The arguments of labor


Material Information

The arguments of labor twentieth-century American women's autobiographical childbirth narratives
Physical Description:
ix, 403 leaves : ; 29 cm.
Hooker, Deborah Anne, 1950-
Publication Date:


Subjects / Keywords:
English thesis, Ph.D   ( lcsh )
Dissertations, Academic -- English -- UF   ( lcsh )
bibliography   ( marcgt )
non-fiction   ( marcgt )


Thesis (Ph.D.)--University of Florida, 1997.
Includes bibliographical references (leaves 377-402).
General Note:
General Note:
Statement of Responsibility:
by Deborah Anne Hooker.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
aleph - 028629731
oclc - 38855552
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Table of Contents
    Title Page
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    Table of Contents
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    Chapter 1. Introduction
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    Chapter 2. Competing discourses: A brief survey of American medical, literary, and autobiographical representations of birth
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    Chapter 3. Romancing the sleep: Twilight sleep and the transformation of labor in early twentieth-century America
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    Chapter 4. Twilight sleep: Forgetting labor, transforming maternity, consuming technology
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    Chapter 5. The military-industrial-complex/context of prepared childbirth
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    Chapter 6. War babies: Violence and discipline in prepared childbirth
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    Chapter 7. The home birth movement and the doctrine of the calling
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    Chapter 8. Epilogue
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    Biographical sketch
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Full Text








It is with a great deal of humility as well as delight

that I acknowledge the contributions of so many good people

without whom this project would have surely faltered. First,

Elizabeth Langland, my committee chair, remained incredibly

steadfast and encouraging over the long haul of this

dissertation. I could not have wished for a finer ally. For

his sensible suggestions about stylistic revisions and his

advice about studies that needed to be read, I am also

indebted to David Leverenz. To my other committee members--

Anne Jones, Stephanie Smith, and Ofelia Schutte--go my

thanks for their keen perceptions about the strengths and

weaknesses of this work.

I should also like to thank my colleagues in the

English Department at North Carolina State University.

Specifically, many thanks to Judith Ferster, Michael Carter,

Edward Shannon, Marcelle Rice, Tom Wallis, and Carolyn

Miller for the provocative conversations about writing that

transpired in our Freshman Council meetings. Others also

offered many kindnesses along the way: Tom Lisk, Barbara


J. Baines, Sharon Setzer, Angela Mensch, Lucinda MacKethan,

Laura Severin, Gloria Maxwell, Judi Gaitens, Don Ball, Cat

Warren, and Blythe Forcey. To the late Robbie Knott, I

remain grateful for the persistent and good-natured

admonishments to "be done." Her strength and humor through

the hardest of times continue to be an inspiration.

Members of my family, both living and deceased, have

also figured greatly in this project. My mother, Anne W.

Jones, has ever been a source of strength and

encouragement, the best example of perseverance a daughter

could want. My father, the late John Francis Small,

introduced me, by example, to the profession of teaching, a

lesson which, no doubt--and I hope to his delight--took. I

also thank my sister, Frances M. Small, for her "blind

faith" in a sibling whose path diverged greatly from her

own. Thanks also to my brother, John Stephen Small, his wife

and children for their constant questions about what exactly

I was doing all this time. To my grandmother, Susie Carter

Wrenn, I am grateful for the example of her strength, the

beauty of her garden, and her general compassion. Her home

births helped to focus this project.

To my daughter, Suzanne Brooks Hooker, who endured with

me the long and often painful separation while I was in

Florida doing my course work, thanks hardly seem adequate or

appropriate. This is for us. My own happy experience giving

birth to her at home inspired this project.

My friend, Stephen John Gurganus, also deserves more

than thanks for enduring all the times when I could not go

and do because of the dissertation. Such lessons in patience

are seldom borne with more generosity and solicitude.

To Betty Wells Anderson, Gale Acuff, and Catherine

Marie Anderson, long-time friends, I am grateful, as ever,

for your willing ears and unfailing belief that I could,

indeed, finish.


ACKNOWLEDGMENTS ....................................... ii

ABSTRACT .............................................. vii


1 INTRODUCTION ....................................... 1

Where the Machine Goes, There the Work Ethic
Follows ......................................... 11
Avoiding Labor/Embracing Labor ..................... 19
Notes .............................................. 33

REPRESENTATIONS OF BIRTH ......................... 38

Literary and Medical Representations of
Birth ............................................ 42
Childbirth Narratives and the Female
Autobiographical Tradition in America ............. 58
Notes .............................................. 69

CENTURY AMERICA .................................. 72

The Romance of the Sleep ........................... 81
The Search for Knowledge and Oblivion:
Broken Narratives ............................... 105
Notes .............................................. 125

MATERNITY, CONSUMING TECHNOLOGY ..................... 133

Eugenics, "Race Suicide," and Twilight
Sleep ........................................... 150
Neurasthenia and Twilight Sleep .................... 161
Marginalism and Upper-class Desire .................... 181
Notes .............................................. 185

PREPARED CHILDBIRTH .............................. 190

Notes .............................................. 227

CHILDBIRTH ....................................... 230

Managing the Knowledge Worker and the Educated
Mother ........................................... 235
Military Metaphors ................................. 272
Notes .............................................. 287

CALLING .......................................... 294

The Doctrine of the Calling ........................ 300
Home Birth and the Sacramentality of Labor ........... 306
Home Birth and the Recovery of Community ............. 328
Self-Reliance and Home Birth ....................... 346
Notes .............................................. 359

8 EPILOGUE ........................................... 363

REFERENCES ............................................ 377

BIOGRAPHICAL SKETCH ................................... 403

Abstract of Dissertation Presented to the Graduate School of
the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy



Deborah Anne Hooker

December 1997

Chairperson: Dr. Elizabeth J. Langland

For the past thirty years, feminist critics have amply

documented the "industrialization" of hospitalized

childbirth, asserting that the patriarchal, technological,

and capitalistic values systems producing alienated labor in

the public sector also shape the social relations of birth.

Following their leads, I read American women's published

autobiographical childbirth narratives from three periods of

childbirth reform, identifying the specific management

theories guiding womens' experiences of labor. In two of

the three periods, the management theories reflected in

parturitive care are fundamentally isomorphic with those


shaping the contemporaneous work experience of industrial


Narratives from the twilight sleep movement of 1915

endorse a birth methodology clearly distinguishing those who

"do the work" from those possessing the knowledge about the

labor process, the hallmark of Frederick Winslow Taylor's

scientific management. Like her industrial counterparts, a

woman under twilight sleep's amnesiac regimes is regarded

mechanistically; any idiosyncratic contributions she might

make to the labor process are deemed irrelevant.

Mid-century prepared childbirth narratives also depict

women's capitulation to management strategies imported from

the industrial sector: maternity care succumbs to the logic

of a certain brand of human relations management theory

devised to accommodate the new "knowledge workers" within

industry. Prepared childbirth theory advocated educating

women about birth labor, and it advised medical caregivers

about the effects of birth's emotional aspects upon the

physiological experience. While paying lip service to

women's emotional well-being, the human relations management

theory practiced in hospitals nevertheless conditioned women

to place the needs of the institution above their own and


taught them to view the violence they often experienced at

the hands of their caregivers as part of the discipline of


The home birth movement of the late 1960s and early

70s, however, reflects a pre-industrial "theory" of labor

management. In many ways synonymous with the early Puritan

doctrine of the calling, the practice of home birth

emphasizes the sacramentality of birth labor and its ability

to suture family and community bonds. It also affirms the

values of self-reliance and the virtues of low-technology

labors guided by small-group decision-making.


