The Birth House


The Birth House by Ami McKay. Alfred A. Knopf Canada, 2006.

Ami McKay is a born storyteller. The Birth House, her first novel, is a swiftly moving yarn. Plenty happens in this action-packed story. Babies are born, men drown, women are murdered, World War I is fought, Halifax explodes. Narrator Dora Rare even makes it down to Boston and reads banned books! Since it was published several years ago, The Birth House has enjoyed amazing popularity and it was recently shortlisted for Canada Reads 2011.

Dora Rare is the first female to be born into the Rare family in generations. There is something mystical about her right from the start, as she is born with a caul over her eyes. Miss Babineau, the midwife who cares for women in backwoods Scots Bay, Nova Scotia, understands from the beginning that Dora will some day become her successor. Dora attends her first birth with Miss B when she is seventeen years old and begins her internship with Miss. B. The old woman is at once revered for her skill and viewed suspiciously as a witch by the good people of Scots Bay. Trouble arrives in the form of Dr. Gilbert Thomas, who sets up a maternity hospital in a nearby town and intends to fill his pockets by promising to bring painless childbirth to his women patients through “twilight sleep”.

The Birth House reminded me of The Help, by Kathryn Stockett. While not great literature, both books provide a popular and accessible, if somewhat shallow, treatment of an important social issue. In The Help, it is the civil rights movement. In The Birth House, it is the conflict between the medical profession and midwifery, and the search for pain-free childbirth. Unfortunately, characters tend to be very two-dimensional, either good or evil. Certainly, most of the men in The Birth House are unpleasant characters, from Dr. Thomas, to the brutal Brady Ketch, to Dora’s own husband Archer. Even Dora herself is narrowly portrayed. Her mother encourages her to learn midwifery because times are changing and woman can do more than get married and have babies. Yet Dora never seems to investigate educational possibilities beyond her own little town, or otherwise seek an opportunity to broaden her horizons.

McKay provides a lot of interesting information about traditional practices and the uses of various herbs and plants in the treatment of illness and in childbirth. However, her presentation of modern medicine is one-sided and unflattering, to say the least. Dr. Thomas is presented as a zealot, out to force his ‘twilight sleep’ on the unwilling women of Scots Bay for his own financial gain.

In fact, ‘twilight sleep’ had a rather short life in North America and it seems highly unlikely that it would have reached a small, isolated community. Developed in Germany, twilight sleep was induced through a combination of morphine, for relief of pain, and scopolamine, an amnesiac that caused women to have no memories of giving birth. At a time of strong class distinctions, it was felt that women of low social status could easily handle childbirth, while refined women, like high-strung thoroughbreds, could not withstand the pains of labour. Twilight sleep was at first seen as a wonderful remedy until it quickly fell out of favour due to side effects such as prolonged labour, fetal asphyxia and delirium. However, it heralded the beginning of an era when childbirth was viewed as a medical condition warranting hospitalization rather than a natural event. While the original twilight sleep was abandoned, scopolamine continued to be used in combination with other drugs well into the 20th century, and anesthesia for childbirth became the norm. The ideal of a pain-free delivery was largely embraced by women and a hospital delivery became the norm. Perhaps the lack of national standards for midwifes contributed to the generally low use of midwives in North America.

My mother, who gave birth in the 1950s, happily repeated her story of waking up in the delivery room, where her first thought was to demand that her dentures be returned to her! She was told that she could have them if she could read the time on the clock, which she promptly did. She had no recollection of the births of her children and she was perfectly happy with that. Further, she disdained breast-feeding and had her own breasts bound while she fed her babies with a bottle. No doubt her attitudes were typical of those of many woman of that era.

While McKay would have it that women were being cheated of an important experience by twilight sleep, the fact is that many women demanded a pain-free delivery once it became available. It wasn’t until the 1970s that the pendulum began to return to a more natural approach to childbirth. If you are interested in reading more about the history of childbirth in the 20th century, consider looking up Deliver Me From Pain: Anesthesia and birth in America, by Jacqueline Wolf. You can read a preview online at Google Books.

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