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Intimate Odyssey

Modern Motherhood and the Birth Narrative

PUBLISHED: December 3, 2020

 

“The good ones can be remembered like that, yes,” the doula said to me. On the other hand, a traumatic birth, she said, handing me a cup of tea, usually has a beginning, middle, and end. There is no narrative arc to my son’s birth.

Even a week afterward, sitting on the couch with the doula as she rubbed my leg with her confident hands, the discrete moments of my labor hadn’t yet cohered into a story. Pregnant, I hadn’t thought much about labor until its inevitability hung over the last month, and then it was all I could think about. Normal tasks receded into a haze, so consumed was I with this single extraordinary thing I was about to do. In bed one night, days before I gave birth, my toenail snagged on my sheet and I wondered at the fact that life went on amid my anxiety, that my toenails still grew and required clipping. 

And then birth happened. I felt stomach cramps one evening, forty-one weeks and change, a dusky feeling of being wound-up tight at the center of my body. I was at home (thank god), folded over like an upside-down L with every contraction, embracing the pain, proud of it. To the hospital at dawn, and the pain changed. I had no room for pride. Everything hurt and I was afraid. Time slowed. Still the labor continued, with moments of grace. When I forgot how to breathe, my husband or the nurse reminded me. And then my son was on my chest—just a blink between all-consuming pain and holding a purplish crying infant. Within a few weeks his cries struck me as inevitable, I knew them so well.

I had little desire to tell anyone the story of my son’s birth in more detail. It was a good birth. But in the months around it, as I had swelled enormously and then began to return to my own shape again, I saw birth stories everywhere. Some of this was gravitational, created by my own condition. Stories about birth were as attractive as they were repulsive to me, but they were never neutral. 

Months and then a year passed, during which birth stories appeared by the hundreds. I still see them everywhere. Even now that I no longer seek them out, they remain. They proliferate on television and in books, from literature to thrillers to the vast and ongoing profusion of self-help. Birth stories have dedicated Reddit boards, Instagram accounts, websites, and podcasts. Op-eds expound upon the luxury and lunacy of the birth plan and how it compares to the experience itself. Media outlets call our attention to childbirth crises around the world, to the racist imbalances in maternal-mortality rates in the US, to the coronavirus pandemic’s impact on women going into labor everywhere. As the drumbeat of the pandemic reverberated around the country, and hospitals began banning loved ones from delivery rooms, the birth stories women had imagined for themselves were the first casualties. “I grew up in a generation of women where having a partner with you is a big part of everyone’s birth story,” one fearful expectant mother told a New York Times reporter in March, dreading the possibility of giving birth in a hospital among strangers. 

Birth stories—the first story, the place where we all begin—offer a way to give shape to something that can never be fully controlled. Indeed, imagining a clean, linear narrative is a good preparatory exercise for an unpredictable event. But the current vogue for consuming and sharing birth stories raises just as many questions as it answers. Who gets to give birth, and why, and how? How much are we entitled to ask of our birthing experiences? The stories themselves have become a kind of repository of anxieties over what a woman is or should be in contemporary society. 

To give birth and to want to talk about it, or to approach birth and to try to learn about it, is to find oneself at the center of a fraught negotiation of power and powerlessness over a woman’s role and place, the inequities she faces or does not face in the United States today. A single story, a moment of violence and vulnerability amid a Western medical culture that aspires to dominion over the body, grows and grows until it becomes a shimmering wall encompassing identity, politics, values, medicine, culture, and more. And beneath it all, no one seems able to agree: What does childbirth mean, and what does it do to the person who gives birth? 


