Director Peter Greenaway has said that one of the sources of inspiration for the film was the banning of the Benetton advertising poster campaign in the UK that featured pictures of a newborn baby, covered in blood and still attached to its umbilical cord. An outcry caused the posters to be removed. "What is so horrible about a newborn baby?" Greenaway wanted to know. "Why is that image (one that is seen many times a day in hospitals all over the country) so unacceptable, when much more horrific images are presented on television and the cinema, featuring murder and rape, but glamorized and made safe?" Thus Greenaway set out to make a film featuring murder and rape in which "nothing was glamorized and nothing was safe".
Director Peter Greenaway originally wanted to shoot some scenes in the famous Cologne Cathedral, but couldn't: "...we had planned to use the cathedral of Cologne, but two days before we began our preparations, O Cozinheiro, o Ladrão, Sua Mulher e o Amante (1989) was shown on German television and the archbishop immediately forbade us from entering the cathedral site!" The scenes were finally shot in the remodeled Old Church of Amsterdam ("Oude Kerk"). ["P.G.: Interviews", 2000]
North American distributors refused to take the film in due its controversial subject matter. As a result, O Bebê Santo de Mâcon (1993) is officially unavailable in any format in the US.
Amazon has this movie as of 2021.
First theatrical film of British actress Julia Ormond. She and Ralph Fiennes share a violent and passionate scene, involving 'full-frontal nudity', which she remembers shooting in a church hall while Peter Greenaway ate wine gums. 'It was the most surreal experience because every now and then you'd hear "rustle rustle munch munch". Being naked in front of people who were clothed bothered me so much I didn't know if I would break out in hives... After a while you get used to it and you want to throw up at the same time.'
Julia Ormond found the film a grueling experience to make, given that her character undergoes mass rape. She regards it as Peter Greenaway's worst film.