but instead highlighted the precarity of my own safety. Birth trauma, often under-treated and misunderstood, can lead to postpartum posttraumatic stress disorder, which affects 3 to 16% of women, and it can take different forms – an emergency C-section, for instance, can be traumatic. But when autonomy is stripped in the delivery room, it can feel like an assault in plain view. I have tried, for the past two and a half years since my daughter was born, not to think of that day as my worst day, as Rachel does. And then I watched Fleishman Is in Trouble, and I heard a woman say the silent thing inside of me out loud.
“She was great. And then she wasn’t,” the narrator says. The cruelty Rachel experiences at the hands of her doctor is the hinge on which her life swings going forward.
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In her immediate postpartum haze, Rachel can’t stop telling the horrific story of obstetric violence she experienced, while her husband wishes she would stop. When she finally takes his advice and talks to someone, she feels more at home in a rape support group than she does in a postpartum group. This trauma, to me, is what the show is really about: how in a country with a maternal mortality crisis that is even worse for women of color, nearly half the people who give birth in the U.S. may experience trauma and many will have no recourse or support unless they seek it out.
I prepared to give birth the way many people do, by taking classes, reading books, and watching and listening to as many things as I could find related to the experience. Nothing could have prepared me for the fear and loss of control I felt being pressed so close to both life and death in the same instant – or the diagnosis of PTSD I would receive in the year that followed.
Giving birth shaped my experience of early motherhood as a time of brutality and fear. My love for my daughter was immediate and forceful, but early on I felt grief and anger about the vulnerability I associated with her birth. Years have passed, my daughter snuggles safely in my lap every night to read with me, yet I still find it painful when other parents refer to their children’s births as the best day of their lives. At least once a week I awake from a nightmare about the event. My child’s birthdays can be an especially piercing reminder of how much that day changed my life. When she turned 1, as we had loved ones over to eat spanakopita and cake in our backyard, I felt teary as my mother said she couldn’t believe it had been a year. A year since I met my soulmate, I thought, and a year since I was in that hospital room, praying to live.
TV and film are not short of scenes detailing the ways women are brutalized, from being assaulted or abused to being the victim of seemingly every murder mystery, yet I have never seen birth trauma considered so seriously on-screen. Fleishman Is in Trouble depicts a wealthy white woman—educated, insured, married to a doctor—violated at her most vulnerable, losing control and autonomy, as the central plot point. Nothing, no amount of money or prestige, can save us from the cruelty of a medical system that doesn’t care about women, the series seems to believe.
Much has been written on the subject of how to mitigate and treat the trauma of giving birth, but many people still don’t see depictions of it and therefore don’t understand the fallout. Without treating obstetric violence as a serious, persistent crisis, we can’t develop the tools to recognize it and call it out. We can’t form support groups like the one Rachel Fleishman needed without a robust language around the trauma. We can’t demand autonomy and consent in the birthing room without knowing how often it is stripped away, and the cost of that loss.
Now, as I am months away from having a second baby, every single decision I’m making around giving birth is informed by trying to avoid the trauma I associate with the experience, from whom I want in the room to which room I will even be in. When people congratulate me, I should smile. Instead, I am tearful and terrified.
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