Book Review: The Birth House - Ami McKay

I love reading. When I was young I would read the back of a cereal box! I especially love reading fiction. However when my children came along it wasn’t really feasible for me to read a lot. When I read a good book I tend to disappear into it and get lost in that world. I don’t really want to talk to anyone or do anything except read that book. This doesn’t go well with being a mother! Kids need someone around lol. Over the last few years I have tended to read more non-fiction, especially around birth. I learn so much from these and as a huge plus, I don’t want to get lost in them, I am happy to read a few pages and then stop - much more suitable for my role as a parent. Nowadays, however, my kids are older and I do get more time to sit and read. So I am starting to read more fiction again. 

The Birth House
By Ami McKay

So imagine my excitement when I found a book that was both fiction AND a birth book! Two of my passions in the one book. I had to get it. Thankfully my local library had a copy in their catalogue and I was able to order it in (I am based in Cork County and the joys of the library catalogue being online is that I have access to all the county library material and can order from any of them to pick up locally in Midleton. Even better I am so near the city that if the county don’t have it I can try theirs instead). 

This book had been recommended to me by a few people who thought I would enjoy it and they were right. It’s a really beautiful book, with a very interesting storyline. When I was at University I wrote a history dissseration on the medicalisation of childbirth and this story encompasses this topic. 

It is set in a rural village in Nova Scotia and the story centres around Dora Rare, who is taken under the wing of the local midwife Miss Babineau to become her apprentice around the time of the First World War. At the same time a local Doctor moves into the nearby town promising women a santised, pain free birth that could be controlled and set in a hospital environment (rather than in their own homes). The local women are tempted by this - they are told they will be put to sleep if they wish and wake up to a new baby. Of course this all comes at a price. The service is an expensive one and the community is not a wealthy one. There is also the issue of how childbirth is taken from the women themselves. As the midwife notes after one of the women is knocked out to have her baby ‘There was no moment of celebration at the end. She’s feeling left behind and unsure.’ (p.111)

But the book is more than just about birth, it’s a fascinating historical novel with the backdrop of the World War 1, the suffragette movement, and other historical events in Canada as well as outlining the lives of women back in this period. 

I loved the pace of the book,  the style of writing, the small dramas. It’s not an epic book or an epic tale, it’s a story about a small community and the people who live there, as well as the struggle between traditional and modern that was taking place all over the world at this time. It was great to see extended breastfeeding as the norm as well (as they talk about feeding their 2 years olds).

What I loved even more about the book is that on doing some research I found that the story was inspired by the house the author lived in. While pregnant on her second child she learned from neighbours in her community that the house she lived in had once been the midwives house and an actual birth house for women in the community. 

The characters are all well written and I found myself getting lost in the story. I loved the way the women’s friendships were depicted, that strength that can come from women banding together to look out for each other - especially in an era where their actual power was limited and men held sway. 

For me of course the most interesting aspect was the battle between the new, modern doctor and the old, traditional midwife. As noted above I wrote my History dissertation in college on this topic and it was really interesting for me to see this written as a fictional account. For this is how it played out. Midwives were dismissed as lazy, drunk, incompetent and outdated, while obstetrics was hailed as superior, knowledgable, modern, scientific and the way forward. Why have women suffer the pain of childbirth when a doctor could take the pain away with morphine and Twilight sleep so that she wouldn’t have to remember a thing. As the Doctor himself argued to the women: 

‘’The latest methods of obstetrics - chloroform, ether, chloral, opium, morphine, the use of forceps - these things can make birth the joyful experience it was meant to be. I can even administer Twilight Sleep if desired.’ p. 132-133

Of course we know now with the evidence based research we have on hand today that it is midwife led care that leads to better outcomes for women. We are also seeing a (slow) shift to midwife led care with Domino Schemes around Ireland and our new Maternity Strategy acknowledging that for low risk women midwifery care is best and obstetric care better saved for those high risk women who need the skills of an obstetrician. 

To finish - this book is well worth a read. It is an absorbing story that will keep your interest - even if you are not as passionate about birth as I am, the story itself is a fascinating one and you don’t have to be a doula, midwife or birth worker to enjoy it. 

Further reading: 

http://www.cochrane.org/CD004667/PREG_midwife-led-continuity-models-care-compared-other-models-care-women-during-pregnancy-birth-and-early

http://health.gov.ie/wp-content/uploads/2016/01/Final-version-27.01.16.pdf