Against the Tyranny of Natural-Childbirth Elitists

Doulas and hot tubs aren't better than doctors and hospitals

by Mark Oppenheimer | May 4, 2014

photo credit: Shutterstock

I love everything about pregnancy. I find pregnant women beautiful—especially, but not only, my wife. I’m fascinated by the entire gestation process, too, from conception to birth. (Our hospital sent helpful e-mails every week, telling us what was happening to the fetus: “Week 7: Hands emerging from the arms!”) And delivery itself seems like a miraculous, extended trip to the world’s best mall: enter the hospital, then leave a day or two later with a new daughter, with some insurance company picking up the whole tab.

My wife feels differently. She was nauseated, from week six until the very end, while gestating each of our four daughters. Her feet didn’t swell, she had no strange cravings, but she was tired all the time: Never a good sleeper, she sleeps even worse while pregnant. And she never found childbirth particularly profound. It was a means to an end: parenthood.

So if one of us was going to read the new collection Labor Day: True Birth Stories by Today’s Best Women Writers, published last month, it was probably going to be me. I finished the book last week, reading in bed next to my wife, who was engrossed in a novel. Every few minutes, I would tap her shoulder and ask her a question inspired by the book. One exchange went like this: “Do you have a spirit cave?” I asked. “Do I what?” she said. “In this book, Sarah Jefferis says that in labor ‘you will go so far down into your own spirit cave that you won’t be able to see the door.’” My wife shot me a look that meant, clearly, “No, I don’t have a spirit cave.”

A few minutes later, I tried again. “Did we have a birth plan?” I asked. “Yes,” she said. “We had the same birth plan for each child: to have a healthy baby.” 

She went to bed, but I stayed up to finish all 30 essays in Labor Day. I wanted very badly to like this collection, for several reasons. It was co-edited by Eleanor Henderson, whose 2011 novel Ten Thousand Saints is one of the best books I’ve read in recent years. It contains blurbs of praise from both Mayim Bialik (TV’s “Blossom”) and Molly Ringwald (The Breakfast Club’s Claire). Forget Alice Munro and Joyce Carol Oates—for a pop-culture slut like me, that’s a pair of blurbers.

I also felt that I had damned well better like Labor Day. Panning a collection by women, about the quintessential female experience, would at best result in some very hostile e-mails, and at worst in an army of angry midwives beating me with copies of Ina May Gaskin’s Spiritual Midwifery. But that was not the real danger, I soon realized. The real danger was that they would secret me in a spirit cave. Or maybe drown me in a Jacuzzi.

Why a Jacuzzi? That gets to the heart of what’s wrong with this collection. It’s peopled by women who are redundantly, tiresomely educated and upper-middle-class, in terms of cultural prerogative if not always income (a lot of poets and short-story writers here, after all), and who share a distinctly left-wing perspective. I just described myself, my wife, and most of my friends, of course. But if I were editing an essay collection, I might try to reach outside my immediate circle, to get beyond the type of people who think it’s progressive—and, weirdly, “natural”—to give birth in an “alternative birthing center” that offers a Jacuzzi whirlpool to ease labor.

My problem is with the collection as a whole, not the individual essays. They are, by and large, elegantly written, and evocative. They go down smooth, with a pleasant, buzzy aftertaste. “I thought of my unborn child as a New York neighbor—someone who, despite my awareness of her rhythms and movements, was essentially anonymous to me,” the poet Nuar Alsadir writes. The essays are often funny. In fact, Sarah Jefferis, of the spirit cave—who is either the only lesbian in the book, or the only woman to say she’s a lesbian—has a terrific wit, which she merrily turns on herself: “Every lesbian who has the mama bug wants healthy sperm,” she writes, “but I wanted articulate sperm … I found a sperm bank that required donors to compose essays that expressed their opinions about families.” 

Many of the essays are sad without being maudlin, in a way that’s hard to pull off on the page. There are in-utero deaths, miscarriages, birth plans gone painfully awry and—worst of all, at least for the reader—Jennifer Gilmore’s thwarted open adoption, in which she is played for a sucker by an abused woman who planned all along to renege and retrieve her baby. “Will he ever know,” Gilmore writes, in the best essay in this book, “about this couple who took care of him, who loved him, who fed him at night, who lay down next to him on the softest blue blankets, who strapped him to our chests and walked with him along the creek during the first two weeks of his life?” 

That “first two weeks” are the hardest words I’ve had to read in 2014. 