When I gave birth, in the summer of 2019, I was one of approximately ten thousand women who did so that day in the United States. Our labors varied: We sat in birthing tubs or lay anaesthetized in surgical suites. By and large, we gave birth safely, with most of us in hospitals and birthing centers, and a few at home. This relative variety of birth settings is new. From 1900 to 1930, most American women delivered their babies at home. Amid the legal flurry of the Progressive Era—women’s suffrage, limits on women’s working hours, the legal right for married women throughout the US to own property—a new federal Children’s Bureau released the first set of statistics on infant and maternal mortality in 1915 (for mothers, it hovered around six hundred per one hundred thousand live births). Between 1930 and 1950, better technology and protocols—the establishment of state and hospital review committees, the use of antibiotics, more doctors going into obstetrics—led to safer births. What’s more, people’s attitudes toward hospitals shifted, and more women began delivering there. Vastly lower mortality rates support the argument that Western medicine’s intervention in childbirth has made American women safer, though the same numbers also belie the stark racial disparities and differences between urban and rural contexts. Though their circumstances vary, today nearly one hundred percent of American babies are born in either birthing centers or hospitals. 

But hospitals and childbirth can be an odd, uncomfortable pairing. Since reaching its lowest rate in 1987, when approximately seven per one hundred thousand women died giving birth, maternal-mortality rates—mothers who die while pregnant, during or subsequent to childbirth, from any cause related to the pregnancy or birth—have risen in the US to seventeen per one hundred thousand, the worst ratio among similarly developed nations. Across nearly all of Europe, in Singapore and Japan and Qatar and approximately forty other countries, meanwhile, the rate remains in the single digits. Much has been written about the stubbornness of this statistic in America. Very broadly: For all its advances in the modern era, one-size-fits-all, data-driven medicine that limits access to preventative care can be fatal, especially when influenced by the biases of the medical personnel handling the birth itself. Birth, meanwhile, is simply the culminating event of a long and arduous haul, all the physical and psychological preparation of the gestational period. The American medical system prioritizes data over far less quantifiable types of care that often undergird a successful birth. Without rituals of empowerment or proper emotional preparation, blood draws and ultrasounds are simply not enough. The data—our woeful mortality rate—points to that fact. 

Childbirth is active, physical, high-stakes, a one-time occurrence. The birth story is retrospective and fluid. And the ways in which they impact each other are undeniable. Narrative, sharing, storytelling—human communication—help generate knowledge and support, which in turn improve the quality of pregnancy—which is vitally important considering the health risks that come with it. Pregnancy has been known to trigger not only depression and anxiety, but diabetes and hypertension, all of which can lead to poor birth outcomes—lackluster fetal health and preterm birth, among other consequences. One recent study found that a two-day mindfulness training improved a mother’s mental health and decreased her need for opioids during labor; another study, on “emotion management,” found remarkably lower rates of depression and C-sections among women who saw both an obstetrician and a psychiatrist during doctors’ appointments. 

Responding to the rapid rise in C-sections in the US between 1996 and 2011—when one in three women gave birth using the procedure, many because of unquantifiable “subjective indications” of fetal distress in labor—the American College of Obstetricians and Gynecologists (ACOG) released a meta-analysis that acknowledged, in vaguely stilted terms, that giving birth is not just a one-time issue to be addressed exclusively by obstetricians. “Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula…. Given that there are no associated measurable harms, this resource is probably underutilized.” By 2014, when the ACOG released these guidelines, some women had already begun to respond to this dearth of holistic help by turning to midwives, who focus on nonintervention, continuous support, and prenatal education. By 2013, 9 percent of American babies were born with the help of midwives, up from just 3 percent a generation prior.