Almost without exception for the past 30 years,

feminist critics of dominant American childbirth practices

have pointed to the increasingly "industrial" flavor of

women's hospital experiences.' Following a logic similar to

that guiding factory production, hospital policy typically

requires a woman to insert herself into a rigid labor

routine, the stages of which have been precisely mapped out

by obstetrical science. That discipline breaks labor down

into "stages and substages" that are "assigned a rate of

progression based on a statistical study. ." (Martin 59).

Any deviations from the "rate of progression" qualify a

labor as defective. To adjust errant labors to the norm,

medical practitioners intervene by, for example,

administering pitocin or performing an amniotomy to speed up

a sluggish labor or an episiotomy to hasten delivery.

Aside from such a perspective that regards the normal

ebbs and flows of individual labors with suspicion, other

aspects of hospitalized birth also recall the industrial


paradigm: routinely attached to numerous machines--like the

IV hook-up and the external or internal fetal monitors--a

woman often moves, in assembly-line fashion, from a hospital

bed, to a labor room to a delivery slab as labor progresses.

Oftentimes her newborn is whisked away to the nursery as

soon as it is born while she recovers from the effects of

the various analgesics and anesthesias she has been given.

Indeed, as Adrienne Rich argues, "alienated labor," a

term usually applied to workers in the public domain,

precisely describes childbirth under this medical model.

Birth labor alienates women when it is

keyed to an "efficiency" and a profit system
having little to do with the needs of mothers and
children, carried on in physical and mental
circumstances over which the woman in labor has
little or no control. (162)

Critiques like Rich's often counter the dominant

medical model of birth with the midwifery model. According

to Kathleen Doherty Turkel, the former "defines childbirth

as a medical event requiring hospitalization, the attendance

of a physician, and careful monitoring with high-technology

devices and procedures" (145). The midwifery model,

conversely, emphasizes the primacy of the mother as the

active birther, values "the experiential knowledge of

birthing women," provides support and assistance through

trained midwives and friends, and welcomes the family into

the scene of birth (Turkel 55).

For most women, this model can only be experienced by

giving birth at home or in the relatively small number of

birth centers, staffed by certified nurse midwives, that

began springing up nationwide in the 1970s.2 Although

typically allied with and subsequently controlled by a

hospital or clinic, birth centers tend to employ standard

interventions less frequently.3 These centers represent,

however, an uneasy compromise between the medical devotees

of high-tech obstetrics and critics of the same that have

emerged from within the medical profession itself. These

internal critics cite the superfluity and, in some cases,

the counterproductivity of many of the interventions

routinely applied to women during labor.

For example, researchers for the National Office of

Health Research, Statistics and Technology in 1979 concluded

that fetal heart rate monitoring conferred "little increased

benefit" (18) to either mothers or infants, certainly not

enough to offset its high cost and the risks of infection it

poses (Banta and Thacker 18). In 1977 and again in 1983,

studies appearing in obstetrical journals asserted that an

"appropriate episiotomy rate is about 20%" of all birthing

women (qtd. in Rooks, Weatherby, and Ernst 320). As of

1989, many hospitals still reported anywhere from a 41.1% to

78.1% rate (Rooks, Weatherby, and Ernst 320) .4

In view of such testimony from the medical field

itself, we have to ask why these procedures and the

alienating social relations of birth they construct persist

as "standard," and why, aside from ignorance of such

studies, do many American women accept them as such?

Studies by Turkel, Emily Martin, and Robbie Davis-

Floyd, among others, attribute part of that persistence to

the widely accepted notion that high technology equals

progressive medicine in America. If doctors and the

American public perceive birth as a event requiring

hospitalization, if good medicine equals employing the most

complex technology, and if the accepted ideology about

machines is that they exist to ease, eliminate, or rectify

problems in human labor, then technologized birth fulfills

all these expectations.

Without a doubt, the profitability of such

interventions also maintains technologized birth as the


norm. For example, the National Birth Center Study compared

the expense of hospital births to those in birth centers

from June 1985 to December 1987. They found that the

"unnecessary use of obstetric procedures" feeds the profit

margins of the medical business. These "unnecessary"

interventions have been "associated with unproductively high

costs" associated with many hospital births (Rooks,

Weatherby, and Ernst 326) .5

Aside from the force of public perceptions and the

profitability factor, Martin and Davis-Floyd also explain

that the governing paradigm of medicine itself keeps the

technological model firmly in place. An outgrowth of the

mechanical concept of the universe that arose in the

seventeenth century, the body as a machine serves as the

primary medical metaphor today, despite other more holistic

or integrated-systems perspectives.6 According to Michael D.

Solomon and George F. Levin, this "modern conception of the

body as a machine" derived, in part, from discoveries in and

discourses from another realm of science and technology,

i.e., the "development of mechanical technology,

particularly the harnessing of steam energy" (522).

For high-risk births, this mechanistic concept has

proven a life-saving and humane one: from the 400-year-old

technology of the forceps to the vastly improved surgical

technology of the caesarean section, regarding the body as a

machine has allowed medical practitioners to save lives and

spare women the agony of abnormal or potentially fatal

labors. However, the perversity of the mechanical model

lies in its extension to the low-risk situations posed by

most births and its inability to accommodate the non-

mechanical components of birth, as well.

Critiques such as those cited above have also

accurately documented how the industrial viewpoint "got

into" birth. They have shown how the professionalization of

medicine in the U.S. and the centralization of medical care

in hospitals ultimately embraced the same patriarchal,

technological, and capitalistic values systems that resulted

in legions of alienated laborers in the public sector.7 Yet

in this capitulation of medicine to the industrial paradigm,

which they have explicated so well, a particular mechanism

of alienation remains to be more precisely mapped--the

specific management strategies following childbirth's

centralization and technologization. With the exception of

Emily Martin, who recognizes scientific management as a

theory imported from industry to medicine via medical

discourse, few studies have identified the distinct

ideologies of management accompanying medicine's emulation

of the industrial model.

This study seeks, first, to identify the management

models directing birth labor. To do so, I read women's

published, autobiographical accounts of birth alongside

three management theories that have, over the course of

American history, guided the work experiences of a great

number of people. Specifically, I examine women's

autobiographical accounts of birth from three distinct

periods of childbirth reform during the twentieth-century:

the twilight sleep "uprising" in the second decade of the

century, the prepared childbirth movement of the 1940s and

50s, and the home birth movement of the late 1960s and 70s.

Coincidentally or not, the periods of childbirth reform

represented by the twilight sleep movement and the prepared

childbirth movement also correspond to eras of "revolution"

in management theory. The second decade of the century saw

the growing influence of Frederick Winslow Taylor's

scientific management; the 1950s witnessed the repudiation

of many of Taylor's ideas in theory if not in fact. Texts

such as Peter F. Drucker's The New Society represented the

growing prominence of one strain of the Human Relations

approach to management.'

The experiences of birth recounted in the texts from

the twilight sleep and prepared childbirth periods reveal

fundamental isomorphism with the management ideology

recounted in the works of these two influential labor

theorists. Conversely, influenced by the anti-

establishment, counter-culture of the 60s and the women's

health movement, the narratives from the home birth movement

of the 70s vividly contest the models of management and thus

the social relations these earlier narratives helped to

construct. They largely adopt a pre-industrial philosophy of

labor where childbearing is concerned--that reflected in the

Protestant Work Ethic's original, nonsecular doctrine of the


The identification of particular management strategies

serves, however, as a means to another end. The value of

putting a name to these strategies lies in how they

inevitably reflect and construct cultural views about the

concept of labor per se--how it is to be performed and for

what ends. In his The Evolution of Management Thought,

Daniel A. Wren explains that although management theory is

typically viewed as a twentieth-century phenomenon, some

type of "management theory" invariably emerges anytime

groups of people come together--either freely or under

coercion--for purposes ranging from simple survival to the

building of cathedrals or pyramids. All those who come

together enter into a formal or informal "contract," which

stipulates "some common rules and agreements [or punitive

measures] about how to behave to preserve the group" or to

accomplish a specified task (6).

