This piece is based on a lecture I delivered during the international conference of the Royal Society of Obstetricians and Gynaecologists, in June, when many, many hundreds of obstetricians and gynaecologists gathered in the Waterfront Hall in Belfast. They were, as a group, confident, charming, and well got. Their smiles were easy and their hands were smooth; made silky, as I imagined, by the fragrant interiors of latex gloves and much hand lotion and the wonderful emollient that is money. The exhibition stands beside the buffet gave new meaning to the word ‘exhibition’. A plastic woman with no legs gave birth beside the coleslaw. There was a poster about vulval health beside the coffee flasks.
My girlfriends thought it was hilarious that I was going to address many, many hundreds of obstetricians and gynaecologists. ‘Just tell them to relax,’ said one. ‘And breathe through their mouths.’ But there was no need for that kind of talk. They were all very nice.
‘Deshil Holles Eamus. Send us, bright one, light one, Horhorn, quickening and wombfruit.’
My heart fails me sometimes if I find myself obliged to talk about James Joyce. Last week I left Trinity College Library – living, as I do, the life of the mind – to find my way blocked by two people roaring and blackguarding in the street. There was a policeman standing there, and he was laughing at them. It was Bloomsday, the 16th of June, and these were actors or enthusiasts who were pretending to be characters from Ulysses. The town, as I walked through it, was full of similar types. I felt like a mouse that lives in Disneyland, a real mouse, who watches Mickey Mouse leading the parade and says, ‘Could everyone stop making so much noise, I’m trying to get some work done.’
But then you go back, for one reason or another – the spooky, almost Joycean fact, for example, that you have to address a hall full of obstetricians and gynaecologists – you go back to the work itself and are delighted.
‘Before born babe bliss had.’
The ‘Oxen of the Sun’ chapter of Ulysses is set in the basement of the National Maternity Hospital in Holles Street in Dublin, where various drunks and scallywags assemble while, on a floor above, Mina Purefoy is in labour. Mina has been married for nine years – ‘Nine twelve bloodflows chiding her childless’ – and has been in labour for three days. As the nursingwoman tells Bloom, ‘she had seen many births of women but never was none so hard as was that woman’s birth’.
Despite the fact that various wastrels are entertained in the basement, Holles Street gets a good press from Joyce. Everything, for Mina Purefoy, is done ‘commodiously’.
A couch by midwives attended with wholesome food reposeful, cleanest swaddles as though forthbringing were now done and by wise foresight set: but to this no less of what drugs there is need and surgical implements which are pertaining to her case not omitting …
I had my own children in Holles Street and can testify that very little has changed – maybe the food, though I never was down in the basement, so there might still be people drinking stout down there, and eating sardines.
The cast list is uncertain. Punch Costello, Bloom and other ‘likely brangling fellows, Dixon jun., scholar of my lady of Mercy’s, Vin. Lynch, a Scots fellow, Will. Madden, T. Lenehan, very sad for a racinghorse he fancied, and Stephen D’. If the language sounds archaic then that is because it is supposed to. The chapter mimics the process of gestation by moving historically through the English language from Anglo-Saxon poetry to the sentimental novel of the nineteenth century and contemporary slang. Of course, the history of language is also a history of attitudes to what is happening upstairs, and the medieval nursingwoman discusses, with mournful grace, the fact that as we are born, so we must also die. The first attitude that is struck is one of tender and ritual sympathy for this particular woman and for all women, who must give birth, as the Bible says, in pain.
Many matters both large and foolish are discussed by the men downstairs. The question arises of who, in the case of a difficult birth, should be saved and who should be lost, and, still in medieval mode, ‘they all cried with one acclaim nay, by our Virgin Mother, the wife should live and the babe to die’. They talk of ‘Lilith, patron of abortions’, and how at the end of the second month a human soul was infused. Interesting ways to get pregnant are discussed, ‘of bigness wrought by wind of seeds of brightness or by potency of vampires mouth to mouth … or an she lie with a woman which her man has but lain with, effectu secuto, or peradventure in her bath’. But time and history move along, and by the end of the paragraph Stephen Dedalus has arrived at the position of the Catholic Church established in late medieval times: that in uncertain cases, the mother should be let die, as unlike the Virgin Mary she was, ‘but a dam to bear beastly … for so saith he that holdeth the fisherman’s seal, even that blessed Peter on which rock was holy church for all ages founded’.
After this there is much bawdy talk among the men of virginity and the deflowering of virgins, fertility and wife-swapping: ‘Greater love than this, he said, no man hath that a man lay down his wife for his friend.’ The good nun, ‘ywimpled’, who let Bloom in, tries to quiet the revellers – but to no avail. Like Chaucerian pilgrims, they show her scant respect. ‘The bedside manner it is that they use in the Mater hospice. Demme, does not Doctor O’Gargle chuck the nuns there under the chin?’
