Director Léa Fehner about her latest film Sages-Femmes

Director Léa Fehner about her latest film Sages-Femmes

Born 15 October 1981 in France Léa Fehner was raised in the world of big-top touring theater. She went on to study film and screenwriting at France's national film school, La fémis. As a student there, she did two  apprenticeships abroad, one at the Film Center of Bamako, and the other in Cambodia with director Rithy Panh. Her first film, 'Silent Voices', was selected at numerous festivals, notably the 2009 Mostra de Venise and the Deauville American Film Festival. It won the Louis Delluc Prize for best first film and was nominated for a César Award. Her second feature, 'Les Ogres', garnered a prize at the Festival of Rotterdam in 2016. Since then, Léa Fehner has collaborated on the scripts of several films, including Woman at Sea by Dinara Drukarova, selected at the 2022 San Sebastian Film Festival. Sages-Femmes is her third film. It is about Sofia and Louise who are newly qualified midwives. They quickly encounter the challenges of everyday hospital life in a broken health-care system. This film is also a warning cry. Léa says: "We must fight today to reject a world in which the most sacred part in our lives, along with death perhaps, is treated with such contempt." - Tomorrow's world is born in our hands.

How did this film project come about?

Twelve years ago, I became a mother and my first child was born with major health issues. Since then, I have spent a lot of time with him and his father in hospitals, which profoundly changed my relationship with that environment. I do not know if it is the result of a few unfortunate encounters, of the worrying situation of hospitals today, or of the brutal experience of the inacceptable, but the fact is that we have often suffered from a lack of attention, abusive reactions, moments of absolute loneliness, and on several occasions, we have
felt mistreated, infantilised, abandoned...

In order to make sense of that experience, I wanted to immerse myself in that world with my tools as a film director, and try to look at caregivers for what they are: not sorcerers, oracles or raging gods, just men and women confronted with distress, pain, death, and life. They also have to face the neglect of the healthcare system, the deterioration of working conditions, the
constant pressure of management. They cannot escape the hard fact that they have chosen a profession where one gets to deal with the tragedy of fate every day.

Why did you choose midwifery specifically?

It was self-evident. Midwives support families through the intimate and overwhelming time of childbirth. Through the most beautiful and the most painful moments. Back then, midwives were already raising alarm about their working conditions. They described themselves as unwillingly "abusive" for lack of time and means. Those were not empty words, but genuinely unbearable situations.

For instance, one midwife told me that she had left a family unsupported for four hours with their dead baby after a therapeutic abortion. Another told me about this woman whose partner had left during the pregnancy and whom she had to let suffer without an epidural because there were more vital emergencies. Another told me that she had not had time to listen to a woman who seemed to have been raped by her stepfather, because she had to rush out of the room to take care of a code-red caesarean section.

All of them told me about their terrible first days on ward, the random supervision, the epidural injections applied because there is no time to properly support their patients in labour, the lack of dialogue for lack of time, the deep feeling of rushing around all the time at the cost of the human aspect that is at the heart of their job.

Their warning cry resonated intimately with I was feeling. So, I tried to understand the inner workings, both systemic and individual, that lead to this situation and that makes the relationship between caregivers and patients so complicated. I made this film to go through the looking glass and take the audience with me.

Almost all your characters are really young, can you tell us why that is?

This profession is essential, yet it hardly gets the recognition it deserves. It involves huge responsibilities which are often shouldered by very young people.  Therefore, I decided to tell the story of two young  midwives, two brave girls who are starting their professional lives in a sinking boat, and yet who retain a strong will to live, to laugh and to rise to the challenge.

So, I asked myself; What does it mean at that age to help deliver babies when you have hardly cut the apron strings yourself? How do you cope with the violence that your patient is going through when you have so little life experience? How can you become a warrior without being heartless? I was going over and over these questions in my mind. I made this film to tackle them head on, even if I think that they go way beyond my personal experience. We are all concerned by birth, in some way or another. This profession is at the heart of our lives.

How did you proceed to understand and adapt those issues for the screen?

I have immersed myself for several months in that world for research. Several hospitals opened their doors to me. Even if it was complicated, due to the pandemic, midwives were keen on voicing their concerns and sharing their experiences. For many weeks, I have shared the daily lives of midwives in their workplace.
Several times a day, I saw babies being born, families being created. I also discovered what happens behind the scenes, the passionate and careful round of caregivers. It is a complex swarm that I have tried to portray as accurately as possible.

