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Midwives: A Novel ()

Vintage Books List of the Best Reading Group Books (2)

    ANSWER: Of course I also learned in my research that midwives who specialize in home birth also
    shoulder enormous responsibility. They deliver babies far from the medical safety net we take for
    granted. Clearly they're extraordinary people, and clearly they're immensely gifted.  But it is still a
    very special woman who can help a laboring mother remain focused and composed when the pain is
    intense and there's no epidural on the horizon. It's a rare woman indeed who--as one midwife who
    helped me with the book actually did--can successfully deliver a breech in a bedroom, with the
    knowledge that failure will result in head entrapment and death.
            -Chris Bohjalian in an interview

Huh?  Did I miss something?  A couple years ago we reached the point where there were roughly as many living people on Earth as there were deceased.  So let's say there were 5 billion live people at that point.  What do we figure, maybe 20% of them were born in hospitals?  And of the 5 billion dead folks, maybe 1% of them were delivered by what we would recognize as doctors.  So where does Bohjalian get this absurd idea that midwives are gifted and extraordinary?  There have been 10 billion live births of human beings and we just figured out that only about 1 billion of those births were aided by doctors.  We're looking at roughly 9 billion deliveries handled by whoever happened to be within hailing distance of the cave, tree, teepee, igloo, sod hut, yurt, etc.  For cripes sake, Archie Bunker delivered a baby on an elevator one night on All in the Family.  This isn't exactly rocket science here.  It might be helpful to recall here that man is a mammal and most of the other mammals seem to do okay without midwives or doctors.

However, not all births go easily.  Throughout human history child bearing was a dicey proposition, claiming countless newborns and mothers whenever complications arose.  But now, thanks to the enormous advances of modern medicine, many of the previously lethal complications can be dealt with effectively, drastically lowering child mortality rates and saving many mothers who might otherwise have died.  Babies are born in hospitals now, not because the average delivery is particularly difficult, but because even a potentially catastrophic development during the birth can probably be handled by today's high tech hospitals.  Most of us accept the relative inconvenience, additional cost and impersonal setting of the hospital birthing pavilion, not because we expect it to be necessary, but because of that tiny chance that it might and the great probability that mother and/or child might be saved in an emergency.

Then there's midwifery.  Anyone who has had a baby in America in the past few years will be familiar with the unsettling fact that it has become less a medical process than a political process.  The doctors, nurses, midwives and volunteers who staff birth clinics have completely politicized nearly every facet of nativity.  Emotionally vulnerable pregnant women and their typically overwhelmed husbands are brow beaten into accepting the sacred nature of drugless birth, breast feeding, refusing circumcision, etc.  Each of these alternatives, some legitimate, some simply doctrinal, is presented as the only choice that a responsible, baby-loving mother would make.  Enormous pressure is exerted to guarantee that expectant mothers will toe the party line.  I'm not sure exactly what that party is, but it seems to be some kind of weird agglomeration of feminist, vegan, organic, hippie and New Age impulses all packaged up and sold as "natural childbirth."

Given this context it is not surprising that midwives have enjoyed something of a comeback.  After all, what could be more natural than to have some women named Fyrn show up at your house, wearing burlap and stinking of patchouli, wave a crystal around and deliver your baby in your own bed, assuming that is that you haven't chosen an aquabirth.  All of which is well and good; as we've acknowledged, for most births you could just grab the Good Humor guy as he drives by and he'd be able to provide all the help you need.  But what about those rare occasions when things don't go well?  A midwife may be able to help with many situations, but what if she can't?  Are you really willing to accept the specter that professional help won't be immediately available because you were indulging some kind of tree hugging whim?

This is the point at which Chris Bohjalian's book picks up.  On an icy Vermont night in 1981, Sybil Danforth is midwifing the delivery of Charlotte Bedford's baby.  When disaster strikes and treacherous roads and downed phone lines preclude the possibility of getting outside help, Sybil, believing that Charlotte has died, performs a C-section to save the baby.  It later develops that, while Sybil's actions did preserve the life of the child, both her assistant and Charlotte's husband believe that the mother was still alive when Sybil cut into her and an autopsy subsequently shows that Sybil in fact killed Charlotte.  The novel, narrated by Sybil's daughter Connie who was fourteen at the time of the incident, tells the story of Sybil's trial on charges of involuntary manslaughter and practicing medicine without a license.