A medical system’s priorities can suddenly become a hazard when a baby decides to be born. When the New York Presbyterian Hospital group, in response to the city’s rising number of COVID-19 cases, imposed a total ban on support people in delivery rooms, it directly contradicted recommendations from both the World Health Organization and the ACOG—recommendations made for good reason, since support during childbirth has been proven to be vital. Setting all hyperbole aside, the ban put the lives of birthing mothers at risk. A petition on Change.org to undo the regulation garnered a half million signatures in just four days, and within a week the hospital reversed its position. Fear—of both contracting the virus and giving birth alone—spread across the country. Midwifery practices began fielding thousands of calls from women hoping to schedule home births. A small Maryland group that sees between six and ten births per month answered upward of a dozen inquiries in a single day as hospitals began to implement rigid protocols. But home births require months of preparation. “[It] is not like going to Walmart and buying a new blanket for your bed,” one midwife told a reporter. As rates of infection and virus fatalities rose in cities around the country, a place that in some birth stories features as bogeyman—the hospital—was suddenly overtly, actually dangerous.

The long-term impact of the coronavirus epidemic on maternal-mortality rates, if there is any, won’t be revealed for years to come. It’s often the case that when medical resources are diverted to help battle a public-health crisis, women’s health—and the health of birthing people in particular—suffers. A flurry of recent papers points to the consequences of this fact, citing CDC estimates that some 60 percent of American maternal mortality is preventable. Also cited is a 2017 study that found that, over the three years of the Ebola epidemic in Sierra Leone, the number of maternal, neonatal, and stillbirth deaths that resulted from diverted medical care roughly equaled the total number of Ebola deaths itself.

Eventually we’ll be able to quantify the coronavirus’s impact on birthing people around the world. Until then, we can only intuit the damage through details here and there. During the initial outbreak last spring, as each day brought fresh anxiety to people waiting for babies to be born, I sat watching fresh names appear on the Change.org petition, second by second, flashing by as if on a ticker. Kathleen, Andrea, Tristan, Gail, Erik, Kat, Sondra. New York Presbyterian’s ban on support people may have lasted only a handful of days, but similar protocols took effect all over the country as hospitals began limiting the number of permitted visitors to birthing suites. Governor Andrew Cuomo issued a statewide executive order that entitled every mother to one support person. “Women will not be forced to be alone when they are giving birth,” a headline quoted Melissa DeRosa, Governor Cuomo’s top aide, as saying. The reversal left only five days’ worth of mothers—342 of New York Presbyterian’s approximately twenty-five thousand yearly infants—giving birth, as the secretary put it, functionally “alone,” even if the delivery rooms themselves were crowded with personnel. 


Photo by Alice Proujansky

The place where most births happen in the West, the hospital—in all its controversy, with its life-saving interventions and doctors who cut into laboring women on the basis of choices that may not always have a woman’s best interests at heart—is so dominant in so many birth stories that it practically becomes a character, not a setting. This character has, over time, come to exemplify either the hopes and opportunities of modern medicine’s benefits to childbirth or its perils, but rarely anything in between. 

“Stories of birth that mothers tell their daughters have been altered by years of a medically managed system,” reads a 2001 study in the Journal of Perinatal Education, in which the authors lament the last several decades’ worth of American births that have been “chemically silenced.” “Before the medicalization of childbirth, young women heard stories about strength and power in birthing, not about difficulty and suffering.” Even in the moment that the study was published, such a claim was dubious, reflecting a growing wariness of hospital births amid an inexplicable rise in maternal-mortality rates. For many women, the exact opposite is true. “We are among the first women in the history of human civilization to approach childbirth fearlessly and with positive anticipation,” journalist Susan Maushart wrote in her 1997 book, The Mask of Motherhood: How Becoming A Mother Changes Our Lives and Why We Never Talk About It. “Whatever else our society may have gotten wrong about motherhood, we have at least acknowledged that the quality of a woman’s birthing experience matters. And that it matters not only on a personal level, to individuals, but publicly and to the culture at large.” The more pressing issue, she wrote, was the disjunction between expectations of having control during childbirth and its actual unpredictability.