(I feel the Irish nursing sisters got more effective, over the years. By my mother’s day, no one was chucking any nuns under the chin; by my own, the nuns were in disguise.)
The irony of the situation, of a pack of wasters getting drunk in a maternity hospital, is deliberate. The chapter is about men profaning the sacred site and rites of fertility itself. They are admonished for their paganry with ‘A black crack of noise in the street’ as a storm breaks over the centre of Dublin.
It is late in the day when we realize that the doctor on call is also sitting there, shouting and drinking stout, when the ‘young surgeon … rose and begged the company to excuse his retreat as the nurse had just then informed him that he was needed in the ward’. And indeed, it is not for the birth he was leaving them, but to deliver the afterbirth: Mina Purefoy has had a boy.
The centuries have passed with each paragraph. The nursingwoman is now ‘the second female infirmarian to the junior medical officer in residence’. Joyce is giving us not just a history of the language but a satirical account of the history of obstetrics. We get the quirky scientific curiosity of the Enlightenment, as they discuss ‘the prenatal repugnance of uterine brothers, the Caesarean section, posthumity with respect to the father and, that rarer form, with respect to the mother’. This then gives way to increasingly specific medical terminology: ‘the benefits of anesthesia or twilight sleep … the premature relentment of the amniotic fluid (as exemplified in the actual case) with consequent peril of sepsis to the matrix, artificial insemination by means of syringes, involution of the womb consequent upon the menopause … that distressing manner of delivery called by the Brandenburghers Sturzgeburt’.
This mixture of superstition, cod science and pomposity finally gives way to the social concern of the nineteenth century, with theories for how to reduce mortality rates among the poor. ‘Mr J. Crotthers (Disc. Bacc.) attributes some of these demises to abdominal trauma in the case of women workers subjected to heavy labours in the workshop and to marital discipline in the home but by far the vast majority to neglect … Although the former (we are thinking of neglect) is undoubtedly only too true the case he cites of nurses forgetting to count the sponges …’
Upstairs, recently delivered, Mina Purefoy emerges into the light of our attention at last: ‘Reverently look at her as she reclines there with the motherlight in her eyes …’. She is presented as a mother in the sentimental tradition of motherhood, a wife, and a contented member of the decent middle classes: ‘as her loving eyes behold her babe she wishes only one blessing more, to have her dear Doady there with her to share her joy, to lay in his arms that mite of God’s clay, the fruit of their lawful embraces’.
Along with this sentimental view of the mother is a new version of the doctor in the case, so recently drinking and gasbagging with Dedalus and Bloom: ‘the skill and patience of the physician had brought about a happy accouchement. It had been a weary weary while both for patient and doctor. All that surgical skill could do was done and the brave woman had manfully helped. She had. She had fought the good fight and now she was very very happy.’
The birth of Mina’s baby is told from multiple perspectives. It is told, you could say, by everyone but Mina. It is not actually told at all. This is a crowd scene; the action – the real and sacred event – happens in private, elsewhere.
Consider, by way of contrast, the labour that Kitty endures in Tolstoy’s Anna Karenina. This is a really simple passage, but what it does is remarkable. When her time comes, Kitty’s loving husband, Levin, runs to the chemist for opium then on to the doctor to beg him to attend to his labouring wife. Back home, he is in and out of the room, to tend and reassure. It is a long labour – or so it seems to Levin. When the doctor arrives Levin stands outside the door, where he ‘heard someone shrieking and moaning in a way he had never heard till then, and he knew that these sounds were produced by what once was Kitty. He had long ceased wishing for a child, and now he hated that child. He did not even wish her to live, but only longed that these terrible sufferings should end.’ When he enters the room again, he finds that ‘Kitty’s face did not exist. In its place was something terrible, both because of its strained expression and because of the sounds which proceeded from it.’
In both these powerful accounts of birth, the labouring woman is absent. In Ulysses the absence of the woman is a both a social and a sacred one. In Tolstoy the absence is much more radical. We see the woman, but she is not there. Kitty’s personhood is, in the process of labour, destroyed.
Tolstoy had many children and he, or at any rate his wife, had no illusions about how human beings make their way into the world. Like Joyce, he was on a mission – the mission is the same for every novelist: somehow, in ways that might surprise you, to tell it like it is. We can only tell truths that are available to us, of course, but the facts of labour and childbirth were always there for the writer who looked for them.
