There has always been an appetite, to some degree or other, for brutality on the screen. Everything from fist fights to wars have been shown with often gruesome detail. With regard to war, that is only fitting (I don’t tend to appreciate sugarcoating something like combat). Movie audiences are familiar, sometimes even alarmingly captivated, by bloodshed on the screen.

But the types and definitions of brutality that movie audiences expect and crave have been specific and narrow. It would be difficult to dispute that when audiences think of bloodiness on screen, they think of some exchange of violence between at least two people — usually men. Hand-to-hand combat, gunplay, or use of some other weaponry are generally the terms of “action” and “suspense” on film. If a movie is described as “bloody,” one’s first thought would likely not be of childbirth.

And yet, some of the most compelling, if unsung, “bloody” scenes in movies have not been between protagonist and antagonist, good guy and bad. They haven’t featured one party trying to incapacitate or even kill the other. Quite the opposite, in fact. Some of the best tension in movies have highlighted the pain, struggle, endangerment, and power of women giving birth.

I am often frustrated by the general attitude of nonchalance around childbirth. It’s easy to understand in a way. 15,000 babies are born every hour. It’s an event that happens constantly and in private, and the brutality of the process is often tempered (at least to those other than the mothers) by a combination of modern medicine and routineness.

But childbirth remains, even today, even in first world nations, an incredible ordeal — difficult, intensely painful, and potentially lethal. It is historically one of the greatest threats to women’s health, and has only recently become less perilous to certain (and by no means all) women. For these reasons, I find childbirth such a compelling struggle on the screen, particularly when, as it often is, it’s against a backdrop of other ongoing chaos.

There is something uniquely vulnerable about pregnancy and childbirth in cinematic moments of stress. No other predicament — illness, injury, entrapment — quite carries the undiluted distress of inconvenient labor. Illness and injury can be treated. Traps can be escaped. As for childbirth, the only way out is through, and “through” can be as dangerous as any external threat.

There is, of course, in childbirth the additional stress that it is not only one life at stake. Again, this can compound the danger. Not only is there another living being’s safety to consider during labor, there is added vulnerability afterward in having not just a woman weakened by a major physical ordeal, but an infant whose well-being is utterly dependent on others.

With all this built-in suspense, it’s surprising that childbirth is not considered a more worthy and captivating plot point in film. So much is on the line. So much can go tragically, catastrophically wrong. So much strength is required to survive it. I would argue that childbirth represents as intense a “battle” (albeit, largely against Mother Nature) as any you’ll find on the screen.

Despite a mostly cavalier attitude toward childbirth in movies, and despite its general omission as a display of fortitude and, frankly, badassery, some films have effectively used the inherent tensity of labor to elicit edge-of-seat attention from their viewers.

Belonging to this small collection is one of the most popular films of 2018: John Krasinski’s A Quiet Place. If you haven’t seen the film and don’t know the plot, it’s a post-apocalyptic story of Earth’s takeover by creatures that hunt by sound. People can no longer talk, laugh, yell, cry, or make any other sounds aloud without fear of instant attack and death.

As a result, the movie has very limited noise outside of climactic moments of action. The effect of this silence for viewers is undeniable (with accounts of the theater audiences being notably quiet and desperately attentive), and there are many moments in the film of incredible tension and genuine fear.

Of all the movie’s nail-biting scenes, easily the most gripping was the bathtub birth by Evelyn (Emily Blunt), the pregnant matriarch who goes into labor while she and her family are under attack by the sound-sensitive creatures. She is alone, without any medical aid, being hunted, and unable to make any sound even in the grips of back-to-back contractions.

The urgency and literal pain in this scene is palpable, due in no small part to Blunt’s brilliant non-verbal performance. As she cowers in the tub, beginning to bleed as the baby crowns, trying desperately to control her breathing and not to scream, one of the creatures creeping steadily nearer, her unique “condition” makes an impact that few others could match.

