MAY 22, 2014
NOTHING brings out the worst in us quite like pregnancy and early motherhood; judgment is as ubiquitous as the fear of crapping ourselves in labor. Women who come at birth from different social, spiritual, intellectual, psychological perspectives tend to be absolutely inscrutable to one other. (You stayed at home to deliver your baby? You went to a hospital to deliver your baby? You had your uterus cut open? You used your vagina? You wanted to feel it? You didn’t want to feel it? All together now: What is wrong with you?)
But birth stories are arguably the oldest genre of storytelling on earth, and the whole blessed point of stories is not to judge, so there is much to love about each and every entry in this so very welcome anthology. Each stars a single, solitary woman doing the very best she can.
Women have always given birth, and until the pharmaceutical industry figures out how to engineer and profit from artificial gestation (give them another decade or two), most will experience the urgent need to share their stories. The way any given woman engages with childbirth offers an interesting window into the way she approaches her body and life in general, and many kinds of birth are duly represented herein: natural, medical, thwarted, terrifying, blissful, traumatic, scheduled, protracted, propulsive. There are twins. There are complications. There is trauma. There is excruciating beauty and triumph. In describing labor some writers use words like “fight” and “defeated”; others relate to labor as an “athletic event” or “test.” Some are “ecstatic” and some are afraid. Several are curiously detached. Taken together they form a redemptive chorus, necessary and vital. The less collectively ignorant we are about birth, the better.
One need not be a particularly great writer to tell a riveting birth story; the sole requirement is having given birth. The least satisfying of these essays are the ones that reek of writerliness: they’re elaborately constructed, overdressed, and trying too hard. Birth is elemental and inherently powerful — it needs no embellishment, no pseudo-craft. Anyone can tell an edge-of-seat birth story; birth is new and important every single time. The key is to face it square and say what happened.
Some consciousness of birth history and politics doesn’t hurt, either. One can write meaningfully about one’s experience without that context of course, but as soon we get into those pesky politics, the ideal sisterly nonjudgment is out the window. There is systemic abuse deeply embedded in the way industrialized women give birth; working familiarity with said abuse would seem a prerequisite for holding forth. In other words, given the truly hideous and maddening history and politics of childbearing over the last century and a half, it can be hard to take seriously the perspective of writers who seem invested in ignoring the context in which they are a) giving birth and b) telling us about it. Never is the personal quite so political as here.
Still, there is no birth story — in the world or in this anthology — that isn’t riveting and instructive, even in spite of political blind spots. There is a profound otherworldliness about birth, which is, in its rites, rituals, and transformations (not to mention the abuses that all too often turn it from a simple passage into a hellish ordeal) more like death than we usually care to admit.
Birth, seen through the eyes of these 30 brave writers, is a quest, a journey, a mirror. One finds out about oneself, if one is willing to know. The pain of labor might be surprising, but so too is the way one handles it. To deny the mystical elements of birth is to maintain a profound ignorance of birth, and the best of these pieces don’t play coy. “We are afraid of the dangers,” writers Rachel Jamison Webster in “The Broken,” “but we are also afraid of the mystery.”
“No one had said if you struggle with feeling vulnerable, labor will be difficult,” observes Sarah Jefferis in “Blood and Chocolate.” “No one had said that that deep self might scare you out of your pants.”
In “It Takes a Building,” Phoebe Damrosch’s “labor personality” turns out to be rather hilariously disgruntled. “If there were a customer service line to call, I would have asked to speak to a manager and not settled for anything less than an apology and promise of retribution,” she recalls. Having her second baby, Damrosch resolves to be more “go-with-the-flow.” Then labor begins, and “guess who showed up? That bitch from the last birth! Except this time, she was a little whiny, too.”
For Amy Brill, having spent her second pregnancy finally finishing the novel she had long hoped to write, labor proves an extension of that endeavor. “I experienced each contraction as it happened, going toward the experience instead of pushing away from it,” she writes. Like finishing her book, Brill makes the connection that giving birth requires her to “harness the focus and direction […] lose the fear and doubt.” En route to the hospital, without much fanfare, she delivers her baby in the car. “‘We’re fine, we’re fine,’ I crooned over and over. And we were.”
Whereas in “The Twin,” Lauren Groff’s dark lament, an anxious, negative, overwhelmed-with-fear persona rules pregnancy and birth, wreaking havoc on both. “I cried a lot,” she writes, “then grew angry with myself for crying, then angry at my body for not behaving.”
And Heidi Julavits, giving birth at home, without her arrogant, overbooked, irresponsible midwife (who failed to show up for or send backup to her labor and delivery), finds her metaphorical nose pressed hard “against the cold glass of the self.” She is alone in the fierce grip of labor. “Now my face was crushed against the glass, and the glass was about to shatter, my face disfigured by the combustible black gas that comprises, or did that night, my soul.” If that sounds a lot like a war narrative, good: there is a vast and important literature attached to the near-death experiences of men; it’s high time for the birthing woman to be heard. And heard. And heard.