The birth stories themselves don’t often reflect the false binary of strength versus suffering. To a certain extent, what they do say can be quantified now that they’ve moved online. A 2019 study of nearly three thousand birth stories on a Reddit board found that positively framed stories outweighed negatively framed stories by two and a half to one. Predictably, the protagonists in these stories were overwhelmingly the authors, followed by the vague collective (“we”…“ourselves”), and then the baby. (Doctors, partners, and nurses came in last.) Told on Reddit, birth stories are neither exclusively about strength or suffering, but often portray both—power in the face of difficulty, strength amid pain. 

The birth story also offers insight into vastly different situations through a narrative that has a beginning (the start of labor) and an end (two human beings meeting for the first time). Within that arc, each birthing person’s circumstances play out differently in the tale’s construction. “Who you bring as your own self to the birth really impacts how you are able to narrativize it,” midwife and doula Rachel Zaslow said. Memories of past trauma, she notes, often haunt the birth experience and shape the story’s telling; even the desire to tell it can be influenced by the same factors. The story, then—remembering it, constructing it, and telling it—becomes a way to create a crucial bridge across an emotional void.

Childbirth contains stitched into it the real possibility of death for both the mother and the infant, if not extreme trauma for both. These things happen, or have happened to people we actually know, not just in statistics or research papers. And yet the worst of those statistics are unevenly dispersed: While only fourteen in one hundred thousand white American women perish of pregnancy-related causes annually, the same statistic for Black women is nearly forty in one hundred thousand; for Native American women, thirty in one hundred thousand. In New York City, a Black mother is twelve times more likely than a white mother to die in childbirth, owing to a combination of factors that includes access to care, poverty, and what one report calls “racism and its attendant stresses.” 

“No matter how many wonderful policies a hospital has in place, the interactions [of childbirth] are deeply personal,” Zaslow told me. She recounted the story of a Black lawyer—fit, educated—whose hospital birth she attended. “How much marijuana do you smoke?” asked a doctor at intake. Another patient had listened as doctors discussed the questionable paternity of her child as she and her husband walked out of the doctor’s office. Racial bias itself may not be fatal, but when it comes to birth, it is arguably not that many degrees separated from poor or even tragic outcomes. In her recent book, Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America, Sarah Menkedick devotes a chapter to a woman named Whitney, whose birth experiences echo such varied indignities, which can often lead—as statistics would indicate—to dire outcomes. “There were moments when Whitney wanted to say, ‘Y’all, I’m married and I graduated from Duke, and it’s okay.’ By it’s okay, she meant, it’s okay to be human with me. It’s okay to see me as a person. I’m not the stereotype in your head.” 

“For all people, you have to tap into a whole other layer of yourself [in childbirth],” Laurel Gourrier, one of two founders of the website and podcast Birth Stories in Color, told me. A woman of color might enter the process thinking, as Gourrier put it, “How much vulnerability can I actually give in this space, because I have to be on defense for how much they’re going to accept me or care for me?” 

“Unless you create your own space,” cofounder Danielle Jackson added, “you are empowered to kick someone out who has to go. We had a mom who recently said, ‘a nurse told me I could fire anybody.’ She felt so empowered. That was one of her takeaways. Know that you can just tell somebody that they can’t come back to your room.” 

Gourrier and Jackson told me that all of the women who share their stories on the podcast hope to influence and embolden other women. And the platforms for doing so are multiplying: books, yet more podcasts, Instagram accounts, conferences, TED Talks, and more. Zaslow founded a doula collective for women of color; rather than asking expectant mothers to read a book or listen to something prerecorded, she is more likely to invite a mother to come and tell a birth story in person, engaging with the group, listening to them.

To Jackson and Gourrier, part of the importance of sharing birth stories from women of color is detailing not only the challenge and the risk but the happiness too. It’s tempting to look at the numbers and conclude that “everybody dying over here, but the white women are doing great,” Jackson said. No. “We do experience joy, we also do homebirths, we do these things.” 

The challenge and the joy is specific to each individual, so unique to circumstances and personality as to render each childbirth incomparable. And yet few experiences are more common. Every single person in the world was born to someone, a fact that awed me in the days and weeks following my son’s birth. I looked around at every woman I knew who had ever carried a child, at women in the street walking casually with their kids, and wondered precisely how it had happened. 


