Stop screaming, Mrs Steiner
- The American way of Birth by Jessica Mitford
Gollancz, 237 pp, £16.99, October 1992, ISBN 0 575 05430 1
Suffering pain, writer’s block, and the rage of critics, Philip Roth’s hero Zuckerman resolves to quit writing fiction and go to medical school. ‘Who quarrels with an obstetrician?’ he reasons:
He catches what comes out and everybody loves him. When the baby appears they don’t start shouting: ‘You call that a baby!’ No, whatever he hands them, they take it home. They’re grateful for his just having been there ... Conception? Gestation? Gruesome laborious labour? The mother’s business. You just wash your hands and hold out the net.
Poor Zuckerman. What an ill-informed – and male – view of the matter! Clearly he has never dipped into the vast popular literature on childbirth, which blames the obstetrician for everything – from the quality of the baby that appears to the quality of the experience of that ‘gruesome laborious labour’. Most American obstetricians, terrified of malpractice suits and broken by astronomical insurance premiums, would give their eye-teeth for nothing more hostile to contend with than bad reviews.
In 1963, when Jessica Mitford’s American Way of Death was published, America was in the middle of a full-scale critique of its mores and institutions. This was the golden age of the exposé. Vance Packard’s Status Seekers, Alvin Toffler’s Future Shock and Galbraith’s Affluent Society all performed the rhetorical feat of revealing what was beneath our very noses – of digging deep to uncover the sordid surface of American life. Back then, Mitford still placed terms like ‘status symbol’ in quotation marks, and caused genuine surprise and outrage by describing the American funeral industry as ‘a huge, macabre and expensive practical joke on the American public’. An ethnographer of consumer life, she discovered a ‘new mythology’ among funeral directors selling their ‘grief therapy’ both to the public and to themselves. She found that crematoria required coffins for corpses because they were in the business of selling coffins, and that embalmers sacrificed the preservative powers of their art in the interest of high production values at the funeral. Equally scandalous were the industry’s sins against language. Grotesque advertisements made coffins such as the Colonial Classic Beauty sound like the latest model of racing-car with their ‘18-gauge lead-coated steel, seamless top, lap-jointed welded-body construction’. Professional delicacy dictated that a burial plot purchased before one’s death be termed a ‘pre-need memorial estate’. The industry justified its lies and euphemisms on the grounds that it was giving the public what it wanted, the same dispiriting argument that continues to justify the abysmal mediocrity of American television (and much else).
The shock value of Mitford’s exposé depended on the novelty of the idea that something as painful, personal and natural as death could be accommodated to the sales strategies of business. But in the 29 years between Mitford’s Death and Birth we have experienced Woodward and Bernstein on Watergate, documentary photos from Vietnam, the Iran-Contra hearings, Foucault’s deconstructions of the ideology of institutions, the reports of Ralph Nader and his consumer watchdogs, feminist critiques of the crimes of an all-pervasive patriarchy, revelations of widespread child abuse and incest, new-journalistic explorations of the criminal mind, and endless press leaks about the secret love-lives of notables. It sometimes seems as if ‘routine news reporting’ is an empty category, that the only news (and scholarship) that counts is an exposé, and that anything looked at through the searching gaze of the consumerist, the feminist, the cultural critic will turn out to be a scandal.
After endless reports about the sins of the medical establishment, The American Way of Birth seems both tame and self-serving: ‘tame’ because the scandal is by now familiar, and ‘self-serving’ because it is used to validate one particular narrative of childbirth – that of Mitford herself. Her book begins with an account of the births of her four children, the first in England at home with a midwife and an ether-wand which Mitford held to her face to calm the pain. Each of the three successive births was more alienating than the last, as modern obstetrics and American exile moved her from home to hospital, female to male attendant, and numbed consciousness to full anaesthesia. The joyful first birth makes a wonderful story which is presented as an ideal that Mitford wishes all women could share.
Some women hate their obstetricians because they ruin what might otherwise have been a profoundly self-validating story. For Mitford, a good childbirth story requires the birth of a healthy baby by a mother in control of the situation. There are probably few women who would disagree. Mitford had such an experience with the birth of her first child, and her investigations have led her to believe that this was no accident, since midwives are non-interventionist, empathetic to women, and inexpensive – everything that male obstetricians, she claims, are not. A raft of distinctly bad stories follows: stories of births marred by the erroneous reports of intrusive machines such as sonograms and electronic foetal monitors; by unnecessary and debilitating Caesarean sections, episiotomies and induced labours; by total anaesthesia and the strapping of women to delivery beds in positions that force them to work against gravity. All these horrors Mitford blames on men. And she is not alone. An anonymous hand, she reports, has added to the index of Williams Obstetrics (1980) the following entry: ‘Chauvinism, male, voluminous amounts, pages 1-1102.’
The full text of this book review is only available to subscribers of the London Review of Books.