Obviously, the cultural framework within which they

evolve greatly affects the shape such "contracts" take and

the nature of the power relations experienced through them.

These contracts are affected by the kinds and availability

of resources as well as by the sociopolitical context of the

group or groups involved. "Management" contacts may take the

form of religious discourse, as in the case of the

Protestant Work Ethic; they may also be dressed in the

brutal and ethnically-perverted political rhetoric of the

Nazi's "final solution."

Given the scope and influence of management "science"

in its twentieth-century American context, Stephen P. Waring

defines it as at least a potent subset of political

science.9 Over the course of the century, management

theorists, like political scientists

investigated similar problems of governance and
studied how to instill obedience, reconcile
individual and collective interests, and
coordinate groups. They offered advice about how
society should be organized and sought to find the
"one best way" of organizing human affairs, thus
arriving at similar judgments on indoctrination,
rewards and punishments, top-down direction, and
bottom-up participation. . Their arguments
were based on differing conceptions of human
nature . and hence were founded on moral
propositions that were difficult, and sometimes
impossible, to reconcile. (Waring 1)

Because of the overwhelming political and moral

implications of management science, the second aim of this

study has been to deduce from women's autobiographical texts

not only the type of management applied to birth labor, but

the overarching ideology of labor, and thus of human nature,

these management strategies convey. Such ideologies are

enacted and perpetuated when they govern the process of

giving birth. This study, then, assumes that labor is a

defining category of human life. It is the activity through

which we change the world around us, and in so doing,

fashion and refashion ourselves.

In this context, birth labor certainly exists as a very

particular kind of work, distinguishable from all others:

thus far, despite the best efforts of reproductive science

and infertility technology, pregnancy still requires the

female body for long periods of gestation; localized in

time, birth is compelled by forces that do not drive other

kinds of labor; because it reminds us of our implication

within those forces that transcend our greatest

technological know-how, bringing a human being into the

world has typically been regarded with even more awe and

reverence than that inspired by our most impressive

architectural or artistic creations. Because of these

distinctions, then, identifying how American birth labor

evinces a specific philosophy of labor would seem to reveal

a great deal about how we define our essential humanness.10

Where the Machine Goes, There the Work Ethic Follows

To some degree, it is not surprising to find that

contemporaneous ideologies about public labor and the

management of industrial laborers structured the social

relations of birth labor in the 1910s and the 40s and 50s.

As the emergence of the modern technological era

indisputably demonstrates, where the machine centralizes

labor, whether in the factory or the hospital, it changes

the social relations of production: it alters the way in

which those who labor relate to one another, to their work,

and to their work environments. Although birth's

centralization in hospitals came later--in the 1920s to

50s--it followed craft labor out of the home and into

institutions where the specialization and mechanization of

work became the norm.

As accounts of life before the onset of highly

technologized labor make clear, it would clearly be wrong to

romanticize the labor experiences of those who pushed the

plows or spun the wool to meet the survival needs of

generations of pre-industrial Americans, just as it would be

misleading to paint the specter of birth for pre-twentieth-

century women as anything less than daunting. However, it

is equally wrong to deny that certain aspects of pre-

industrial craft, agricultural, and birth labor conferred

kinds of satisfactions hard to come by after

industrialization: for women giving birth, for example, the

comfort of everyday surroundings, friends and family members

whose very familiarity helped to ease the pains of labor;

for other kinds of workers, the satisfactions of self-

direction and self-expression found in owning one's labor.

As recently as 1971, the Nixon administration's Work in

America, a report on the quality of working life, painted a

rather grim picture of worker satisfaction in this country.

It asserted that contemporary labor conditions

ignored the "social needs" of manufacturing
workers of the "baby boom generation. ...
rais[ed] business costs by encouraging high rates
of turnover, absenteeism, wildcat strikes,
sabotage, and low rates of productivity. .
burden[ed] society with crime, alcoholism, and
physical and mental illness; and .
contributed] to "alienation" that made people
prone to "radical social or political movements."
(Waring 132)

As Work in America appears to substantiate, and as

numerous labor theorists remind us, when work is

centralized, mechanized, and increasingly bureaucratized,

workers lose the satisfactions associated with the

traditions of pre-industrial labor. For many pre-industrial

Americans, at the very least for those in New England, labor

conformed to the demands of the Protestant Work Ethic, with

its essential underpinning of the doctrine of the calling.

And the Protestant Work Ethic is, in the larger sense, a

management theory. With its roots in Pauline doctrine,

given new emphasis by Luther and Calvin, the Protestant Work

Ethic guided the work habits of large groups of people

through their devotion to Protestant dogma rather than the

devotion to efficiency that superseded it.

Much has been written about the strain of

individualism within the Ethic that subsequently overwhelmed

its originally communitarian impulse and neatly fed the

fires of liberal capitalism;" however, in its original,

non-secular form, the Ethic emphasized three components

antithetical to that economic ethos.2 It maintained a moral

orientation to labor, reminding its adherents that all forms

of labor, honestly performed, glorified God and thus stood

as virtual sacraments, connecting humanity to divinity. The

"general" calling--to serve God--remained inseparable from

the "particular" calling--the specific kind of labor chosen

through which one served one's fellow humans. Early Puritan

fathers, like John Cotton and John Winthrop, constantly

reminded their flocks that the work to which one was called

should serve the community, either directly through

providing a needed service or through sharing the fruits of

one's labors with others in need.

Finally, since material wealth could potentially lead

one away from God, prosperity, as well as material or

physical adversity, could be regarded as a sign of God's

displeasure, as a test of one's faith. Both the plentiful

resources of the New World and the development of various

technologies subsequently tilted the contest in favor of

Mammon, but for a while, a doctrine of restraint, where

consumption was concerned, prevailed.

By the end of the nineteenth century, the closing of

the frontier, the advent of the factory system, and the

centralization of capital had, for many, altered the

conditions whereby a calling might be pursued with the

assurance of community support in times of need. If the

doctrine of the calling had, in some sense, acknowledged

that we work "to express our individual selves or to

articulate the essence of humanity,"(Schleuning 9) then,

endlessly feeding ingots into the fire of the iron mill,

weaving shoelaces into a Nike, or pumping data into a

computer provide only the barest scrap of such an

opportunity and express little more than an automated will.

"Meaningful work," according to Neala Schleuning, "is not

mechanistic or formulaic. .. It . requires . a


physical and intellectual engagement that puts the worker in

charge of the product and process of work" (17).

The widespread conversion of labor itself into a

commodity produces other well-documented results, not the

least of which is artistic and political apathy. Work

"reduced to 'employment'" not only diminishes the

opportunity for self-expression, but it subtracts "some

essential ingredient of freedom as well. . The more

power to create is taken from us . the more we lose the

ability to create" (Schleuning 18)

Technology's critics also point out that the

mechanization of labor extends beyond the workplace and into

the domestic arena, where it conditions us to a certain kind

of political passivity. For example, Langdon Winner points

out how television has altered our sense of political

participation. He notes that

the passive monitoring of electronic news makes
citizens feel involved while releasing them from
the desire to take an active part, and from any
genuine political knowledge based on first-hand
experience. (27)

If one implicit form of political self-expression, a

chosen work, once allowed us to feel a connection with a

diverse community, enriched and no doubt sometimes put off

by our talents and efforts, then the bureaucratization of

much labor today has conferred upon us the peculiar

anonymity of living in the class-segregated enclaves of

America. We most often connect to others outside of our

class by sharing items we have purchased, such as canned

food or portions of our paycheck. We contribute to

charities or churches, in whose outreach work we believe but

often do not participate in directly through our labors."