Another movie where pregnancy and childbirth play a central role is Children of Men. Alfonso Cuaron directed this 2006 film about a hellish future (2027) where women have become infertile. Enter one young woman, Kee (Clare-Hope Ashitey), who has somehow become pregnant and must be rushed to sanctuary.

Kee, under the protection of Theo (Clive Owen), goes into labor while they’re on the run and being chased. In many films, the symbol of hope of the film is the protagonist who fights, who shoots, who outsmarts. The hope in Children of Men is a pregnant woman, A Black mother, successfully and safely giving birth and nurturing her child.

The scene of the birth itself is powerful enough — the agony of labor with no medical aid or pain relief, with only a lantern to see by and a mattress for Kee to lie on. But the message that a Black woman is re-creating the human race, as she created us to begin with, is the crux of the film — a potent piece of historical and cultural commentary.

The future of humanity is not emblematized by a man with lethal fighting skills. It is a young Black woman with her baby. The future is not ensured in Children of Men by any men taking life; it is ensured by a woman creating it.

There is, of course, one childbirth scene that is a part of cinema history, as is the film to which it belongs. In 1939, the Academy allowed itself 10 Best Picture nominations to accommodate for the overflow of quality content that came out in what has come to be thought of as Hollywood’s greatest year. At the top of that list of nominees, and the winner of the award, was Gone With the Wind.

The birth in question is that of the first (and ultimately, the only) son of Melanie Wilkes (Olivia de Havilland), who goes into labor just as Sherman begins moving into Atlanta. With no doctors or nurses able to pull themselves away from the thousands of wounded soldiers, and enemy forces and their shells moving closer, this kid’s timing could not be worse.

With only the competent but inexperienced Scarlett (Vivien Leigh) and an enslaved maid, Prissy (the inimitable Butterfly McQueen), to be her nurses, Melanie must give birth in an Atlanta summer during a Civil War invasion with no relief from heat, pain, or danger.

For all the uncomfortable aspects of the scene and the film from a contemporary perspective, this scene is a moment of strength among women who are utterly on their own. Prissy, even while portrayed as stupid and useless, nonetheless stays through the birth and the impending invasion and provides aid to Melanie and Scarlett, despite how she’s treated.

After the birth, which Melanie only just survives, there still remains the escape from the city. As shells fall and the infamous burning begins, Melanie must travel with her newborn in a wagon along bumpy dirt roads. And once again, she is a symbol not just of unique strength, but of creation amongst destruction. As the troops move in and the city falls, Melanie and her child move out, weak and tired, but unbeaten.

Childbirth has, of course, been featured in more films than these, and a good bit has been written about its portrayals, mostly in contemporary film. Much criticism and much snark can be found on the subject, specifically about the realism in how birth itself is shown . It is often shown in a comedic light, which is not in and of itself a problem. Humor from struggle is a time-honored and often excellent source of quality writing and filmmaking.

I have no “gripe,” per se, with Hollywood’s portrayal of childbirth. But I do find the subject itself, the characters who endure it, and the gore that comes with it, worthy of more attention and respect on film in terms of the toll it takes and courage it requires. Most heroes on screen, particularly in bloody scenes, tend to be either male or violent or both. Our symbols of strength have always leaned a certain way. I think it’s time to widen that scope.

I must admit, I do not think it a coincidence that two of these three films, which treated childbirth with something more than chagrin and indeed like the grueling ordeal that it is, were based on books written by women. It’s common wisdom to say that “a baby (sucker or not) is born every minute.” What a fascinatingly passive way to say that. Consider instead, “Every minute, a woman risks her life to create another.”

A few years ago, I learned an interesting factoid. In ancient Sparta, the law declared that there was only one way for any citizen to get his or her name on a tombstone. For men, to die in combat. For women? To die in childbirth. Setting aside the rigid and brutal roles men and women were expected to play, I can’t say I’d be sorry to see that equation of childbirth to combat make a modern-day comeback, on and off the screen.