This precise machinery keeps being brought to a halt
by the appearance of a miracle: the birth of a child. I felt so lucky to be able to discover that world, and I have tried to share that experience with the audience. I wanted them to really feel the beating heart that is a maternity ward, to experience what these midwives go through in their flesh.

Can you tell us how you got the midwives involved in the film? How did you work with them and how  they took part in the filmmaking process?

Early on during that immersive research phase, I befriended half a dozen midwives who became central to the filmmaking process. They were incredibly generous, sharing their time and experience with us, and searching with us how to faithfully depict the reality of their work. Then we set up writing workshops on set with the cast, and the actors would improvise scenes based on their stories. As I said, we were all deeply moved by what they had told us. There was a lot of joy, of course, but also painful memories, anger, and sometimes even despair.

The current situation is so difficult. But even so, what was stimulating was the sense of mutuality: when
the midwives discovered the scenes improvised by the actors, they laughed, they were upset, but mostly, it made them think. As unsettling as it may seem, they often told me that this experience had allowed them to question their practice, which they usually never do, because they simply do not have the time!

After that, and throughout the filmmaking process, the midwives were fully involved in the project. They were on set, encouraging the actors, playing supporting roles alongside them, clarifying procedures or technical aspects. They took part in the editing process as well, even sound editing, so that we would not make mistakes about machine sounds! But make no mistake, they
were not there for the sake of naturalism. We really wanted to make the film together, and to try together to get as close as possible to the very soul of their work.

I was so glad it worked out the way it did, because it was really important to me: I think the experience of shooting a scene goes beyond the mere purpose of the film. Every minute we spent on set, something would get us closer to what I was aiming at: bringing more understanding, gentleness, and indulgence in the relationship between caregivers and the outside world.

The cast is mostly made of students from the French National Academy of Dramatic Arts in Paris. How did you work with these young actors?

Working with these young actors was another decisive aspect of this project. The film is also about a part of today's youth, about their resilience and idealism. So, together with my co-screenwriter, Catherine Paillé, we started out by meeting with them one by one, to get to know them better. We wanted to get a sense of their background, their story, but also their sense of humour, their outlook on the world, their dreams, their desires...

That way, together we could take the pulse of today's youth. We chose to turn the usual process on its head: not to create characters first and then choose actors, but to create our characters with the actors already in mind, at the crossroads between documentary and fiction. Just like with the midwives, we did not write for but we tried to write with them: with their bodies, their words, their creativity, their energy, their joy, or their anger.

It is a fascinating, yet also complicated process. We are constantly dancing on the border between tribute and insult, between respect and betrayal. I love this process, it brings a whole new dimension to the work with actors, we are no longer in a dominant position, but of course, we need to keep a direction, and it can be tricky to find one as a group. After writing the workshops with the midwives, the actors started their own immersion phase in a hospital. They learnt the motions, the  techniques, but above all, they were shaken by the  beauty and violence of reality.

This experience exceeded my expectations. For instance, one actor witnessed the joyful birth of triplets, while another saw a stressful resuscitation; an actress supported a couple who had just lost their baby in utero with much gentleness and empathy...

In that environment, they all touched on their own boundaries, their fears, their self-control, their strengths. Obviously, they are not caregivers, but they all experienced first-hand the challenges of this job.

Did you want to make an ensemble cast film right from the start, as a gesture to the necessarily collective work in a maternity ward?

I have always been fascinated, haunted by questions about the collective, the group. In my previous film 'Les Ogres', I already tried to immerse viewers in the life of a theatre company. The idea of community is at the core of the cinema I want to make.

I think that films can provide us with solutions, with examples on how to pursue this fundamental and increasingly contemporary adventure: being a group. Being a collective. Building together.

So, to me, the hospital is one of the best playgrounds. It relies on teamwork to function. Solidarity among the staff is fierce. Relationships are powerful, just like the
difficulties to be faced. The staff is constantly exposed to the world, to the other, to the "collective" of patients and their loved ones. It only made sense to try and approach that collectiveness.

How did you produce the delivery scenes? Did you set up a particular device?

Sages-Femmes is a fiction film. But how could I approach childbirth, this pivotal moment in the life of the maternity ward? The midwives told me they had always been disappointed with the way labour was depicted in films. Admittedly, the documentary truth of childbirth is beyond comprehension. There is the woman's power, her strength, her emotion. There is the midwife's extreme concentration, the profound empathy that shows through her work: "I am here for you, with you, you are not alone."

There is also the astonishment of the person who came with the mother, in most cases the father, the look on his face when he discovers the person who was not there before, but who is to become the centre of his life. And then, of course, there is the newborn baby. That face which has never seen, never breathed, and which suddenly sees, breathes, smells. It is a truly magical and primitive moment, and I wanted to share this absolute with the audience.