Photo by Alice Proujansky

Five minutes into the first episode of the Australian Netflix show The Letdown, the members of a new-mom’s group introduce themselves by way of how they gave birth. Their birth stories—how they tell them versus what their flashbacks reveal—paint archetypes. There is the woman who scheduled a C-section—she’s the breadwinner in her family, all business, a stereotypical bitch—asking the nurse for the Wi-Fi password under a no-cell-phone sign. Later, with the group, she shrugs off another woman’s judgmental comment about her having chosen the procedure. A disheveled supermom with two older kids says, “I just knew that this one was in a hurry, so I got into the perfect position, of course, and here she is!” The perfect position, it turns out, was in a parking lot, bent over a car, groaning and screaming at her other children. Another woman, one who won’t name her kid and instead prefers to wait for him/her to reveal his/her name and gender, is “consciously aware of making that transition from womb to world as graceful and peaceful as possible”—cut to the tub in her living room and her primal screams. 

These contrasts between narrative and experience imply that memories of birthing can mostly only lie. With the editing of hindsight, birthing becomes a kind of self-presentation through revision. And the births they all recount eventually seem overwrought anyway. The privilege of telling the story is embedded into the scene itself: in the babies cradled in their arms, in the time they are spending getting to know one another via storytelling. 

Different motives distinguish activist-driven birth-story forums, whether in person or online, from entertainment. But overlaid with so much performance, even a superimposed narrative arc—“strength and power,” as the 2001 journal article put it—the two impulses sometimes appear remarkably similar. Away from the screen, in real life, midwife and writer Alana Apfel told me, “there’s a movement of positive births at the moment, and it tends to be a very specific type of birth and type of person that’s marketed. Slim, married, white, they had a home birth, or whatever birth they had is revered as this ideal but you rarely hear other stories from other people.” Lost on Instagram among the two hundred thousand or so photos tagged with #birthstory, I came across countless variations on this pristine (and mostly white) birthing fantasy: hands with sparkling wedding rings holding weightless babies; mothers gazing at their new infants, eyelashes heavy with mascara; a woman wearing a crown of flowers, cradling her newborn in the hazy water of a birthing tub; a baby curved like a comma, connected by an umbilical cord to a blue, veined placenta, the cord shaped into a heart between the two. Somewhere in there, though not nearly as prevalent, were more diverse stories told by women of color, birth stories from Bhutan, stories of perinatal depression, psychologists reassuring mothers that grief over a bad birthing experience is okay too.

Considering the mysteries, emotions, and life-and-death stakes of childbirth, it isn’t surprising that the entertainment industry would find a way to capitalize on the inherent drama of childbirth. Of course, the industry itself had to grow up before this could happen. In the 1950s, just the word “pregnant” was deemed too vulgar for Lucille Ball to use on CBS, so the episode in which she gives birth, in what had become television’s first high-profile pregnancy, was titled in French: “Lucy Is Enciente.” Now, on YouTube, you can find home-water-birth vlogs and Swedish childbirth videos that show all but the blurred-out vagina and nipples. You can watch reality shows such as A Baby Story or One Born Every Minute or 16 and Pregnant or Bringing Home Baby. But like Real Housewives or any well-composed memoir, these stories offer a performed reality that can be confusing if not pernicious when taken for truth. 

I prefer television and literature that openly declares its own fiction, like the BBC’s Call the Midwife or Taffy Brodesser-Akner’s 2019 novel, Fleishman Is In Trouble. Her book captures many of the gendered aspects of late-capitalist life in New York—extreme wealth and its degradations, women’s bodies and their cultivation and utility, the divisions that even similar people manufacture to create hierarchies. At the novel’s centersits a birth story: The trauma that the book’s antihero, Rachel Fleishman, feels when a doctor more or less rips her baby out of her, and the distress she continues to feel when she understands that she will never be herself again, because the thing that Rachel knows—the thing that few mothers want to discuss—is that even successful birth stories are also death stories.