We also typically seek to recuperate the meaning lost

from work in consumption, a compulsion that "works because

it approximates a satisfaction of some of our basic needs

[and] gives us the illusion of having control over our

environment . ." (Schleuning 41). Yet the value we put on

"hand-made" things testifies to our lingering belief that a

quality inheres in these objects--conferred by the

painstaking labor that creates them--higher and greater than

in the mass-produced items we settle for simply because they

are more affordable. We admire the artisan whose name we

search out and recommend to our friends; we pity the poor

assembly-line worker whose individual imprint disappears

into the sleek contours of our cars, largely

indistinguishable from all others of the same make and year.

When mechanization evacuated all prior intrinsic

satisfactions and motivations aside from survival from

labor, and when centralizing labor brought together large

numbers of people reduced to selling their labor, new

secular labor theories emerged. When the self-directed and

self-controlled opportunity for work disappeared, as it

largely did at the turn of the century, theories for

governing large groups of disaffected workers substituted

other values and goals for these former attributes.

Rational, efficiency-based theories, like scientific

management, arose to specify methods of work and strategies

of relationship between a hierarchy of laborers, to control

the rate and quality of work done, and to make the work

experience at least minimally bearable to the laborer.

In short, the centralization of labor and the

increasing applications of technology to all forms of work

revolutionized the way we conceptualize labor and ourselves

--the ability of our bodies and minds to do work and the

values we associate with various kinds of labor, their means

and their ends. Schleuning asserts that "with the

dehumanization of work, the dominant ethos that has emerged

from the industrial era is a characteristically modern

contempt and avoidance of work"(5).

Therefore, when birth moves from home to hospital and

is increasingly technologized, it is in some sense

inevitable that the social relations of industry provide a

model for those of birth labor. And it is entirely

understandable that, in such a context, many women view

childbirth labor with that attitude of avoidance by which

Schleuning characterizes the widespread perception of work

in America.

Avoiding Labor/Embracing Labor

To map the influences that have helped to construct the

social relations of birth labor over the course of the

twentieth century, chapter 2 offers a brief survey of the

three American discourses that have most influenced our ways

of conceptualizing birth labor--literature, medical

discourse, and women's autobiographical accounts of birth.

Chapter 3 then focuses on the writings from the

"twilight sleep" movement of 1915. Texts like Marguerite

Tracy and Mary Boyd's Painless Childbirth and its associated

periodical articles facilitated a view of birth labor

fundamentally isomorphic with scientific management's


reformation of industrial labor at the turn of the century.

The scopolamine-morphine mixture of twilight sleep

mercifully suspended a woman in a state of amnesia during

the course of her labor; however, her unconscious state also

relieved her of any experiential knowledge about birth. That

knowledge remained with her medical caregivers. Thus, as in

Frederick Winslow Taylor's scientific management paradigm,

we see the separation between those who perform physical

labor and those who retain the knowledge about the labor--in

his schema, the managers.

Tracy and Boyd's texts also reveal other homologies

with Taylor's science of efficiency. Without the

interference of the mother, birth labor, like industrial

labor, could be streamlined. This becomes necessary as more

and more expectant mothers in the century's early decades

come to the few hospitals that offered fully anesthetized

births, crowding the schedules of obstetricians and nurse-

attendants. Twilight sleep paved the way for this

systemization of birth with its "memory test."

A woman laboring under "twilight sleep" would, ideally

remember nothing about the birth of her child. If she could

remember portions of her experience, her twilight sleep

would be deemed "imperfect." Thus, her experiential

knowledge about her labor and her individual contributions

to the process come to be perceived in the same light as

that of industrial laborers--as impediments to the efficient

production scenario. As Georg Lukacs concluded about the

status of labor under scientific management: their

idiosyncratic contributions to the labor process comprised

"mere sources of error when contrasted with [the] abstract

laws functioning according to [the] rational prediction" of

scientific management (89).

Undergirding the logic of both twilight sleep and

scientific management lies a hierarchized valuation of work

per se, with physical labor resting securely and with little

status at the bottom. This view of physical labor in the

early twentieth century symptomizes a profound reversal in

the dominant, national ideology, one that had regarded

physical labor as a source of dignity, meaning and personal

value for over two centuries of American experience. By the

end of the nineteenth-century, with the advent of the

industrial dynamos, physical labor lost its status to the

machines that could produce more products more quickly than

human, physical labor combined with less complex technology

could ever hope to. The doctrine of restraint that had

counterbalanced the exhortation to labor in the original

Protestant Work Ethic gave way to a new ethic: the duty to


As my chapter 4 demonstrates, applying the technology

of the sleep to childbirth helped to transform our

perspectives of the maternal body in labor from a productive

one to a consuming one: no longer mentally engaged in the

labor of birth, women are increasingly positioned as passive

consumers of the birth services of the medical profession.

For the upper-classes who supplied its most influential

advocates, this refashioning of maternal labor by twilight

sleep also conveniently affirmed class identities based upon

distinctions of labor. It was widely held that a lifestyle

largely devoid of physical exertion had rendered upper-class

women incapable of withstanding the rigors of birth.

Twilight sleep allowed these women to give birth without the

knowledge or experience of the physical labor involved. It

kept intact the signifier of class--the repression of

physical labor--that had hypothetically created the need for

the sleep in the first place. Ironically, the twilight

sleep texts also characterize the hypothetically painless


childbirths of women used to physical labor as pathological.

Thus, the sleep must intervene to correct the inherent

wrongs of the (hypothetically) painlessly laboring, lower-

class body.

Aside from scientific management, which certainly

hierarchized mental and manual labors, one of the greatest

influences on the design of American production has come

from the national military agenda. In many ways, militarism

and most American management theories since the turn of the

century have endorsed similar priorities: "setting a .

goal and developing the most efficient organizational means

to see to its accomplishment" (Locke 3). They also share a

belief in a labor hierarchy largely separating those who

devise such goals from those who actually carry them out.

The historical record of the twentieth-century demonstrates

that from World War I onward, military and business concerns

have become increasingly intertwined, culminating in what

President Dwight D. Eisenhower recognized in 1961 as the

military-industrial complex.

As my chapter 5 demonstrates, the demands of the

military agenda, especially after World War II and during

the cold war era, also contributed to new doctrines of

management in the civilian sector. The design and

application of sophisticated technology to meet the demand

of the Cold War armories required more highly educated

workers--"knowledge workers" as they were referred to in

management literature. This new kind of worker demanded a

tempering of scientific management's condescending view of

labor. Because of their higher levels of education, these

knowledge workers could no longer be viewed as motivated

"solely by self-interest" or "the paycheck coming at the end

of the week" (Miller, Living 85). Their emotional and

psychological dimensions, as well as their economic

motivations, had to be considered. The Human Relations

approach to labor, variations of which had existed since the

1930s, gained new prominence.

Similarly, obstetrical literature of the 1940s and 50s

began to consider the emotional and psychological aspects of

childbirth, not merely its physiological components, as

worthy of its attention. Like the rise of the "knowledge

workers," the prepared childbirth movement also represented

a newly educated cadre of mothers who desired more autonomy

during their birth labors. The popular Grantly Dick-Read

and Fernand Lamaze methods touted the educated mother as the


answer to women's fears about and mounting dissatisfactions

with the totally anesthetized births initiated by the

twilight sleep movement. Theoretically, through employing

either prepared childbirth method, women reclaimed the

knowledge about labor and delivery that had devolved to

obstetricians under twilight sleep and the regimes like it

that had prevailed in hospitals since the 1920s. Via

prepared childbirth, the mother could remain awake and aware

during the experience.