We met families who agreed to let us film the delivery of their babies. They often thought that midwifery deserved more recognition as well. Like on-call midwives, we waited for some of them to call us and tell us to join them at the hospital. We waited desperately for that call. Would it happen tonight, tomorrow, in two weeks? It was a wonderful tension, which brought us much closer to the work of midwives, and to the unknown they have to face every day.

After that, the families we had filmed came back to "do over" the birth of their child with the actors, and then we mixed all the footage during the editing process. Shooting the "second" births was a really strange, intimate and almost relieving experience. Even though it was purely fictional, it was impressive to see how the actresses were both really intimidated and completely committed to their mission.

I myself had the opportunity to take part in the birth of a little girl when I was preparing for the film. A midwife guided my hands and I helped delivering the baby. What was astonishing to me was the fact that what is happening in your hands, is so important that it leaves almost no room for emotion. There is just the highest and deepest form of concentration.

There is nothing more important than what is playing out there, in your hands. Nothing. Strange as it may seem, with this  device, with the gift that these families have given us, I had the feeling that the actresses shared that same experience

Feminist movements have often claimed that women should distance themselves from motherhood, and break out of this imposed role. Where does your film stand on this issue?

Many feminist movements today embrace this crucial moment, central in most women's lives that is motherhood. Motherhood entails values that should be
at the heart of our whole society, but which are  marginalized, made invisible or played down as simply "old wives’ stuff": attention to the weakest, solidarity, care, respect for the dignity of others, bonding, sharing.

I have the utmost respect for all journeys regarding motherhood. Let's not forget that midwives are also the first to fight for the right to abortion! It is a bit like the debate about giving birth with or without an epidural: the most important thing is to give each woman the freedom to make an informed, conscious and supported choice.

I think that our approach in this film is profoundly feminist: showcasing midwifery is above all a way to bring to light a profession that is made invisible, because it has to do with care, and especially with the care of women. The work of midwives is political in that sense. It is one of the most relevant indicators of the place of women in our society. Midwives support women and couples emotionally, psychologically, medically, physiologically, and even socially; when they are given the proper time and means to do so, that is.

They have a ringside seat when it comes to abuse, to memories of psychological and sexual violence that may resurface in that very special time in life, and of course, to social issues. Let us give them the time to perceive those red flags! Also, what a woman feels during childbirth is simply incredible.

Childbirth is a primitive, wild and trying experience. When midwives manage to support women through that process, they help them discover an unbelievable power within themselves. Each woman who has been able to access this, who has been assisted in the discovery of that inner power, has gained this for the rest of her life!

You seem to take a critical look at the situation of public hospitals. Which impact would you like your film to have on today's debate about our healthcare system?

The way we die and the way we are born say a lot about the state of a society. The current healthcare crisis affects us all. Intimately. When you work in this environment, as I have for several years, you get the feeling that it is a huge waste. Public hospitals are one of our greatest treasures. I even think it is one of the most beautiful things that humanity has ever created.

Today, we are already getting used to counting our  dead, as various groups did in emergency departments last winter. The shortage of caregivers caused
unnecessary deaths. It is not inevitable; it is the mere result of political decisions. I must say I see this as a liberal choice to favour the use of the private sector by allowing our public service to deteriorate.

Many midwives who took part in the film feel the same way. These are not mere figures or abstract data. These are lives, as I have tried to show in the film. Caregivers
who can no longer bear to mistreat patients, beginners who are not given enough time to find their own place, their dignity. Women and couples who are left alone in such a vulnerable time in their lives. What we need is a wakeup call.

Now, babies are born in hospitals ruled by financial concerns, where patients are overmedicated to keep a pace set by the lack of staff, where women are robbed of their power through overmedication, and where the
weight of it all falls on the shoulders, the courage and idealism of very young caregivers for whom caring is the only way to live in this world. And they often
end up getting burnt...

We must fight against this feeling of waste. We are depriving midwives of what drives them the most: the certainty of a job well done. They need to have enough time to connect, to build relationships that can save lives. We must fight so that midwives can take care of one woman at a time; we must fight to get them the financial and social recognition they deserve.

When at the end of the film, a midwife wears the protest slogan "Tomorrow's world is born in our hands" on her  uniform, to me, beyond being an undisputable truth, it is a warning cry. We must fight today to reject a world in
which the most sacred part in our lives, along with death perhaps, is treated with such contempt.

Photos - trailer 2023 ©  Cherry Pickers Film