Even under the best circumstances, giving birth requires an inevitable metaphorical death—that of the woman whose body has only ever been her own—at the very least, and the death of a certain kind of freedom. The lucky couples might mourn, however quietly, the final moments of their prioritizing of one another. There is also the evaporation of any broad social tolerance for a woman to place her own ambitions and desires somewhere at the center of her life, a primacy that today still feels tenuous, as-yet incomplete. 

Rachel and Libby, the book’s narrator, exemplify, in different ways, this death inherent in the birth story. Libby used to write for a men’s magazine, profiling interesting men, and through them earning an audience because “this was the only way to get someone to listen to a woman—to tell her story through a man; Trojan horse yourself into a man, and people would give a shit about you.” Libby quits when she has children and understands that “my problems were now different. They could no longer be grafted onto a man because they were so unique to the problem of being a woman.” 

Rachel never gets over the horror-birth of her first baby. She finds a greater sense of self in her work than in mothering, and no one can forgive her for it. She tries to make her husband understand her perspective by offering “if I were a man” hypotheticals, and he goes ballistic. Rachel is not a man. Rachel is a woman, and she is a mother. At every turn she is penalized for not doing womanhood right, though she looks like she can play the role: the coy glances, the lipstick, the babies. Pregnancy and childbirth complicate a birthing person’s hard-earned, imperfect, and constantly threatened bodily autonomy. And now, amid the multiplying possibilities for women’s careers and aspirations, one who gives birth for the first time faces the end of all that, along with judgment for daring to prioritize herself or her work—or anything, really—other than her family. 

Part of the haze of complication around the birth story is that birth is the rite of passage that leads, for most, to motherhood, and so the story becomes a metonym for a troubling aspect of American culture: Are women people? Or are we all mothers-in-waiting? And if we become mothers, do we then quit being people? 


Fear dogged my pregnancy from the start, nonsensically. I often found myself terrified of things I wouldn’t have thought of fearing before being pregnant: slipping on ice; eating listeria-laden deli meat; the too long, too hot bath I took before I knew I was pregnant, while my son’s cells were just beginning to replicate in my uterus. Every day, the things I was afraid of multiplied. Eventualities that had been abstractions—the unknowns that hovered over the child I was growing inside of me, his illness or death, my illness or death, the inevitable pain of childbirth—became suddenly very real. 

I was afraid of something going wrong, but I was also afraid of nothing going wrong. Wanting to have a child had never felt like a question until it was a physical inevitability. Rounding into my last trimester, I found myself crying with panic and sorrow daily. I had never doubted wanting to have a baby, but it had only just occurred to me that in doing so, I would become a mother too. I couldn’t imagine my way into the joy I would feel; I saw only what I would lose. From the outside, it looked like a complete obliteration of self, and I felt no kinship with the baby who would take my independence from me. 

Toward the end of my pregnancy, I read that the governor of Alabama had signed the Human Life Protection Act, a near-total ban on abortion, including in cases of rape and incest. By then I already felt reduced to a vessel with every physical gesture, a feeling that had worsened as the weeks ticked on: thighs that just kept growing, ankles that seemed to flap as I walked up the stairs, the baby so tight against my ribs that food would not sit. As I went on long, arduous walks around the small Vermont town where I live, I couldn’t help but look at people suspiciously: The fact of Alabama’s legislation—which was quickly adopted in Missouri, Ohio, Louisiana, and Georgia—was a reminder that anyone who agreed even in principle with the law likely considered every part of me other than my bulging midsection expendable. I assessed my new body, already reconfiguring itself for birth. The baby shifting lower in my torso; the ligaments around my hips, unstable and loosening. 

