HACKENSACK, N.J. — For her first film, an ode to the joys of childbirth, Debra Pascali-Bonaro needed an attention-getting title. She had five minutes at a pitch session with 200 television executives.

First, she announced her working title, “An Ordinary Miracle: Global Models of Care.”

Sit back down, they told her.

Then she tried “Ecstatic Birth.” Still not good enough.

Finally, a friend Pascali-Bonaro had brought along for support whispered an idea in her ear. “Just go for it,” she urged.

The fledgling filmmaker stood up and announced: “Orgasmic Birth!”

Now they were interested.

The documentary that Pascali-Bonaro directed and co-produced debuted in May and has been screened around the world. This fall, it’s the subject of a segment on ABC’s “20/20.”

It has been quite a journey for the River Vale childbirth educator, who began her career teaching Lamaze classes.

When expectant couples she taught invited her to accompany them during their baby’s birth, Pascali-Bonaro happily accepted, becoming a birth companion, or coach.

That role was more widely recognized in the 1980s, as Pascali-Bonaro became one of the founding mothers of the “doula” movement, eventually expanding her training work to inner cities and abroad.

From those experiences witnessing the joys and pains of childbirth — in settings ranging from Mexico to New Zealand — the idea for her film was born.

The goal of the movie is to show that giving birth can be more than painful and messy. It can be powerful and life-changing.

Even orgasmic.

“Without a doubt,” two women in the film do experience orgasm during childbirth, says Pascali-Bonaro, 50.

The birth of her own third child, 19 years ago, “was an orgasmic experience in the way that dark chocolate is,” says Pascali-Bonaro “The release, the absolute release, as I felt his body slip from mine, was orgasmic.”

As the film explains, the hormone associated with intimacy, oxytocin, is the same hormone that peaks during childbirth, creating the potential for orgasm. If the circumstances are right — the woman has privacy and a sense of safety, she feels relaxed as well as open to the intense sensations — it can be the opposite of what most women expect, the film says.

For many women and their doctors, this notion is unbelievable.

But Pascali-Bonaro hopes her film will help reclaim childbirth as something to be embraced, not feared.

Many of the 11 women in her film labor at home, with their partners and assisted by midwives. They walk around. They rest in candlelit bedrooms or on sunlit back decks. Some deliver squatting, some in hot tubs. They speak afterward of a surge of pride and power.

Pascali-Bonaro doesn’t deny the role of medical intervention in saving high-risk mothers and babies. One baby in the film is born by C-section in a hospital, its umbilical cord wrapped around its neck. But after attending more than 400 births over more than two decades, she believes most births can occur with less technology.

Many doctors disagree.

Because complications can arise without warning, medical monitoring during labor is essential for the safety of both mother and baby, according to the American College of Obstetrics and Gynecologists. The group has long opposed home births. To reduce the likelihood of a bad outcome or even death, the group believes an OB/GYN should be available — at a hospital or hospital-related childbirth center — during births.

The American Medical Association is also concerned. In April, it began urging states to enact laws against home birth.

Pascali-Bonaro is not using her film to pick a fight. “I don’t want to be blaming people,” she said. “I hope this will touch people and open their hearts to see the possibilities.”

‘She lives the message’

“The childbirth movement is full of angry people,” says Christiane Northrup, a holistic obstetrician/gynecologist, author, frequent Oprah guest and host of her own PBS specials. “But Debra is the most gracious, gentle person. She’s not pushing an agenda. She lives the message.”

A mother to six children, Pascali-Bonaro graduated from McGill University in Montreal with a bachelor’s degree in education and started teaching childbirth classes after the birth of her first child in 1982. That had been an “empowering, positive birth,” and she wanted to help other couples have a similar experience. When couples who took classes at her New Jersey homes in Westwood — and later, River Vale — asked if she would come with them, she attended their childbirths.

She was actually serving as a doula, a person who stays with the mother throughout labor. The American College of Obstetricians and Gynecologists endorses their presence for psychological support.

A woman’s constant, helpful presence with a laboring mother has been shown to have practical value — it lowers the rate of Caesarean sections, the use of epidurals and other pain medication, and the use of forceps or vacuum extraction, according to the Cochrane Collaboration, which systematically reviews multiple studies.

Pascali-Bonaro worked with recovering drug addicts in Paterson, N.J., training older neighborhood women to be doulas.

As interest in that project grew, it launched Pascali-Bonaro into a new career training doulas around the world. She co-chairs the International MotherBaby Childbirth Initiative, a worldwide effort to make maternity services more mother-friendly. Through her work, she has attended births in Mexico, Brazil, New Zealand, the Netherlands, the United Kingdom and all around the United States.

“What an incredible gift,” she says, “that people opened up this most intimate experience to me.”

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