The 1950s witnessed the entry of birth mothers'

testimonials about prepared childbirth into the periodical

industry in the form of book-length diaries. These texts

document the nine months of one woman's pregnancy and birth

experience, such as Marjorie Karmel's Thank You, Dr. Lamaze

(1959), Barbara Gelb's The ABC of Natural Childbirth (1954),

and Cathleen Schurr's Naturally Yours (1953). They testify

to the benefits of educated motherhood, advocating some form

of prenatal training and education for all women; however,

these texts overwhelmingly represent such education as the

prerogative of middle-class and upper-middle class women.

The two other accounts of pregnancy and birth that I

examine from this period do not advertise or support one


childbirth practice over another such as the above texts do,

although they do reference the Read method in their accounts

of their experiences. They are exploratory of the

parturitive experience rather than didactic in nature.

Abigail Lewis's An Interesting Condition: The Diary of a

Pregnant Woman (published in 1950 in America and in 1951 in

England) and Charlotte Painter's Who Made the Lamb (1964)

use the 9-month period of pregnancy and the months after

birth as a springboard for examining the meaning of

motherhood in the last half of the twentieth-century and to

question prior and extant constructions of that role.

The evidence from these journals and diaries shows that

despite the Read and Lamaze theories about the prerogative

of the educated mother to direct the course of her labor,

these women submitted to a form of industrial management

similar to that practiced in the public sector on knowledge

workers, one that gave the lie to the promise of autonomy in

both domains. The industrial and medical relationship that

these new management strategies constructed can best be

characterized as paternalistic. They situated managers and

doctors as parents and patients and workers as well-meaning

but largely incompetent children.

Chapter 6 demonstrates that in industry and hospital,

both types of laborers were schooled in "the managerial

attitude," that is, seeing production or birth from the

managers'/doctors' viewpoint. While both hospital staffs and

industrial managers paid lip service to the emotional

satisfaction of the workers/patients, the few, petty

concessions granted in the name of patient/worker

individuality always swiveled toward accommodating the needs

of the institution, not the laborer. Management rhetoric

boldly asserted that "it is the organization rather than the

individual which is productive in an industrial system"

(Drucker, New Society 6). The medical management of women

giving birth carried that same reality into the birth


The militarism undergirding this coercive allegiance--

to the corporation or medical institution--becomes clear in

Drucker's identification of the two driving forces behind

American economic success: "the desire for a higher

standard of living," he admits, rests on a totally

destructive base--"the need of defense--that is, the desire

for a higher standard of warfare" (New Society 15).

This underlying militarism also shows through in the

metaphors by which these women writers describe their birth

experiences. All of the pregnancy diaries and testimonials

appearing during this post-ward period depict birth as a

violent experience, using images of warfare and weaponry to

describe the violence. What becomes clear is that the

violence does not inhere in the bodily experience of labor

itself, but in the relationship between these women and

their caregivers. However, women schooled in the managerial

attitude by the American modifications to prepared

childbirth often misperceived the violence to which they

were subjected as a part of the "discipline" of labor.

With the "home birth movement" of the late 1960s and

the 70s, a challenge to the industrial paradigm of labor and

its model of social relations arose. In many regards, the

accounts of home birth offered in Ina May Gaskins' Spiritual

Midwifery, Raven Lang's The Birth Book, E.J. and Cybele

Gold's Joyous Childbirth: Manual for Conscious Natural

Childbirth, Fred and Charlotte Ward's The Home Birth Book,

and Janet Issacs Ashford's Birth Stories: The Experience

Remembered attest to a belief in a totally different

ideology of labor.

Childbirth choice becomes emblematic of a life-style

choice, of where one situates oneself along the great divide

of culture and counterculture that had arisen in the 1960s.

A counter-cultural philosophy of labor formed part of the

resistance to the American status quo. The values and

beliefs expressed in these home birth narratives therefore

dovetail, in key regards, with the philosophy underwriting

the non-secularized Protestant Work Ethic--specifically in

its essential component of "the calling." This does not

mean that home birth adherents embraced something that we

might recognize as Puritanism, although, as chapter 7 will

show, the beliefs and behaviors of some specific groups have

more in common with their colonial forebears than just a

philosophy about work.

Most of these compilations of birth narratives are

careful to acknowledge that no one birthing procedure or

setting can or should answer all the desires of all women;

however, they largely endorse midwife-assisted home birth.

They justify the risk of such a choice by citing the

continued infant mortality rates in hospitals as well as the

trauma resulting from the largely impersonal treatment women

often receive there. However, these texts implicitly assume

that the choice of childbirth methodology and setting

identify women and their families with a particular

lifestyle, one either resistant to or in collusion with the

forces of institutional domination, particularly, but not

limited to the American Medical Association as a

representative of the bureaucratic "establishment"


Chapter 7 documents the decidedly spiritual orientation

toward birth that predominates in many of these texts.

Spiritual Midwifery, The Birth Book, and Joyous Childbirth

all emphasize the transcendent possibilities in childbirth

labor, an experience frequently compromised by the secular

and scientific orientation of the hospital. Although these

texts represent many different orientations to the

transcendent--whether it is figured as Nature or a

particular deity--the spiritual component of labor recalls

the exhortation in the calling, that one labors within the

context of a greater, transcendent purpose and for the good

of the community, not for individual aggrandizement. The

choice of home birth also allows women to experience labor

in a way that is consistent with the expression of their

spiritual beliefs. In that way it is reminiscent of the

"fit" prescribed by the doctrine between the general and

specific callings--the latter should in no way compromise

the former.

The emphasis on mother-child bonding and sharing the

birth experience with family and friends in The Home Birth

Book and The Birth Book also echo another component of the

calling: laboring in a way that serves one's community.

Almost all of these texts emphasize the importance of

mother-child bonding as a way to suture the anomie and lack

of community they saw as symptomatic of American life.

They embrace midwife-assisted home birth because hospitals

regimes routinely separated mother and child, interrupting

the crucial period in which the bond is established. In the

most extreme example, in Spiritual Midwifery, childbirth

serves as the primary means through which less-than-ideal

conjugal relationships are "sorted out" and healed, ensuring

the cohesiveness of the commune in which the births occur

(Kern 208-211).

Finally, the emphasis on families taking responsibility

for childbirth and the eschewal of the high-tech medical

model of birth result in decidedly less consumption of

medicine's standard goods and services. Home birth

implicitly embraces low or simple technology, and in that

way echoes the calling's doctrine of restraint. While this

emphasis on self-reliance is not expressed as self-denial as

in the original ethic, it springs from similar philosophical


In the larger context of the 60s, the counter cultural

theme of self-reliance emerged as an ethical response to the

emptiness of post-war affluence. As Patrick Conover points

out, as "children of affluence," the constituents of the

counterculture had "not known severe economic depression

[and] . had the luxury of asking the question of how to

use resources instead of being forced to answer questions of

survival" (437). In the specific context of birth, home

birth adherents rejected the consumption of standard

technological goods and services because their use

contributed to neither the physical nor spiritual health of

the individual or the community.

Testimonials compiled in The Birth Book, Spiritual

Midwifery, The Home Birth Book, and Birth Stories: The

Experience Remembered also reflect the influence of The

Women's Health Movement, emerging as an off-shoot of Second

Wave Feminism in the mid-60s. The movement, like the

authors of these texts, emphasized self-reliance and self-

knowledge where gynecology and childbirth were concerned.

The consciousness-raising groups that sprang up around the

country in the 60s and 70s "accentuated ways in which

women's reproductive rights were largely controlled by men

or by the male-dominated medical profession. . ." (Morgan,

Sixties 226). Embracing midwife-assisted home birth meant

refusing to consume standard birthing technologies and

rejecting the control, exploitation, and domination that

often accomplished their applications.

The general feminist critique of the 60s and early 70s

also recognized and valued the female-identified qualities

of nurturance over the male-identified competitive ethos.