The apparent difficulty of differentiating between a pregnant person and the fetus they carry—indeed, between the word “woman” and the uterus itself—is a variation on the tug-of-war that plays out in the discussion of trans rights in childbirth and infertility too. “Not all people who identify as women can get pregnant, and many people who do not identify as women can,” writes Syrus Marcus Ware in the essay collection Birthing Justice. A fetus can be both a cluster of cells capable of being extinguished or a yearned-for child—and a deeply felt loss, if it comes to that. What a fetus before viability is—what gender a birthing person is—depends on acknowledging the emotional life of the person in whose body those cells reside. Several new books examine the consequences of this fact—among them Joanne Ramos’s novel about surrogacy’s issues of race and money, The Farm, and Alexandra Kimball’s nonfiction monograph The Seed: Infertility is a Feminist Issue. That the fetus is a different thing depending on the person who bears it implies a degree of autonomy that is, for some, impossible to navigate. 

For me, the precise combination of hormones, physical discomfort, and politics that insisted on only ancillary personhood for a sexually active woman—or any woman, for that matter—did not trigger anger so much as a sense of defeat; it dunked my every day deep in cloudbank. Later, after I had given birth and the hormones receded and my body was mine again, I would be furious with those lawmakers who had put thousands of women’s lives in danger—who by extension tried to push all women, every single one of us, into subservience to unborn fetuses. A year later, I would read about senators’ attempts to slide regulations on abortion into coronavirus-relief packages and feel a predictable—and productive—rage. But during pregnancy, in the thick of it, all I felt was a tired sadness and fear, all the time. 

I am not, by nature, a fearful person, sometimes to my own detriment, and so this newly frightened person felt like the first identity shift of motherhood. My fear felt unearned, unnecessary, and indulgent even as it consumed me. I knew that in South Sudan, Chad, and Sierra Leone, more than one in one hundred births result in the death of the mother. I knew exactly how much more likely a Black woman in my condition was to die in childbirth than I. But I was also far from alone in feeling the sudden and overwhelming onslaught of anxiety, even where it logically did not belong. When it comes to childbirth in America, “Women are given fear-mongering information that doesn’t square with any of the evidence-based medicine in any other domain of our lives,”Sarah Menkedick told me later. “You can think, if I reduce every possible risk, if I do everything right, everything will be fine. That’s especially dangerous when it comes to birth. It’s easy to undervalue how much you being empowered with your own experience might influence the outcome.” 

And when it comes to birth, the traditional knowledge-is-power equation just isn’t so clean. My mother had given me the 2014 essay collection Labor Day: True Birth Stories By Today’s Best Women Writers, which, though I devour books written by many of the writers in its pages, I hated. I would pick it up off my nightstand dutifully, read an essay, put it down, and then bring it downstairs and settle it decisively back on the bookshelf. Not for me. But every few weeks, bowing to the curiosity—what might birth be like?—I brought it back up to my nightstand to repeat the cycle. Many of the stories felt needy, clamorous, and confessional in a way that repelled me. Others felt baldly instructive, overlaid with ulterior motive. With a few months’ distance, I was able to admit that bits and pieces of the collection had comforted me. Novelist Lauren Groff’s tender and agonizing description of her own pregnancy sorrow, her baby’s “imaginary twin, a baby made not of flesh but of sadness”; poet Nuar Alsadir’s description of her unborn child as “a New York neighbor—someone who, despite my awareness of her rhythms and movements, was essentially anonymous to me.” In the moment, though, the more I learned about these women’s birth experiences, and the more I read their descriptions of empowered births, the less empowered I felt. “Our expectations about childbirth have skyrocketed along with our access to information,” Maushart wrote in 1997. Birth stories are both instrumental and at the same time totally beside the point. A birthing person can prepare, can know everything there is to know and hear all of the possible stories, but eventually birth will do what it wants to the body. 