After her unassisted delivery, Julavits finds herself spiritually sunk, obsessed with death. “Would it happen quickly,” she wonders, “and would I stay strong? Or would it be endless and painful, and would I, in the process, become unrecognizable to myself as myself?”
In each and every case, what’s obvious is that our minds have a powerful effect over how we labor and birth.
Full disclosure: I’m a doula. Doulas are supposed to be even-keeled and supportive: whatever the expectant mother wants to submit to in childbirth is fine. Except, for better or for worse, I can’t be that doula. So I read with great weariness some of the more traumatic birth narratives herein, pileups of unnecessary intervention and outrageous treatment at the hands of disinterested hospital personnel. Conventional wisdom, perhaps unwisely, holds that you go to a hospital to have your baby because hospitals are simply where one goes to have a baby. As an idea, that one’s only about a hundred years old — it was (ironically) first wave feminists in the late 19th century who first questioned whether we necessarily have to suffer in giving birth. Curse of Eve? They thought not, and our long collective nightmare of trying to somehow outwit birth, to outsmart and circumnavigate its simple realities, began. It has been an unarguably bad ride.
Respected medical journal The Lancet reports that the United States now ranks 60 for maternal deaths on a list of 180 countries, up more than 50 percent since 2000. According to Save the Children’s 2014 index by, the US rate has gone from one in 3,700 to one in 2,400. “Only 14 countries in the world made less progress than the United States on this indicator during the same time period,” the report says. A woman is considerably less likely to die in childbirth in Saudi Arabia or in China than in the United States.
In early 2014, the American College of Obstetricians and Gynecologists issued an unprecedented statement entitled Safe Prevention of the Primary Cesarean Delivery. In it, they acknowledge that rising rates of medically assisted childbirth (C-sections are up 500 percent since 1970) have not reduced maternal or neonatal mortality at all. Quite the contrary: routine medical intervention has been shown to do much more harm than good. Their statement culminates in “significant concern that cesarean delivery is overused.”
Many of these pieces hew to roughly the following structure: pregnancy is strange and/or cool and/or lovely and/or a bummer; “due” dates come and go; protocol is followed, procedures are initiated, doctors or midwives induce manually or with synthetic drugs; labor starts out fine, gets intense; an epidural is eagerly/regretfully requested, labor stalls and/or goes on longer than regulation allows, doctors and nurses threaten, and/or condescend, and/or terrorize; one way or another all hell breaks loose.
Every doula I know rolls her eyes and sighs at these kinds of stories, which we hear and witness with sorry regularity. Immersing oneself in the world of expectant women can often feel like standing near the edge of a cliff trying in vain to persuade people not to drive their cars off the drop. One tries to look away; one cannot look away. So it is with this anthology: one wants to retroactively grab some of these writers by the shoulders and intervene — you’re doing fine!Of course you’re scared and anxious — you’re surrounded by people who are scared and anxious! You’ve drunk the Kool-Aid of a society rife with fear and anxiety and ignorance! The deer-in-headlights pose endemic to many of these essays — Oh my! These entirely commonplace phenomena took place! Color me surprised! — can make for repetitive, frustrating, and deeply unsatisfying reading, despite the fact that, sure, yes, of course, every woman is the legitimate hero of her birth story, however it goes down.
Again and again hospital staff are depicted as careless, condescending, cruel, and downright “disdainful” of the laboring woman. “When I protested that I’d like to […] have a drug-free birth, they all but said, ‘Sure, lady, whatever you say,’” Jane Roper writes.
Joanna Rakoff’s “handsome resident” lashes out when she’s not dilating fast enough: “He sighed, glaring at me as if I’d done something wrong, then turned on his heel and walked out.” When she decides she wants an epidural, “Suddenly, everyone loved me. A team of residents and nurses […] all of them jovial and calm. […] I was complying, admitting defeat, succumbing to […] the miracle of modern medicine.”
Nuar Alsadir, in fine spirits at nine centimeters dilation, is threatened with surgery. “[The resident] was like an enraged driver honking for me to move, driving up to my window to […] intimidate me.”
“Buck up,” a doctor tells Heidi Pitlor as she’s experiencing what she’ll soon know is a miscarriage, “Pregnancy hurts.”
Marie Myung-Ok Lee is sent home in fast, active labor only to rush frantically right back to the hospital to deliver.
Mary Beth Keane is impressively forthright about her nightmarish first birth: “I felt like I’d been roasted alive.” Then, after the scheduled surgical delivery of her second, the “absolute certainty that I could have delivered him.”
As Damrosch points out, the silly Hollywood convention of yelling “PUSH!” at a laboring woman is a lot like yelling “Sneeze!” at someone who’s about to. It’s a witty observation, but charged with heavy contradiction; the final stage of labor is prolonged and obscured by epidural anesthesia, so a laboring woman with a spinal cannot feel or heed her body’s own signals, and thusly numbed must be thusly instructed.