But the co-editors, Henderson and her friend, novelist Anna Solomon, have drawn their contributors almost entirely from the pool of MFA-credentialed women who, for reasons of genuine conviction, cultural indoctrination, or weakness under pressure presume that “natural” birthing is better than unnatural birthing; that doulas and midwives are better than doctors; and that the birth experience is supposed to be profound. As a result, many of them end up in alternative birthing centers, or ABCs, instead of in traditional maternity wards. And in those birthing centers—if these essays are to be believed—the women can relax in Jacuzzis instead of mere showers or hotel-style tubs.

Because, as Ina May Gaskin and indigenous midwives from throughout the Third World can tell you, the electric whirlpool bath has for millennia been integral to the authentic, woman-centered birthing experience. It just took the Italian-American Jacuzzi brothers to market the idea to post-war America.

The whirlpool bath appears in five of these essays, by my count, but the assumptions that go with it permeate the book. These are women with myriad birthing options, which they see not as evidence of their privilege but as opportunities to exercise virtue, or prudence. “But as my child’s yet-unknown birth day drew inexorable closer,” writes Marie Myung-Ok Lee, “and our midwife and doula (why not have more people on our side?) made us sit down and write an actual birth plan…”

Lee’s italicized “and,” as well as the parenthetical question she poses, at least show that she is in on the joke. She knows that she’s special: a 21st-century American woman, presumably with health insurance—no woman in this collection seems like the kind to worry about bugs in Healthcare.gov. She can have her Jacuzzi and eat her postpartum cake, too, served by an obstetrician if, at the last minute, an emergency C-section was needed.

The editors’ introductory essay is far less self-aware. “We,” Henderson and Solomon write, “are encouraged—by doctors and co-workers, family and friends—to tackle our labors as we might a new job, to make detailed birth plans, to hire doulas who will advocate for these plans, to train our partners as our coaches and cord-cutters.” Who’s this “we,” the shrewd reader will ask? But we know: it’s the editors’ friends, quite literally. After they got the idea for the collection at Bread Loaf, the prestigious writers’ conference in Vermont, in 2005, “Eleanor sent out a missive to her friends,” they write. “The emails came in spades…”

In one sentence, Henderson and Solomon anticipate this criticism: “Of course, for many women across the United States and certainly across the globe, these choices are still limited, but those of us privileged enough can do and be almost anything—including paralyzed by the sheer number of possibilities.” But they apparently were not troubled enough to seek out an essay from a woman whose background, whether economic or ethnic, pushed her toward a hospital birth, or toward baby formula, rather than breast milk. Or an essay from a woman who had a home birth that went wrong. There are several essays by women who had epidurals, but only one, as I read it, from a woman who had an epidural without any regret, shame, or second thoughts (thank you, Cristina Henríquez).

I could pile on here. There are some non-white women in this book, but no women who went through delivery without a partner (Nuar Alsadir got divorced years after her children were born). While several women have had more than two pregnancies, including miscarriages and children who died, none of them (again, as far as I can tell) is raising more than two children. That selection bias queers the whole project, in a subtle way: Delivery is a lot less profound when you have to get home to two, three, or more older children.

In the world our editors inhabit, small, planned families are “natural,” as are electric whirlpools—but not big families, and certainly not Caesarean sections, which of course are old enough to be mentioned in the Talmud, and earlier. And women who simply don’t make a big deal out of delivery, or who did what their doctors advised, had their babies, and got on with life, seem to have little to offer.

Henderson and Solomon have assembled a book that will surely please the elite crowd for whom, as the editors write, birth plans “have become as ubiquitous as stretch-mark creams and layettes.” It pleased me at times, too, as when Gina Zucker recalls her attempt to induce labor naturally. Her midwife recommends an enema—“Oh let’s," Zucker says—while her doula suggests nipple stimulation, telling Zucker, “Why don’t you sit on the bed with Russ and he can do nipple stim on you and you can read these trashy magazines I brought for you.” Labor Day is, come to think of it, a lot like a trashy magazine, albeit one with an expansive vocabulary. There’s some sex, a lot of nudity, celebrities (at least in my writer’s world), divorce, death—the whole checkout-aisle shebang. There's real sadness and genuine human interest, too, but those of us who don’t inhabit the particular world of these people may be tempted to ask, as when we read about Lindsay or Angelina or the royals, “Who lives like that?”

Image via Shutterstock.

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