Half of what you need to learn to be a midwife is external stuff, pretty straightforward—textbook knowledge and bedside manners and how to interpret vital signs. The other half is subterranean. You learn by plummeting through your personal history to the molten core. No one goes there willingly. I certainly didn’t. Sure, I can coach you to draw blood or measure a cervix, but how can I convince you to dig under your easy actions and reactions down to the fiery furnace of your heart? This story’s my best attempt.
“You know why they crown royalty? To remind them of crowning at birth. They’re born into a new role. Whatever you do, honey, wear your midwife crown.”
Here is the secret to being a good midwife: In every woman are two compelling and contradictory forces. The first says a mighty NO to birth. Out of safety or familiarity or pride, this force yanks women away from the wellspring of their power. The second shouts YES. It is the creative impulse, the source of our resilience and spark. It desires more than anything to be born. In childbirth these forces play tug-of-war with a woman. Your job is to direct her YES inward, downward, until it’s concentrated on labor. Only when a woman surrenders to her own life-giving power does a baby emerge. But remember, something else emerges as well: A new woman howling with all of human suffering lodged in her groin, aware now that life begins regardless. Serve her.
Why did you choose to write about a midwife?
My sister is a homebirth midwife in New Mexico. I admire her and her colleagues tremendously. They get to kneel at the entrance to life, which is a mysterious and wondrous place. They also have to face the possibility of death, witness tremendous pain, and open their hearts to the breadth of human relationships. Midwives tend to be earthy and wise in ways few people are anymore. They must have profound faith in women’s bodies.
It was this last fact that hooked me. I’m interested in faith in all its forms, and midwives work with an intriguing, countercultural form of faith. I wanted to explore how this faith might work and set it next to traditional, Christian faith to see what the differences are.
Maybe I also secretly want to become a midwife but know that’s completely impossible. So I lived out that fantasy by writing Hannah’s story!
How much of this story is true?
Literally? Almost none. The only births in here that are based on true stories are the crazy stories that Maria and Sunny tell Stuart and Hannah in the café—the woman who gave birth in her pants, the man who held a gun to the midwife’s back as she was catching his girlfriend’s baby, and the couple who thought they’d been impregnated by aliens. Reality is always stranger than fiction. That said, I changed these stories a bit to protect people’s identities.
I interviewed a lot of midwives and mothers as part of my research, and tried to represent their emotional truths within my characters’ lives. So Hannah shares her terror of drawing blood with a number of midwifery apprentices, and Melinda shares her rebelliousness and stubbornness with a lot of mothers.
You’re not trained as a midwife. How did you acquire all this knowledge about birth?
Early on I asked my sister who’s a midwife for some examples of typical births. She laughed at me and said, “Write whatever you want. There’s no typical birth.” I did, and it turns out that a fiction writer really can imagine births that would be impossible. So I had to research enough to represent birth accurately. Many midwives have read my drafts and corrected my errors. I’m sure this story is still riddled with mistakes. I hope my knowledgeable readers will blame me for not being thorough rather than blaming Hannah for being a bad midwife!
Sample Blog posts
Why Natural Birth Matters—Even If You’re Not Pregnant
I’d been working on my novel about a homebirth midwife for five years when my partner and I decided not to get pregnant. We wanted a kid, but Emily’s cancer history and the complications that come of being two women convinced us to go with adoption.
I was disappointed. I wanted to have the experience of pregnancy, not the way some women do with a fierce biological need but rather out of curiosity: How would it feel to have another living being inside of me? Not getting pregnant was also a setback for my novel. I’d hoped that first-hand experience would make me more qualified to fill 350 pages with stories about pregnancy and birth.
But I recognized that these weren’t good enough reasons to pursue extraordinary measures. Instead, in a fantastic variation on Internet dating, two college kids in a predicament found us and chose us to be their baby’s moms. Emily and I moved into a time of intense paradox: We were expecting a baby, but birth parents change their minds all the time, so maybe not. We bought diapers and infant clothes but said no to a baby shower. I was determined to breastfeed, so I ordered illicit drugs from Canada and pumped every two hours for an entire month. I tricked my body into thinking it was pregnant, all the while I prepared my heart for disappointment.
Emily and I chose to risk the possibility of loss for the sake of the terrific miracle of gain. We chose to trust the birth parents even though we hardly knew them—even though they were so young they hardly knew themselves. Loving this unborn baby was worthwhile, regardless.
With hindsight I see that this same leap of faith is what initially inspired me to write about natural birth. Natural birth requires that we love women’s bodies—that our bodies hold wisdom that’s worth heeding. One midwife I interviewed called natural birth “feminism’s final frontier.” I think she meant that if our culture embraced a woman’s inherent capacity to give birth, women’s power and wisdom would finally achieve its rightful place in the world.
What amazes me is that this is true inside the hospital and out; it’s true regardless of the outcomes of a birth; and it’s true whether you’re pregnant or not, even a woman or not. Loving women’s bodies is worthwhile. Regardless.