When the Irish writer George Moore wrote his novel Esther Waters, about the plight of a pregnant servant girl, he did not spare the details. The book, published in 1894, describes with a rare accuracy the details of her lying-in in the Queen Charlotte’s hospital in London: the medical students eating fondant sweets, their laughing indifference to Esther’s pain and to the screams of a woman in the bed across the room. Moore describes not just her paranoia and distress – both of which I remember from my own labours – but also (and he really did his research here) the pains that ‘creep up from her knees’. When the moment arrives, after a pain that seems to tear her asunder, the doctor places ‘a small wire case over her mouth and nose, and the sickly odour which she breathed from the cotton wool filled her brain with nausea; it seemed to choke her, and then life faded, and at every inhalation she expected to lose sight of the circle of faces’.
The absence of the woman herself is made total, in this scene, by the use of chloroform. Is it not possible to be human at this moment – or is it just impossible to be depicted as such? When Esther comes to, it is to discover not just that she has had a baby boy, but that she herself has been magically changed. ‘A pulp of red flesh rolled up in flannel was laid alongside of her. Its eyes were open; it looked at her, and her flesh filled with a sense of happiness so deep and so intense that she was like one enchanted.’
Moore’s book was a great success. The content shocked many, but his social zeal won the approval of others, including Gladstone. Despite the fact that Moore was born on an estate in County Mayo, the novel’s realism exposes not poor suffering Ireland (Gladstone felt sorry for us too, you know) but the suffering of English serving classes in the industrial age.
Perhaps Ireland was not real enough to have real childbirth in it. The question remains as to why, in a country obsessed by reproduction, obsessed for decades with the ownership of female fertility – a country, moreover, with more decent writers per acre than any other piece of land in the world – there are so few accounts of labour and birth in Irish literature.
These subjects are deeply taboo, but that is not a real excuse: Irish writers have long been in the business of breaking taboos. Many Irish writers were men – but so was George Moore. Many of the women writers did not have children, or if they did, they had no time to write anymore. ‘For every baby a tooth,’ they used to say, and, when I started out, ‘for every baby a book’. (They were wrong.)
But even if the writer is a woman, and one who has given birth, there are problems writing the experience into a novel, as opposed to a non-fiction account. It is hard to remember a labour, unless you remember it too well. There is also an uncoupling of cause and effect. The beauty of the child, the fact of the child, has very little to do with the ease or difficulty with which they came into the world, and novels are all about cause and effect.
Birth is so melodramatic. It is, in a funny way, an accident, the way a car crash might be an accident, and accidents make us question the fiction – Who made this up? you say. This is one of the reasons why there is a lot of sex in novels and very few babies. Paradoxically, modern fiction describes many, many sexual positions, and almost no contraception. Babies themselves make poor characters in novels: they may have personality, but they have very little moral agency. Actually, let’s face it, mothers make poor characters in novels: they have limited choices, and there is always something on their mind other than the plot. It is very difficult to think of novels – or, indeed, of Shakespeare plays – that have a mother as the central character.
Of course, when the novel shades into genre – historical fiction, sci fi, and horror, it deals with childbirth alright, but in the gothic, spooky, or sweaty-screamy way: there are birth scenes in Gone with the Wind and in Rosemary’s Baby, and Danielle Steele is rarely without one, apparently. But the history of the modern novel is the history of the individual in society, and childbirth, I would argue, is not about the individual. It is about … something else.
Still, you might think that Ireland should be, in this matter, a special case. So much of our energy, over the years, has been spent trying to wrest control of the process back from a celibate church, and there have been important tragic births in grottoes and fields. Éilís Ní Dhuibhne deals with infanticide in her story ‘Midwife to the Fairies’, as Seamus Heaney does in his poem ‘Limbo’. ‘Sarah’ by Mary Lavin, published in 1943, deals with the death of a woman in childbirth, in a ditch. But most of these births happen off camera, between paragraphs, in the past. No Irish writer has tackled the subject, merged female suffering with national suffering, with the verve of Toni Morrison in Beloved, in a remarkable scene where a runaway slave gives birth on ‘the bloody side’ of the Ohio River.
Fiction is full of orphans and the problems of inheritance, but pregnant women are few and far between in the Irish tradition as in every other – despite the fact that women used to be pregnant all the time. This may be a case of the writer covering his eyes, the way everyone else covered their eyes, when they saw a bump. It is, of course, possible to ignore the nonsense and just write about the way people live their lives. Frank O’Connor describes a pregnant character, safely married and glum, smoking a cigarette and complaining that she feels like a yacht who has been turned into a barge.
Another exception is Edna O’Brien, who is always amazing for the things she will say. In A Pagan Place, which is set in the fifties, the mother saves up crinkly tissue paper to use as a barrier method of contraception. And to the question ‘Do we really need to know that?’, the answer is, Oh yes we most certainly do.
A Pagan Place deals with the pregnancy of the narrator’s sister, Emma, who comes home to the farm in an interesting condition. ‘Are you bleeding?’ says her mother. ‘Spotting,’ she says. Emma is confronted, in the kitchen, by her alcoholic father and his drinking companion, the local doctor. ‘From the way she shivered,’ writes O’Brien, ‘it was evident that she thought they were going to kill her.’