Certain aspects of this valuation resonate with the

communitarian impulse and the critique of consumption

enshrined in the non-secularized doctrine of the calling as



l.For commentary on the contemporary hospital birth
experiences of American women, see Martin 25-69, 156-66;
Rothman; Arms; Corea; Harrison; Shaw; Haire; Rich 146-166;
Turkel; and Davis-Floyd.
For good studies of changing childbirth practices over
the course of American history, see Leavitt, Brought to Bed:
Childbearing in America, 1750 to 1950 and Wertz and Wertz.

2.At the time that Kathleen Doherty Turkel published
her long-term study of a free-standing birth center in 1995,
only 130 birth centers existed in the U.S. She does note,
however, that 90 new centers were in the process of opening,
bringing the number of birth centers in this country closer
to the level of the 200+ existing in the late 1980s (152).

3.As Turkel argues, since birthing centers "require the
recognition and support of the legal and financial
institutions which support the medical model," they exist
uneasily in a compromising and antifeminist context of
"legal rationality, professional hierarchy, and economic
rationality." These institutional constraints prescribe
"objectivism, emotional detachment, and technical
calculation" (150) as the guiding values of the birth
centers, the antithesis of the model of birth that those who
support birth centers hope to emplace.

4.Davis Floyd devotes nearly 100 pages in her Birth as
an American Rite of Passage to an exploration of the uses
and misuses of typical medical interventions. See pp. 127-

5.The National Birth Center Study (NBCS), surely one of
the most comprehensive studies of current institutional
birth practices, describes "the experience of 17,856 women
who received care at 84 birth centers between June 15, 1985
and December 31, 1987." The entire report consists of three
parts: Part I, published in the Journal of Nurse-Midwifery
in July/August 1992, laid out the study methodology and
"compared the NBCS subjects with all women who gave birth in
the U.S. in 1986, described the prenatal care and referral
practices of birth centers in the study, and described the
women who were admitted . (Rooks, Weatherby, and Ernst
Part II--"Intrapartum and Immediate Postpartum and
Neonatal Care" appeared in the Journal of Nurse-Midwifery in
August of 1992. It provides extensive documentation of the
"care provided to those women and their newborns during and
after labor and delivery" in 84 birth centers (Rooks,
Weatherby, and Ernst 301).
Part III, published in the November/December issue of
the same journal reports only on

complications experienced by the women during
labor and by the women and newborns soon after the
births, transfers to hospital care and the care
provided and complications experienced during the
28-day postpartum/neonatal period. (Rooks,
Weatherby, and Ernst 301)

6.See Davis-Floyd, Birth 74-84 and Martin 54-67 for
their discussions of the "mechanical metaphor."
In "The Discursive Formation of the Body in the History
of Medicine," Michael D. Solomon and George F. Levin
acknowledge that late modern medicine is slowly beginning to
incorporate a more wholistic "multifactoral" view of human
health and disease. Epidemiological and immune systems
research made it possible to see the body as "a self-
regulating system whose functioning is dependent on and
inseparable from the larger world . a complex field of
social, cultural, historical, and environmental conditions."
(524). They note, however, that "such a discourse has not
yet abandoned an essentially mechanistic way of thinking
. (521).

7.Another source of patriarchal influence comes through
the scientific method upon which medicine is based.
Although it was once largely accepted as an objective and
value free method for comprehending the truths of the
natural world, subsequent feminist critiques have revealed
the gendered oppositions upon which the methodology rests,
e.g., rational man versus emotional woman. In western
medicine dominated by the scientific paradigm, this
opposition privileges experts as those operating with
"rational thought" whereas lay people "represent emotion
combined with a lack of thought and information" (Turkel
22). In the medical subset of obstetrics, such a bias
"privileges the technical knowledge of the physician while
it discounts and ignores the experiential knowledge of
birthing women" (Turkel 5).
For feminist critiques of the philosophy of science and
the scientific method, see Bleier; Fee; Harding; Keller;
Griffin; and Merchant.

8.The "Human Relations" variation of management theory
arose almost in tandem with Taylor's scientific management

theory. It attempted to mediate Taylorism's mechanistic
conceptualization of workers by taking into account the
sociological and psychological components of work. Daniel A.
Wren notes, however, that despite the studies of Richard
Whiting, Elton Mayo and Kurt Lewin, all of which tried to
insert a view of the social animal within management theory,
"those trained in the behavioral sciences, such as
psychologists, sociologists, and anthropologists had little
impact on management theory until the 1950s" (369-70).

9.The quotation marks around the word "science" points
to the misapplication of the term. According to Stephen P.
Waring, although management writers
claimed that they were scientists making empirical
tests of the most efficient means to given ends,
they become philosophers when they made
existential choices about the meaning of
efficiency (not to mention when they accepted the
ends of business as givens). Behind their
positivist pose, they were defining ends when
answering such question as "efficiency at what?
efficiency for whom?" and were choosing a
particular government when selecting means.
Waring argues that they are more accurately to be seen
as "new 'mandarins' . whose values and vision were
limited by their membership in a governing class"(6).

10.Almost everyone who studies childbirth comes to the
same conclusion--that it represents a rich condensation of
societal values. For example, in Giving Birth: How it
Really Feels, Sheila Kitzinger writes:
Birth, like death, is a crisis, but one which can
also be a developmental experience for those
sharing it. . At the depths of both
experiences, in spite of pain, there is a fierce
joy. Death leads us to thanksgiving for all that
a person has been. In a similar way, birth is a
celebration of life. Both are more than
biological events. They express human values. (x)
Jacques Gelis introduces his study of childbirth in
early modern Europe contending that "the fundamental
attitudes of [any] society towards the experience of living"
can be adduced from "the way in which a society receives a

newborn child into its bosom . (xi). For Adrienne
Rich, birth evinces "nothing less than our entire
socialization as women (160).

ll.See, of course, Weber's The Protestant Ethic and the
Spirit of Capitalism. For views reacting to Weber's thesis,
see Tawney; Lensk; McClelland; and Viner.

12.See Perkins; Foster 99-126; and Michaelsen on the
doctrine of the calling.

13.In his "Secession of the Successful," Robert Reich
describes the demise of traditional communities, asserting
that most of us now live and work within specific
socioeconomic enclaves. He also notes that, quite often,
instead of helping to support institutions that conduct more
traditional kinds of charitable outreach, charitable giving
supports culturally elite institutions and organizations,
such as operas, symphonies, and museums, utilized by those
who contribute to them (16).


If, as David M. Levin and George F. Solomon argue, "the

human body is as much a reflective formation of multiple

discourses as it is an effect of natural and environmental

processes" (515), then although women's autobiographical

accounts of birth exist as only one among a number of

influential discourses, they have no doubt influenced the

ways we perceive both the female body and birth labor. They

have provided a supplement to and in some cases a corrective

for other kinds of birth representations. Aside from

women's autobiographical writings, the two other most

influential public, written discourses to represent birth

throughout the course of American history have been

literature and the discourses of lay and professional


In this study, I have privileged autobiographical

representations not because these texts offer us a "purer"

version of the events of pregnancy and childbirth: as these



texts demonstrate, women's personal writings are as subject

to particular ideological and material constraints as are

writings that spring from any other perspective or those

following the dictates of specific genres. But these

personal, non-fictional texts fill in a significant aporia

of many medical and literary representations: they let us

hear the mother's voice and her story.