Abby, the birth mom, had chosen a hospital with a low C-section rate, a fabulous team of nurse midwives, and a birth tub. When the time came for Abby to push, she asked Emily, Alan, and me to be there. At one point the midwife suggested that Abby leave the bath to use the toilet. Abby said, with impeccable manners, “Please, can I stay?” and then gave a mighty push. The midwife reached into the water and pulled out a milky infant. I cried, Emily cried, and Abby said, “Congratulations, mommies.”
Gwyn is five now, and she loves the water. She’s just now learning to float. In one rare moment I watch her relax on the water’s surface, and I’m filled with joy at her utter faith in her body. This is what I want to pass along. This is why I’m a natural birth advocate.
Have we forgotten how to move through fear?
When Hannah, Delivered was just a vague possibility (my sister, who just happens to be a midwife, had suggested I write a novel about a midwife), I was invited to participate in a birth at a small birth center in northern New Mexico along with two midwives and three family members. The young woman seemed to thrive on the party atmosphere in the room. I stood in the corner holding the warming blankets as though I had a truly important job.
The moment that most sticks in my memory was when the mom was pushing. She lay on her side on the double bed with her legs propped up against the midwife’s body, pushing so hard the midwife had to brace herself. It was such an odd position for delivering a baby, I’ve since doubted my memory. The midwife said to her, “Push through your pain. Your baby’s on the other side of that pain.”
And that amazing young woman did.
That’s when I knew I had to write Hannah, Delivered. Because don’t we all have to push through our pain if we want to come more alive? We need to move through our fear of pain and through pain itself, and only on the other side is the possibility, but not the guarantee, of new life.
So I immersed myself in research about natural birth, which has been marginalized and medicalized and discredited, especially here in the United States. I discovered that our terror about natural birth is matched only by our wretched maternal and infant mortality statistics. And I realized that, as a culture, we’ve lost this fundamental part of our humanity—the knowledge that significant beginnings happen on the other side of pain. Have we forgotten how to move forward through fear? Are we denying ourselves some fundamental, embodied wisdom? Are we limiting the possibility of bringing new creations into being?
I find it ironic that I, who have never given birth myself, should be writing this novel. Hannah, my main character, doubts her ability to be a good midwife because she’s never given birth either. But anyone who has been terrified of making something new with their life and pushed through the pain of creation has, I believe, tasted childbirth.
As a culture, we all shy away from pain, deny death, and are easily persuaded by fear. So in a way we all need to reclaim natural birth. We need to learn what we’re capable of.
I hope Hannah, Delivered is a helpful midwife in this process.
Feminism’s Final Frontier
Early on in researching Hannah, Delivered, a midwife said to me, “Natural birth is feminism’s final frontier.” I was intrigued. Plenty of liberated professional women sing praises about epidurals and scheduled C-sections. Modern medicine frees women from pain, gives them control over the timing of their births, and allows them more predictable outcomes. Right? We can make choices about birth and delivery. Choice is good. Right?
But then I talked with women who felt profoundly disempowered by their hospital births. In most hospitals, doctors and medications are the active agents, not the mothers. Professionals are the authorities on birth, not the laboring women. There’s a billboard north of St. Paul that reads, “Where do babies come from? Regents Hospital.” I began to wonder: How does medicalized birth affect a woman’s power? Or her relationship to the beautiful, mysterious workings of her body? Or her intimate connection with her baby?
Natural birth is unpredictable. It’s messy. It hurts. It brings women to their knees. Sometimes it’s dangerous. It asks women to trust their bodies when their bodies are in tremendous pain—even when they feel like they’re dying. This is not what most of us want when we cry out for equal rights. If natural birth really is feminism’s final frontier, then the source of women’s identity and strength is not what we expect.
While I was writing Hannah, I got to attend a birth at a center in northern New Mexico. The young mother was lying on her side, laboring with her legs pushing against the midwife’s body. The midwife said to her, “That’s it! Push through the pain. Your baby’s on the other side of that pain.”
And it was—a healthy baby boy.
I was awed by the miraculous capacity of this young woman’s body and by the midwife’s deep trust in the body’s process. The room was filled with creative power. This is not the kind of power that our culture recognizes—not a power we usually associate with the word ‘feminist’—but rather an essential, I’d say sacred, embodied force. Later on another midwife told me, “Accepting natural childbirth is fundamental to a culture’s ability to love women. If we loved women, we’d trust our bodies.”
Love and trust: These are the “final frontier.” When our culture finally trusts women’s capacity to give birth, we’ll have achieved the goals of feminism.
In the meantime, we each struggle to trust our bodies within our various circumstances. An epidural or C-section, in context, can be the most loving and necessary choice. In my case, my partner and I opted for adoption. Regardless, natural birth shows us this truth about our humanity that we all need to remember—that our bodies are wondrously made, profoundly wise, and worthy of our ever-increasing trust.