Wednesday, November 19, 2014

The Midwife, Jennifer Worth

Ah, the miracle of pregnancy and childbirth.  That beautiful time when glowing women contentedly rub their ever-swelling bellies, whiling away the hours crafting beautiful hand-made works of art for their well-appointed nurseries.  When the time comes for the special bundle to make its way into the world, they execute their meticulously planned labor plans, breathing away the pain without the use of drugs, pushing for all of two minutes before the baby appears, perfectly formed, into the hands of the doctor (or midwife or dula, if they are really going natural).

What?  This doesn't sound like your birthing experience?  Yeah, mine either, but as a culture we have mythologized pregnancy and childbirth to the point that women feel guilty if they haven't had the perfect Pinterest birthing experience (which, if you think about it, is good practice for once the child is actually born, and then they can feel guilty about the non-Pinterst perfect birthday parties and Elf on the Shelf ideas).  The reality?  Pregnancy and childbirth are wonderful, for most women.  But even women with a completely normal pregnancy have to deal with swollen ankles, strange bodily fluids, sore and swollen breasts, constipation, back aches, and morning sickness.  Child birth itself is miraculous, yes, but also messy, and, let's face it, pretty gross.  

If you'd prefer to hold on to the description at the beginning of this post as your mental image of pregnancy and childbirth, then I suggest that you do NOT read The Midwife by Jennier Worth (also called Call the Midwife, depending on which edition you have).  This memoir, upon which is based a PBS historical drama, is the first in a trilogy of books that examine the experiences of a group of midwives in post-war London.  And it is not for the faint of heart.  

London after World War II was battered.  Many buildings had been destroyed by the Germans during the Blitz, and rebuilding plans were stalled due to budget cuts and changes in government leadership. This left many poor families crammed together in tenements that had been slated for destruction, until id became clear that there was no where near enough housing left for everyone in London. Jennifer Worth left her comfortable middle class home to join a corp of midwives working in London's East End, treating women who lived in unsanitary conditions most of us can only imagine, many of whom already had many children.  That close to the docks, the men tended to be hard, and the women tended to be overwhelmed.  This first book tells about Jennifer's early days as a midwife, and is full of fascinating and graphic descriptions of cases she worked on.

If you are not comfortable reading graphic, rather vivid descriptions of other women's lady parts, and the smells and fluids that might come out of them, then you probably want to avoid this book.  Ditto if you can't handle stories about dead and dying babies, or mothers, or both.  The reality for most poor pregnant women in post-war London was that they dealt with their pregnancy living in a two room apartment with their husband and two or five or eight other children, an apartment that had no running water, no bathroom, and was either sweltering or freezing depending on the season.  

If you can handle the content, then you will find a book that is written with what strikes me as typical middle-class English reserve.  The stories are straightforward, with Worth sharing just enough of her own reactions to the situations to keep it from sounding too clinical.  It's an interesting look at the beginning of the National Health Service, founded to provide universal, no-cost health care to the people of the United Kingdom.  It is also an examination of how doctors, who were predominately male, either valued or dismissed the experience and knowledge of the midwives, causing a few tense and adversarial moments for the midwives themselves.  And despite the circumstances of many of their patients, I think that there are things that American health care could learn from the way they provided services to their patients.  The mythologized version of pregnancy might be prettier, but the reality is so much more interesting!

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