I have also privileged autobiographical accounts for

more personal reasons: some of the birth stories examined

here provided the only sources of comfort for me when I was

pregnant for the first time and anticipating a home birth in

1978. This study, in a small way, honors those texts and the

women writers who helped to shape my own experience of


My desire to give birth at home had been inspired by my

grandmother, who gave birth to all seven of her children at

home in rural North Carolina in the 1920s. Since I admired

her self-reliance, I was determined to do the same. Having

also read Suzanne Arms' Immaculate Deception, I saw no need

to regard myself as sick and, thus, submit myself to the

indignities of hospital birth. There, according to Arms,

even women educated in and prepared to assume responsibility

for the birth of their children, as I was, had their

initiatives sabotaged by hospital routine and a medical

perspective that viewed each birth as a potentially

pathological event. When my doctor announced that, because

of fears of liability, he couldn't take part in my plans for

a home birth, he also refused me further medical advice or

prenatal care. Ina May Gaskins' Spiritual Midwifery, Raven

Lang's The Birth Book, and a knowledgeable lay (and thus in

N.C. an illegally practicing) midwife became my prime

sources of information.

I was definitely looking for signposts in what was, for

me, alien territory, and I was looking for comfort and

encouragement. My mother and other women like her who had

given birth in the 40s and 50s could not tell me much about

a conscious birth because most of them had given birth like

the women in 1915--they were simply "put out" when their

labors were well underway. Consequently, I was left

wondering what birth would feel like if I was to remain

awake and unmedicated during the entire process. How much

pain was really involved? Could I really endure a process

culminating in what my cousin, years later, described as

"passing a watermelon through the eye of a needle"?


In 1978, I read the "amazing birth stories" compiled in

Spiritual Midwifery and other accounts of home birth in The

Birth Book very closely. It appeared to me that my life, or

at least my sanity during the rigors of labor, depended upon

emulating those examples of capable women who actively gave

birth--women who worked with their bodies, without any great

fear of the forces moving within them. They didn't

helplessly endure the pain of what literary representations

usually depicted as a totally irrational event.

I looked to these autobiographical accounts because the

representations of women giving birth in novels, movies, and

the medical texts I had studied were, in a word,

frightening. I knew that times and methodologies had

changed, and a kind of medical backup was available to me as

it had not been for many women up until the midpoint of the

twentieth-century. I would not face the rigors of

childbirth with the stern rationale of God's will as my

primary comfort, as Anne Bradstreet so movingly documents in

her "Before the Birth of One of Her Children."

Yet more modern literary versions of birth offered less

comfort than did Bradstreet's poems, evacuated as they were

of any comforting, spiritual underpinning. I did not want to

emulate the birthing women I remembered from Kate Chopin's

The Awakening or the missionary wife Julie Andrews played

opposite a stern Max Von Sydow in the movie version of James

Michner's Hawaii. These women were lost in a panic and a

pain I could not imagine but feared mightily. I could not

accept the idea that a conscious and unmedicated birth had

to be an experience of excruciating pain and helplessness.

Otherwise, why did women consent, if and when they did, to

keep on reproducing?

Literary and Medical Representations of Birth

According to Maria Curro Kreppel's survey of fictional

representations of birth, The Awakening and Hawaii offer

typical representations of birth inasmuch as fictive

accounts of labor seldom depict the experience of birth from

the mother's perspective: she serves as the object of many

other gazes that interpret her words, her cries, and her

gestures. Whether authored by men or women, the stories

containing birth scenes rely on an observer's account. "That

observer may be a father, friend, or physician, perhaps even

a 'she' but typically not the mother herself" (Kreppel 4).

One has only to think of the spectating narrator in Sylvia

Plath's The Bell Jar, the young boy in Hemingway's Indian

Camp, witnessing the brutal cesarean his uncle performs on

the Indian woman, or of Byron Bunch's perception of Lena

Groves' labor in Faulkner's Light in August to see that what

others see is a woman adrift in a sea of pain, ignorance,

and sometimes shame about what is happening to her body.'

Such are Bunch's discomfiting observations of Lena

Groves in labor, however much they are tempered by his

overwhelming love and concern for her:

Her hair was loose and her eyes looked like two
holes and her mouth was as bloodless now as the
pillow behind her, and as she seemed in that
attitude of alarm and surprise to contemplate with
a kind of outraged unbelief the shape of her body
beneath the covers, and gave that loud, abject,
wailing cry. (Faulkner 441)

When, later in the century, fiction begins to include

the mother's perspective, the "key elements" emphasized in

such representations largely remain the same: "Control is

still not the mother's; pain is still the focal image;

unnaturalness and depersonalization are still the themes"

(Kreppel 10).

In Jessamyn West's Leafy Rivers, for instance, Leafy,

a young backwoods woman, awakens to her labor from a deep

sleep, screaming. She carries on a broken, yet coherent

conversation with the attending doctor. His replies to her


questions confirm birth as an ill-conceived way to reproduce

the species, an unfortunate series of events created by an

inscrutable god, which a woman simply has to endure. Leafy


"Why does it hurt?"
"What's inside's bigger than the gate it's got
to go through."
"A farmer wouldn't plan that way for his
"A farmer didn't make this plan."
"Who did?"
"They say, God ....
[Leafy] sat up, wildly, with the idea that if
she got out of bed, she might run away from the
pain. (West 133-135)

Later in the century, in 1987, Toni Morrison's

depiction of Sethe's labor in Beloved in some ways alters

standard literary depictions. The runaway slave experiences

a mercifully short but somewhat violent labor; it culminates

in her daughter's birth in a "useless" rowboat that Sethe

and her white companion, Amy Denver, discover as Sethe's

labor intensifies:

Panting under four summer stars, [Sethe] threw her
legs over the sides, because here come the head,
as Amy informed her as though she did not know it
--as though the rip was a breakup of walnut logs
in the brace, or of lightning's jagged tear
through a leather sky.
It was stuck. Face up and drowning in its
mother's blood. Amy stopped begging Jesus and
began to curse his Daddy.

"Push!" screamed Amy.
"Pull," whispered Sethe.
And the strong hands went to work a fourth
time . . (Morrison 84)

While the architect of this means of reproduction comes

in for no better treatment than in Leafy Rivers--Amy Denver

curses God--Morrison alters the traditional sense of female

helplessness by emphasizing the hard and successful work the

women do together and the bond that evolves between them.

The birth, in fact, significantly dignifies these two

"throw-away people, two lawless outlaws, a slave and a

barefoot whitewoman with unpinned hair" because they are

able to do "something together appropriately and

well . .," birthing and "wrapping a ten-minute-old baby in

the rags they wore" (Morrison 84-85).

Other representations, like that in Plath's The Bell

Jar, blatantly warn women away from birth by stressing its

grotesqueness, an attribute localized in the body of the

laboring woman captured by hospital technology. Esther

Greenwood recoils from the "enormous spider-fat stomach" of

the woman on the delivery table, her "two little ugly

spindly legs propped in the high stirrups" (Plath 76).

Kreppel further suggests that in Plath's novel, the

experience of watching a birth is designed to teach

Greenwood, and by extension, women readers, a lesson (8).

As "a third-year man" sneaks Greenwood into an obstetrics

ward, he has second thoughts about the adventure. He tells

her "that she oughtn't to see this [because] . You'll

never want to have a baby if you do. They oughtn't to let

women watch. It'll be the end of the human race"(Plath 75-


With their atomized shots of a baby's head bulging

against a distended vagina, one subsequently opened by the

doctor's scalpel, the medical representations of birth

seemed to affirm the perspective of Plath's heroine: birth

is grotesque and ugly; a woman is better off unaware of all

that will befall her in the process. And the medical texts,

as the majority of the literary representations, patently

omitted the mother's perspective. An interest in the base

mechanics of a body giving birth prevailed instead. The

woman disappeared. In her place a uterus functioned

mechanically, and a "presenting part" became a child once

labor, described in strangely algebraic terms, was done.

