Labored Prose

Why are depictions of childbirth taboo in literary fiction?

childbirth illustration.

Mike Dawson

Are there any taboo subjects left in literature? Graphic violence and sex in any of its endless variations have become mainstream. Even excretion is now explicit: Think of the unforgettable scene of Joey searching for a ring in his own shit in Jonathan Franzen’s Freedom. But read almost any novel in which childbirth, one of the most universal of human events, takes place, and you will find that the actual act has been deleted. An author as celebrated for her visceral and detailed accounts of female experience as Elena Ferrante offers the following as a description, in full, of the birth of the narrator’s first child in the third book of the Neapolitan novels, Those Who Leave and Those Who Stay:

I had atrocious labor pains, but they didn’t last long. When the baby emerged and I saw her … I felt a physical pleasure so piercing that I still know no other pleasure that compares to it.

Pages later, the birth of her second child gets even less elaboration: “Everything went smoothly. The pain was excruciating, but in a few hours I had another girl.”

Certain ways of avoiding a childbirth scene in contemporary fiction have become almost predictable, as clichéd as the clothes scattered on the floor in a movie rated PG-13: the frantic car ride to the hospital, followed by a jump cut to the new baby; or the played-for-laughs episode of the laboring woman screaming at her clueless husband, followed by a jump cut to the new baby. What happened to what actually happens?

My latest novel, Eleven Hours, takes place entirely during one labor and delivery in an urban hospital. I’ve been through childbirth twice myself, and found it the most physically painful and most transformative experience of my life. I wanted to write something I felt I hadn’t read: a story that described childbirth from the inside. I wanted to depict the alterations of consciousness that come from the confrontation with great pain, and the ways in which the crisis of labor can cause a woman to find in herself previously unknown strengths. I wanted to conjure up the feeling of long waiting punctuated by intense activity. I wanted to show what it felt like to be so very close, simultaneously, to the creation of life and the possibility of death.

When Eleven Hours had been accepted for publication in the U.S. and my agent was shopping it abroad, a publisher that had taken one of my earlier books turned it down. “Sales and marketing did not feel confident they would know how to pitch it,” I was told. “It’s such a specific experience recounted here.”

Such a specific experience? You mean, one that billions of women have been through? Did not feel confident they would know to pitch it? The novel, as I saw it, was about the severe challenge to mind and body that childbirth is for a woman, just as combat is a severe challenge to the minds and bodies of men. Would any publisher ever claim that they wouldn’t know how to pitch a war narrative?

The analogy between childbirth and battle may strike some as extreme. But it’s only in the past hundred years or so, and only in some countries and among some populations, that childbirth has ceased to be extremely perilous for women. A woman in 18th-century England who had seven children (the average was seven to eight live births) had a lifetime chance of more than 9 percent of dying during labor. Contemporaneous accounts of births during this era are hair-curling. Recalcitrant babies might be extracted by means of a hook inserted into an eye or mouth; attempts to turn babies in the womb led to broken necks or decapitation. Naturally, these procedures were excruciatingly painful, physically and emotionally, for the mothers. Even in the affluent West today, childbirth can lead to nerve damage, scars, and incontinence, along with the less likely outcome of death to mother or child.

These are not details and scenes which appear in literary fiction. Most would be too ugly, too stomach-turning, would they not? But wait:

He put the pistol to her head and fired … A fistsized hole erupted out of the far side of the woman’s head in a great vomit of gore and she pitched over and lay slain in her blood without remedy … He took a skinning knife from his belt and stepped to where the old woman lay and took up her hair and twisted it about his wrist and passed the blade of the knife about her skull and ripped away the scalp.

That’s one of many such scenes in Cormac McCarthy’s modern classic Blood Meridian. It is a war narrative of sorts, describing the skirmishes between frontier Americans and Native Americans in the mid–19th century. War narratives of course provide the backbone of our literary tradition, from The Iliad to The Song of Roland to War and Peace to the robust crop of novels and stories that grapple with the legacy of our recent engagements in Iraq and Afghanistan. It might be thought that war offers higher stakes than childbirth—the fate of nations, rather than of one mother and child or at most one family—and is therefore richer material for fiction. In fact, it is rarely the fate of nations that drives us to read imaginative narratives of war. We do not pick up War and Peace because we feel passionate about whether Napoleon will win or lose the battle of Austerlitz. What engages us are its individuals and their destinies. Many celebrated war narratives have as their engine the relationships between fighting comrades, from Achilles and Patroclus all the way down to The Naked and the Dead and The Things They Carried. They are no less “domestic,” in this respect, than novels of family life.

So why are stories of childbirth absent from literary fiction? Like many women, I’m fascinated with birth tales. When I was pregnant, I coaxed other women to tell me theirs; mostly I wanted to know how bad things could get, what I might need to be prepared for. Afterward, I wanted to be part of the commiserating, empathizing, “can-you-believe-it?” community of birth-story–swapping women. Women tell each other the details of labor and delivery, but we don’t use these as material for literary art. Why?

The reason surely is, in part, that childbirth has to do not just with blood and suffering but with blood and suffering down there. You know, the vagina. But there’s more to it than that. In a much-discussed 1998 article for Harper’s magazine, “Scent of a Woman’s Ink,” Francine Prose quoted the novelist Diane Johnson as saying that male readers “have not learned to make a connection between the images, metaphors, and situations employed by women (house, garden, madness) and universal experience, although women, trained from childhood to read books by people of both sexes, know the metaphorical significance of the battlefield, the sailing ship, the voyage, and so on.” I would add to Johnson’s list of “house, garden, madness” the childbirth bed (or birthing stool or birthing bathtub).

A few writers have glimpsed more potential in the birth narrative, among them—who else?—Tolstoy. In Anna Karenina, Tolstoy takes three chapters to describe Kitty Shcherbatsky’s labor. Though the point of view is that of her husband, Levin, these passages beautifully render the distortion in the sense of time, the disbelief at the casual attitude of those who are not suffering, and the terror and awe that are part of almost any childbirth. In The Handmaid’s Tale, Margaret Atwood draws out certain political and economic implications of childbearing, here transformed into work forced upon indentured female servants. In the birth scene in this novel, the upper-class woman who will take the baby squats, according to ritual, over the birthing mother and pretends she is the one pushing out the child. It’s riveting.

These kinds of passages in fiction are rare, and offer only the barest beginnings of possibility. We have been trained to see childbirth as all immanence, an event that is confined to our bodies and evaporates in the next days or weeks as our memories of the pain recedes. But why shouldn’t stories of labor and delivery become vehicles for exploring matters of the utmost importance, among them the urgent dichotomies that draw us to fiction in the first place: will and fate, courage and terror, love and hatred, meaning and emptiness, power and impotence, the fleshly and the transcendent? Every birth crackles with these possibilities. To write these stories authors will have, first, to believe that they are important: fertile, to use an appropriate metaphor. Women will have to get past their habit of sharing the details only in private, with other women who have been through childbirth themselves. They will have to grapple with any trauma they may have experienced—a callous doctor, the shock of pain that broke them at times, postpartum depression, a birth defect, a stillborn child. They will have to plumb memories that adrenaline and fatigue have made fuzzy, and set aside shame about how they may have behaved in extremis.

It will be worth it.

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