How ‘The Pitt’ Redefines Realistic Childbirth on Television

LOS ANGELES, CA — In a groundbreaking approach to medical storytelling, the HBO series ‘The Pitt‘ has engaged viewers by showcasing an intensely realistic depiction of childbirth in its latest episode. Released on March 13, 2025, the episode, titled “5:00 P.M.,” has garnered significant acclaim for its unfiltered portrayal of the birthing process.

Creator R. Scott Gemmill emphasized the show’s commitment to authenticity: “It’s really being cognizant of the reality of the medicine, trying to stick to it, trying to present it as authentically as possible. That’s why we’re doing it this way: not to cheat it.” This clarity of vision has resonated with both fans and critics, particularly during this significant episode which highlights the complex realities of childbirth.

Director Quyen Tran brought her personal experiences to the project, stating that her own childbirth journey influenced how the scene was depicted: “It was really important that I was able to film the baby coming out and then tilt up to the mother so it’s all connected. And at the same time, how do we film it in such a way that we don’t see all the off-camera support?” Tran aimed for a representation that respects the vulnerability of childbirth.

The production team developed a custom rig, featuring a gurney and a silicone prosthetic of a pregnant belly used for filming realistic birthing scenes. “My actual legs were hidden by the gurney and other medical draping,” actress Enuka Okuma explained, who played the birthing mother, Natalie. “It created a seamless visual that contributed to the authenticity of the scene.”

To enhance realism, two puppeteers were employed to simulate the birthing process. The intricate rig allowed for a detailed portrayal without resorting to cut-away shots. One puppeteer added blood and other fluids, while the second articulated the silicone model that represented the baby, creating a more immersive experience for viewers.

However, the team faced challenges with Okuma’s comfort and the alignment of the prosthetics. Tran stated, “I got in the rig, and it didn’t feel great, because the chair didn’t allow the perfect marriage of the prosthetic with the actress. We made adjustments to ensure that she was comfortable while performing in such a physically demanding scene.” A kneeling-style chair was later introduced to provide additional support.

While shooting this sensitive and graphic content, an intimacy coordinator was present to ensure Okuma felt secure despite the circumstances. “Everyone understood it wasn’t me, but it’s still a vulnerable position to be there, with people kind of gawking,” Okuma remarked. “I really appreciated it. Let’s make this actress comfortable, even though we all know it’s make-believe!”

In addition to physical authenticity, the narrative itself addressed deeper themes. Writer Elyssa Gershman pointed out that the episode interweaves emotional arcs with the medical plot. The storyline included complex medical issues such as shoulder dystocia and postpartum hemorrhage, paralleling the unique family dynamics presented through a surrogacy arrangement.

Gershman elaborated on the significance of showcasing the birthing process realistically: “There is a higher infant and maternal mortality rate for Black women in America. We wanted to show a successful story of a birth happening, where even though there are complications that often arise, this woman was treated with the utmost care, and ultimately, they were able to save both her and the baby.”

‘The Pitt’ uniquely interlaces the emotional struggles of its characters, intensifying audience engagement as they witness uncertainties in the lives of the patients. It uses profound implications of childbirth to highlight the nuances of family and societal expectations.

Noah Wyle, who portrays Dr. Robby, emphasized the importance of the prosthetic in aiding their performance, saying, “It allowed me to not have to simulate or imagine anything that I was doing. This one, my hands were inside. The baby was in there. Everything we did was possible because of the beautiful artistry behind the prosthetic.”

The show utilizes EM:RAP, a database of medical knowledge used by ER physicians, to prepare their cast for specific procedures, ensuring authenticity down to the last detail. “We knew we wanted to do a birth scene in the ER. It does happen, and we wanted to show something we hadn’t seen before,” Gershman added.

As the series progresses, ‘The Pitt’ continues to push boundaries in how medical processes, especially childbirth, are represented on screen. By focusing on authenticity, emotional depth, and comprehensive storytelling, it elevates discussions about family dynamics and maternal health, marking its place in modern television as a leading example of realism in storytelling.