Book Review – The Birth House by Ami McKay

“Why would you read a book like that right now?” was Peter’s reaction when I told him I’d just finished reading a novel about birth and midwives in the early 20th century.

“I’m not sure,” I had to admit. “But it wasn’t scary.”

Partly, I think, I read The Birth House (Vintage Canada, 2007) now precisely because I am pregnant. Because that inevitable birth is getting closer and closer. Certainly, it coloured my reading of the novel.

We meet Dora Rare in her late teens. She has six brothers and is as rare as her name – the first daughter of the Rare family in three generations. Her family lives in Scots Bay, a small village on the coast of Nova Scotia. They are not wealthy but there is a good deal of affection among them. However, Dora’s father, while not exactly cruel, has trouble understanding his only daughter and bans her from the books she loves. Eventually, she is sent to live with Miss Babineau, the local midwife, sometimes said to be a witch. From Miss B, Dora learns the skills of midwifery and herbal healing. Talents used, but not always appreciated, by the rest of the villagers. Life has always been this way. When the local women have their children, they call on Miss B and they labour at home. She’s skilled and so is Dora and, while not every child or woman survives, it’s clear that Dora and Miss B do good work.

This is threatened by the arrival of Dr. Gilbert Thomas in the next town. Dr. Thomas has built a maternity house where women can go to deliver their babies. He claims to provide pain-free labours. (Pain-free may be relative but he does provide consciousness-free deliveries.) Suddenly, where women give birth becomes a source of tension in the community – often a battle between what women want and what the men around them think is best for them. (A common theme throughout Dora’s life.)

My baby will be born in a hospital, delivered by a doctor. And so while I completely support midwives and the traditions they often represent, I was disappointed by what felt like a very one-sided view of modern birthing.

The problem is that the doctor is such a buffoon. There’s nothing appealing about him or his maternity centre. There’s nothing to suggest any reasonable woman would ever desire him as a doctor (and the women who do support him in the novel are little more than stereotypes) or want to have a child in his presence. I would have preferred to see some nuance, some more authentic tension between the old and new styles of giving birth. A scenario, perhaps, where a doctor is able to perform where the midwife can’t. Maybe a c-section, or the care of a premature infant. (A chapter where Dora is in Halifax following the 1917 explosion, where dozens of women are sent into labour by the shock, would have been perfect for this.) It could even have been a different doctor so as to leave Dr. Thomas as a fool while still presenting some of the benefits of modern medicine.

Dora deserves a better antagonist. And McKay is clearly capable of greater nuance and layers. She can write fascinating, sympathetic and detailed characters so it’s disappointing when she doesn’t. The character of Archer Bigelow, for example, Dora’s sometimes love, demonstrates that McKay can create a character that we love, then hate, and then want to love.

As I said, my reading of the novel is coloured by the fact of my current pregnancy. Ironically, I feel that the care I currently receive – and that is the norm in Canada now – is much closer to the portrayal of midwifery than medicine in the novel. I’m encouraged to listen to my body, intervention is kept at a minimum and I will (hopefully) be conscious during my child’s birth. I believe my doctor respects me (and yes, I have a male doctor).

But I also got a flu shot. I have no desire to give birth in my own home. And if I require pain killers or a c-section, so be it. My baby today has a higher chance of survival than at any other point in history.

By not giving her a more worthy opponent, McKay in fact does a disservice to her protagonist. Dora is touch and fascinating, with just the right amount of vulnerability. And in the end, her character and her story make the book worth reading. Just maybe not while heavily pregnant.