BIRTH

A freelance journalist follows three women through pregnancy and childbirth at a Portland, Oregon, birth center.

Grant, who writes about reproductive rights, health, and justice, trains her investigative eye on maternal health, following her subjects from preconception through the postpartum period. The three mothers whose experiences anchor the book (a teacher, a nurse, and a birth center administrator) all chose to use a birth center, “a middle ground between the home and the hospital”—a choice made by only a few percent of American women each year. Birth centers generally don’t offer pharmacological pain relief and are the “domain” of a “small but mighty category of birth workers: midwives.” Grant’s subjects all had slightly different reasons for deciding to give birth outside of a hospital, but a few commonalities emerged: wanting to feel more “in control” during labor; a desire for a personalized, nurturing care environment; and a fear of the so-called “cascade of interventions,” the process by which, during a hospital birth, one obstetrical strategy, such as induction via Pitocin, can create situations requiring greater intervention, such as a C-section. The author skillfully interweaves the personal stories of her subjects and their families with a clear and engaging history of American childbirth practices over the years. The “modern midwifery system,” Grant writes, “can be traced back to the 1600s,” when women crossing the Atlantic “became midwives by necessity” when babies were born aboard ships. These de facto birth workers included both enslaved African women and the wives of White colonists. For the next several hundred years, midwifery retained a stronghold in Southern Black communities “due to a profound suspicion of white healthcare providers.” In the 20th century, a concerted effort on the part of the medical community moved birth out of the home and into the hospital—and, as the author notes, into the hands of largely male obstetricians.

A significant and compelling sociological investigation.