Your father asked if it could be prevented. The doctor said that was a moot point. Your father said wasn’t there ergot. Your mother uttered an ejaculation …
The book is written in the second person, which makes it feel more chaotic, and intimate:
Your father said he wanted something done and pronto at that. The doctor said Indeed. Your father said it was a little matter of circumventing nature. The doctor said there was such a thing as professional ethics. Your father said to ethic his arse and play ball and do something.
The doctor, drunk as he may be, refuses. Emma spends the rest of her pregnancy confined to the house of an accommodating landlady in Dublin. When the family goes up to visit, her father asks to be sent a telegram once the baby is born. The only problem is how to phrase it: ‘He hit the palm of his hand with his fist, said he had it. He said to Emma, Now suppose it’s a boy, we’ll call that a Volkswagen; and suppose it’s a girl, we’ll call that a Hillman Minx. Then overjoyed with himself he worded the telegram, Arrived safely in Volkswagen or Arrived safely in Hillman Minx. He and Emma repeated it like it was a couplet.’
The telegram, when it comes, says ‘DIFFICULTIES WITH VOLKSWAGEN’, and ‘they were demented trying to interpret it, trying to decide who was endangered, it or Emma’. They send back ‘REQUIRE FULL DETAILS CONCERNING VOLKSWAGEN AND DRIVER IMMEDIATELY’.
Emma, in fact, has done a bunk, leaving the baby in intensive care. They track her down and write a letter. ‘Emma’s reply was in a brown business envelope and marked personal. It was succinct. It said she was not bursting to see her mother, pointed out that she had just gone through a neo-Victorian confinement and the loss of her child. Your mother said did anyone ever hear such impertinence, neo-Victorian and the loss of her child.’ She says it is time her daughter toed the line and came down, not just off her cross, but also ‘off her high horse’.
O’Brien is capturing a key moment of social change. It is arrogant of Emma to use such phrases, to criticize the institution where she gave birth, and to hint that a mother’s love for her child gives her any rights in the matter. One way or another, that accusation of arrogance has been levelled at speaking reproducing women ever since.
It’s not about you, you know.
In the past fifteen years, there has been a flood of non-fiction accounts of labour and birth – my own among them. Perhaps the Edna O’Brien scene shows why many of us seem a little defensive. Some of these non-fiction accounts are full of affront – and indeed there is much to be affronted by. There is, for example, the fact that at this moment your existence is being pulled inside out: that you are, as a person, beside the point.
The debate about labour and birth is more difficult to negotiate in individualistic cultures, such as America and Britain, or in individualistic enclaves of those cultures, such as the middle classes. But our anxiety is not all a few painful hours: the greater the loss of status that motherhood brings in the long term, the greater the sense of grievance about the birthing process. When you become a mother some of the doors in your life shut with a bang, and you do not know what lies beyond the one that has opened for you now. There is also a philosophical pain: birth is not, in fact, ‘about you’. It is about a new kind of biological entity, one we have no name for, the mother-and-child.
Perhaps nine years ago a piece I wrote about the experience of being pregnant was published in the Guardian newspaper. There were some very angry responses, of the ‘who does she think she is’ variety. ‘Very interesting to read about the first woman (she just had to be a writer) ever to get pregnant. Myself, I just looked under a gooseberry bush three times,’ said Doris Barrett – I am so glad she was called Doris. And this, from a much sadder person altogether: ‘Thank you so much for the details of Anne Enright’s extraordinary pregnancy (her timing of digestion was especially engrossing). Next, can we look forward to a heartwarming account of a humdrum miscarriage, or “What One In Three Pregnancies Really Feel Like” (the figure last given by the Miscarriage Association)?’
The letters are interesting to me because it is difficult to tell what the writers are angry about, or most angry about. The anger slithers around. But they share a sense that it is highly presumptuous to speak about being pregnant.
The novel as a form does not like pregnancy and childbirth because the novel is concerned with the individual and the choices that people make. And though sex is a choice, and conception is sometimes a choice, childbirth most certainly is not: it is a consequence, and one that is hard to define. Is it terrible or glorious? Or is it just, in a strange way, not about you?
Much of the modern debate about childbirth deals with ideas of agency and ownership. Who is doing this, the mother or the doctor, who is in charge of it? If we say ‘the body does it’ then who is in charge of that body? I think that birth is not about being in charge, is not an activity of the ego; that it takes place at the limits of story, at the limits even of language and what language can say.
‘I am having a baby.’ This is such a simple sentence, but who can make sense of it? We bring our ideas of the sacred, the scientific and the personal, and they are not enough.
How do you tell a woman this? How do you tend to the person, when her ideas of what it is to be person are about to change?
Read more in The Dublin Review issue No. 40 Autumn 2010.