“Surviving birth is tantamount to evolutionary success,” writes celebrity childbirth educator Britta Bushnell in her 2020 book, Transformed By Birth. “There are few moments in a person’s life that expose us to such radical change as does the act of giving birth for the first time.… So even while Western culture celebrates birth with few meaningful ceremonies, birth has maintained its place in the overall importance of things because of its evolutionary value, but also because it utterly transforms us.” 

And what if I don’t feel that my son’s birth transformed me? Motherhood may be transformational, but birth need not be. For some, birth is a means to an end, a trial in the way that any extreme physical feat is realized, but no more. And so birth stories wind down, in so many cases, to the same thing that consumes how we often talk about women: the need to provide a reason for her story to be important. 


Last spring, as the spread of the coronavirus accelerated, Instagram’s #birthstory content shifted slightly. Not long after the virus reached its first peak, as social-media engagement spiked amid worldwide quarantines, a slightly higher proportion of posts appeared featuring women wearing masks as much as makeup, their hair bedraggled, their hands unmanicured. The captions below sounded softer, more grateful. One woman, in preterm labor at twenty-eight weeks, recounted the fearful eyes of nurses and doctors, asking her as her fever spiked if she’d been coughing or had chest pains, hearing no cries when the C-section was complete, waking up from general anesthesia to wonder if her infant had made it. (He did.) Another woman, diagnosed with coronavirus, gave birth in a medically induced coma. 

There were more photos of women lying in hospital beds, tentative smiles on their makeup-free faces; there were fewer color-coordinated portraits. Entire cities and countries worth of people sat at home, afraid. In this atmosphere of death and fear, giving birth was materially different. 

Childbirth is specific and essential and also utterly banal. It masquerades as an equalizer, but really, it is as diverse as are the humans who do it. The birth story becomes a way back—back to the illusion of control over the world that birth wrests from a woman, back toward a self that makes sense as a person or as both a person and a mother, back toward other people and away from the utter solitude of birth. 

Birth itself may not change you. But the shocking vulnerability that comes with it—being so utterly at the mercy of a fickle and demanding body—probably will. After that, the story of how it happened will start to matter, whether you tell it widely or hold it close. 

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Kim · 5 months ago

While as a birth parent I devoured this story, I was pained at Ms. Cooke's utter exclusion--but for a COVID coda toward the piece's end--of a significant number if pretern birth stories. She states, "The birth story also offers insight into vastly different situations through a narrative that has a beginning (the start of labor) and an end (two human beings meeting for the first time)."

I have given birth; I have never experienced labor. My daughter was born via C-section at 30 weeks due to a combination of her distress and my blood pressure. 

Having missed out on so many dimensions of the traditional birth story (a bursting, fully pregnant belly; water breaking; mucus plugs and, yes, labor), Ms. Cooke's framing of what all birth stories share stings.

In a piece meant to span all birth stories, a more expansive and inclusive conceptualizaroon of birth's "narrative arc" is both necessary and correct. 

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Kim's picture
Kim · 5 months ago

As the birth-parent of a premature baby (technically two, one living and one not), I often feel left out of birth stories. Ms. Cooke's otherwise beautifully written piece did not mitigate this feeling. She states, matter-of-factly, that "The birth story also offers insight into vastly different situations through a narrative that has a beginning (the start of labor) and an end (two human beings meeting for the first time)."

Apparently, the "vastly different situations" she cites do not include birth stories like mine, which never involved labor. My daugher was born via C-section at 30 weeks due to a combination of her distress and my blood pressure. I have given birth; I have never experienced labor. 

For me, this lack of attentiveness to the outer reaches of birth experiences (I also gave birth to my daughter's twin, who had passed away in utero at 20 weeks. Would I say this was an example of "two human beings meeting for the first time"? Questionable) mars an otherwise fascinating and sensitive piece. 

Please, endeavor not to exclude those of us who already feel largely excluded from mainstream birth-parent experiences. 

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