The Birth House - Ami McKay

A novel based around one of my current favourite topics: childbirth. Set in a remote part of Nova Scotia in the early years of the twentieth century, the book follows the life of a young girl learning traditional midwifery from the local wise woman, and continuing to practice it in the face of increasing opposition from the doctor who attempts to replace her with a commercial medical facility in a nearby town. The traditional midwives are portrayed as sympathetic characters, acting out of love and knowing the circumstances of the women who come to them for help, and the folk remedies they offer are shown to have a kernel of effective power buried in the supersition & rituals. The doctor, on the other hand, is portrayed as aggressive and de-humanising, interested only in the moment of (sterile, controlled) birth and not offering ante-natal care or interested in the impact of the birth experience on the mother's recovery or bonding with her child. While I have much sympathy with this view, I found it a little overstated - my own opinion is that both approaches are valid and the real tragedy of the story is in the failure of the two to communicate and share knowledge, rather than in the medicalisation of birth. (I was fortunate myself to experience care from compassionate midwives within a medical context, which allowed for a swift & effective intervention using modern medical techniques when required - I truly feel that I experienced the 'best of both worlds' and that this should be the ideal.) A couple of other points that caught my attention: the revelation that the vibrator was originally developed as a remedy for 'hysteria'(!), and the description of married life for many women as an inexorable series of babies arriving under harsh circumstances, resulting in moral dilemmas for midwives approached for help by women desperate to prevent or 'lose' pregnancies.