Connie is a reasonably pleasant narrator and the trial setting provides inherent tension, but the courtroom drama simply drags on far too long, particularly since we never have any question that Sibyl was responsible for Charlotte's death.  The question here is not one of legal guilt.  What happened was surely an accident and no good would be served by sending Sybil to prison.  The moral questions that lie at the heart of the story are whether she should and will take moral responsibility for her negligence.  The answer to the first seems obvious; as Bohjalian explains the medical emergency it seems to be one that could have been handled in a hospital without loss of life and Sybil apparently should have been able to determine that the mother was not dead.  In light of these facts, and out of simple recognition of her own role in the death, it is inexplicable to me that Sybil does not accept the sweetheart deal offered by the prosecution.  But she refuses to countenance any resolution which will put an end to her practice of midwifery.  How can someone justify in their own mind continuing this practice, knowing that they have killed someone, even accidentally, and that due to their own limitations, should the same situation arise again, she might well kill again?  Sybil's insistence on continuing amounts to elevating her own selfish desires over concern for her clients well being.  It is a monstrously selfish position to take and effects our ability to sympathize with her plight.  By the end of the book, I wanted to see her imprisoned just so that she could not claim any more lives.

This book fits squarely into the group of recent best sellers which make some pretense of addressing serious moral issues, but which are actually so obtuse, so limited in vision, that they call into question their authors' moral judgment.  Like  While I Was Gone (1999)(Sue Miller)(read Orrin's review), Snow Falling on Cedars (1994)(David Guterson 1956-)(read Orrin's review) and Before and After (1992)(Rosellen Brown) (read Orrin's review), Midwives is most interesting for what it says about the deplorable state of moral discourse in our nation.  The thought that folks find pretty straightforward questions like those presented in these novels to be the stuff of dramatic ethical dilemmas, must be sobering for anyone who cares about the type of society that we live in.  Bohjalian writes well enough and you do get caught up in the drama of what's going to happen, but as a philosophical meditation on medical moral issues it's appallingly vapid.


Grade: (C)


Book-related and General Links:
    -PROFILE: Chris Bohjalian (Mike Mills, Burlington Today)
    -INTERVIEW: A Q & A with Chris Bohjalian (Random House)
    -INTERVIEW: (Joseph Beth Booksellers)
    -ESSAY: Of Memory and Hope: On Memorial Day, the town of Lincoln, Vermont,
honors the dead who are its past and the children who are its future  (Chris Bohjalian, Boston Globe)
    -ESSAY: Why Vermont by Chris Bohjalian (Northshire Bookstore)
    -REVIEW: of INSOMNIA By Stephen King (Chris Bohjalian, NY Times Book
    -REVIEW: of THE WAY WE KNOW IN DREAMS Stories. By Gordon Weaver  (Chris Bohjalian, NY Times Book Review)
    -REVIEW: of A PLACE WHERE THE SEA REMEMBERS By Sandra Benitez  (Chris
Bohjalian, NY Times Book Review)
    -OPRAH'S BOOK CLUB: Midwives  by Chris Bohjalian
    -READING GROUP GUIDE: Midwives (Random House)
    -EXCERPT: from Midwives
    -REVIEW: of MIDWIVES By Chris Bohjalian (Suzanne Berne, NY Times Book Review)
    -REVIEW: of Midwives Or is it murder? (YVONNE CRITTENDEN -- Toronto Sun)
    -REVIEW: of Midwives (Margaret Prior, Mentor Mercury)
    -REVIEW: of Midwives (Mariann T. Woodward, Under the Covers)
    -REVIEWS: of Midwives (
    -REVIEW: of The Law of Similars By Chris Bohjalian (Liz Rosenberg, NY
Times Book Review)
    -REVIEW: of The Law of Similars, By Chris Bohjalian (Leonard Gill, Memphis
    -REVIEW: of The Law of Similars, By Chris Bohjalian Law of Similars is no clone: Chris Bohjalian expands on the formula of the successful "Midwives" in a novel that melds love, death (Floyd Skloot, The Oregonian)
    -REVIEW: of The Law of Similars, By Chris Bohjalian The Healing art Chris Bohjalian sets another novel in the gray area where  `do no harm' becomes a legal question (Jessica Treadway, Boston Globe)
    -REVIEW: of The Law of Similars, By Chris Bohjalian  Something Similar,
Something Enthralling (Curt Schleier, Lit Kit)

    -Oprah's Book Club
    -ESSAY: Reaching to the converted  Oprah's Book Club introduces readers to people they already know -- themselves. (Gavin McNett, Salon)
    -ESSAY: Silence the snobs!   They may look down their noses at Oprah, but what have the literati done for books lately? (Mary Elizabeth Williams, Salon)
    -Vermont Only