Thankfully, literary big sister Cheryl Strayed shows up to offer up a useful list of “What Not to Believe,” which includes this sage advice:
Don’t believe your body should cooperate with some plan that a medical association made because it protects them from lawsuits […]. Don’t believe you shouldn’t educate yourself beyond what whomever you’ve hired to help you with your birth tells you. […] Don’t believe a pregnant woman is psychologically fragile and should be protected from the realities of labor and birth. […] Don’t believe you can’t do this. It’s a rough business, but you can.
(Strayed’s piece ran on Slate and received upwards of 700 comments, including the gem “You should have gone to a hospital. F*** that midwife s***.”)
While many beautiful babies emerge throughout these pages, there is also, inevitably, heartbreak. Injury, illness, infertility, miscarriage, stillbirth, death.
To “face the grief” of a stillbirth, mother of three Arielle Greenberg insists on delivering her dead son at home, in a way that feels “sane, and intimate, and loving, and private.”
Adjusting to the reality of her newborn daughter’s severe congenital muscle disease, Amy Herzog marvels at her carefree pregnant self. “I am envious of her: her blithe assurance, her optimism, her illusion of control.”
“How hopeful and ignorant we are!” writes Ann Hood in her haunting account of two births, first a son and later a daughter, who then dies suddenly at age five.
We’re not as accustomed to the unpredictable as perhaps we once were. We’re certainly not accustomed to losing babies. But make no mistake: to give birth — no, sorry, to be in possession of a body — is to enter the continuum of loss: machines and privilege and desire and entitlement notwithstanding, neither birth nor motherhood nor the NICU are for the faint of heart.
Nevertheless, it’s disappointing to repeatedly see the tired trope of “My baby is here and that’s all that matters” in these pages; yes, healthy living babies matter, yes, healthy living babies are the inarguable goal, but women’s bodies and minds — and the all-important connection between the two — matter also. Birth, as the indomitable Ina May Gaskin reminds us in the title of her essential recent book, Matters. Regrets and what-ifs resound powerfully in these pages. There is meaning and purpose to the sorrow that accompanies violation of body, mind, and spirit. Responding to a fundamentally broken modern maternity care system with what amounts to “whatever, onward” undermines the power and meaning and shape and substance and legacy of the quite brutal experiences many women go through. It also — and this is precisely where all that lovely nonjudgment comes to seem downright stupid — consigns younger and future women to similarly brutal experiences. Nothing will ever change if every woman who’s been shocked and scarred by childbirth, every woman who has felt rightfully broken by it, simply expresses gratitude for her living baby and closes the case. Because for the most part it didn’t have to be that way.
Here is the library I gift expectant women I love: Jennifer Block’s Pushed, everything by Ina May Gaskin, Naomi Wolf’s Misconceptions, Barbara Ehrenreich and Deirdre English’s For Her Own Good, and Rachel Zucker and Arielle Greenberg’s Home/Birth. I cannot begin to tell you how many otherwise seemingly intelligent, well-educated women refuse to so much as open a single one. Alas, it can be impossibly overwhelming, if one has never before considered the history and politics of childbearing, to begin to do so while in the excited/anxious throes of pregnancy. Received assumptions are just simpler than troubling the waters of a defective system. I don’t want to know is a common refrain.
Regardless, I’ll certainly add “Labor Day” to the above-mentioned pile: given its wide range of voices and experiences, no reader will be able to dismiss it out of hand. Women of all stripes may actually feel compelled to read it, and in so doing may experience the creeping awareness that they might prefer not to be treated like shit by strangers in a markedly dangerous, unfamiliar environment while working in good faith to accomplish the greatest physical/spiritual feat of their lifetimes.
Probably this book is purported to be “for” pregnant women, to be given at baby showers and passed around among birthing-class buds. But a good book is never “for” anyone in particular. A good book has something to teach any able reader.
The notion of the “overdue” pregnancy is largely an invented necessity of malpractice insurance. This anthology, however, is long overdue and so much bigger than the sum of its parts. Whether one’s pregnancy, labor, and delivery is empowering, disempowering, emboldening, heartbreaking, healthy, compromised, fearful, triumphant, or some completely inexplicable combination therein, nothing — nothing — is ultimately so disastrous as silence. That being so, I’m hoping for a sequel to Labor Day, and then another, and another; more and more and more birth stories until birth stories have become such a commonplace part of our collective consciousness that no woman will ever again be able to say “no one told me.” An endless library of birth stories awaiting our daughters and their daughters, that’s what I wish. Stories are powerful and can change the way we think. Therefore, a new edition every year, how about it? Best American Birth Stories, they can call it, if it makes them feel important, though “best” is so absurdly beside the point.