Ralph M. Wynn's, M.D. descriptions of labor in his

Obstetrics and Gynecology: The Clinical Core represent what

Emily Martin calls the "mechanical metaphor of birth,"

prevalent in medical texts: "the contractions of true labor

begin in the lumbar region at intervals of 20-30 minutes

. A normal effective uterine contraction reaches an

intensity of 25 to 60 mm. Hg."(Wynn 38).

Obviously, no woman in labor can speak of her

sensations this way. This kind of measurement is available

only if she is hooked up to a machine that could certify

whether or not she had produced an "effective uterine

contraction." Without the machine, this terminology is

useless. As Martin astutely notes from her survey of

contemporary obstetrical texts, "what the uterus does is

expressed in terms that would be familiar to any student of

time and motion studies used in industry to analyze and

control workers' movements"(58).

The terms describing the progress of labor in Wynn's

text similarly evoke images of a technician calibrating a

tool or sighting a target:

Progress in labor is determined by the gradual
descent of the presenting part, or change in
station (the location of the presenting part in
the birth canal). Designation of station as "+" or
refers to the level in cm. below (+) or above
(-) the ischial spines. . When the occipent

is at station 0, the vertex is said to be
engaged clinically. (Wynn 38)

Martin argues rightly that "women lose" when birth

labor is regimented like "labor of other kinds . in our

society," especially those characterized by "technology and

machinery . used to control those who labor . (66).

Perceptions like those expressed in Wynn's textbook diminish

"a complex process that interrelates physical, emotional

and mental experience" by treating it as if it "could be

broken down and managed like other forms of production"

(66). The mechanistic language of birth at once symbolizes

medicine's reduction of birth labor to a one-dimensional

experience and evinces the way it constructs women's

alienation during parturition.

Aside from the technocratic terminology of contemporary

medical representations, the other problematic aspect is

their overwhelming male authorship, a tradition that

stretches back to the classical period of medicine.2 This

is not to say that women, as medical professionals--doctors,

nurses, and nurse-midwives--and as lay practitioners, have

not written about childbirth. They have, as I will

demonstrate momentarily. But until fairly recently, women


published about childbirth from a marginalized and usually

embattled position vis-a-vis professionalized medicine in

the United States.

The history of medical representations of childbirth in

the U.S. until the middle of the twentieth century reflects

the masculine take-over of a once exclusively female domain

of midwifery, a take-over underway in the seventeenth-

century Europe from which many of the earliest American

settlers departed. Writing in 1876, Dr. William Goodell, no

friend to American midwives, attempted to explain the rise

of the "male midwives" and "accoucheurs" in England and

France during the seventeenth century. The gender shift in

birth attendants did not, he concluded, come about because

"royalty . set the fashion" and sought to hide "the

wantonness and immodesty" of courtesans (61).1 Rather, "the

art of printing . gave the death-blow to the monopoly of

midwifery by midwives"(62).

The settlement of America necessarily transplanted

European views, texts, and practices of childbirth to the

new world. The extant historical records on colonial America

makes it clear that before the professionalization of

medicine beginning in the mid-18th century, women

,"monopolized the practice of midwifery in America as in

Europe . (Scholten 429). Given the then prevalent view

of female intellectual inferiority, low literacy levels

among women, and the virtual male hegemony of the publishing

industry, however, those texts on childbirth that might have

accompanied the colonists to America were primarily penned

by male practitioners, who were steadily gaining status as

childbirth attendants because of their contributions to the

new science of the body.'

Along side the "father of English midwivery," William

Harvey's De Generatione Animalium, stood Percival

Willoughly's Observations on Midwifery: A Country Midwife's

Opsculum, and Peter Chamberlen 1I's The Crie of Women and

Children. An American edition of the English version of the

anonymously penned Aristotle's Master Piece appeared in


The Master Piece, which was the creation of an
English physician, "W.S." and a succession of hack
writers, first appeared in England in 1684. The
numerous later editions were the only works on sex
and gynecology widely available to 18th-century
Americans. (Scholten 431, fn. 20)

Female midwives of Europe had, however, published their

observations on birth, among them the highly regarded


seventeenth-century practitioner, Jane Sharp, who based her

The Midwives Book or the Whole Art of Midwifery Discovered

on her thirty year's practice. In 1760, Elizabeth Nihell

published Professed Midwife. A Man-midwife or a Midwife? A

Treatise on the Art of Midwifery. Her text is part polemic

against the man-midwives who were, at the time in England,

seriously encroaching on the livelihood of female

practitioners there. Sarah Stone, another eighteenth-

century midwife, recounts forty of her "presumably most

memorable cases" in her A Complete Practice of Midwivery in

1737 (Towler and Bramall 123) .5 We can assume then that

some of these texts might have made the Atlantic crossing

with women experienced in or who knew they would be called

upon to serve as midwives for friends and family members.

The tenure of uncontested female midwifery in America

lasted only a relatively short time. In her "'On the

importance of the Obstetric Art": Changing Customs of

Childbirth in America, 1760-1825" Catherine M. Scholten

notes that as early as the 1760s, male physicians began to

make inroads into what had formerly been exclusively female

territory: "among well-to-do-women in Philadelphia, New

York, and Boston, childbirth became less a communal

experience and a more private event confined within the

intimate family" attended by male practitioners. The

professionalization of medicine as a male practice (now

including midwifery) in England extended the domain of its

male practitioners to America. American candidates

travelled to Europe for medical education and accrued the

status associated with such training. Female midwives did,

however, continue throughout that century and for the

entirety of the next "to serve both the mass of women in

cities and women in the country" (Scholten 435) who did not

have access to or could not afford the more expensive,

urban, male practitioners.'

At the end of the eighteenth century, when reputable

medical schools opened in America, they adopted midwifery as

a specialty (Scholten 436) Yet it existed as a somewhat

neglected specialty, that is if the survey conducted by Dr.

J. Whitridge Williams, professor of obstetrics at Johns

Hopkins University, in 1912 is any indication of prevalent

medical training. Williams surveyed 120 medical schools in

the U.S. and found that

the average medical student witnessed but one
delivery, and the average for the better 20
medical schools was still only four ...

Several of the professors admitted that they
themselves were incapable of performing a
Caesarean section. (Kobrin 98-99)

One of the most vocal medical allegations about midwifery at

this time accused women of unsanitary practices resulting in

a high incidence of puerperal fever. Yet Williams' survey

challenged the assumed superiority of professional medicine.

He concluded that, in general, American medical schools

"were turning out incompetent products who lost more

patients from improper practices than midwives did from

infection" (Kobrin 99).

While "a few American physicians instructed midwives or

wrote manuals for them," by the early 1820s, these "private

and sporadic" attempts "had ceased . . Denied formal

medical training, midwives of the early 19th century could

not claim any other professional or legal status" (Scholten

440-41). Though male practitioners had to overcome the

resistance to having men in the birthing chamber, thereby

threatening the modesty of their female patients, by the

decade of the 1860s, much of that resistance had faded

(Litoff, American Midwives 134).

Regular medical schools did finally open their doors to

women at mid-century, but female students often attended

under duress if they attended at all.7 Still, many went on

to become licensed practitioners, and near the end of the

nineteenth century, after the notion of women as regular

doctors gained wider acceptance, female doctors wrote of

childbirth in conduct books. This discourse was

nevertheless modulated by the same Victorian ideology of

female modesty that had temporarily stymied the entry of men

into the birthing chamber. For example, Alice B. Stockham's

Tokology: A Book for Every Woman (1885), Mrs. P.B. Sauer's

Maternity: A Book for Every Wife and Mother (1881), and Mrs.

Emma F. Angel Brake's What a Young Wife Ought to Know (1901)

describe the experience of birth but were loathe to

represent it pictorially. The female authors of books about

female physiology and the experience of birth shared the

residual Puritanical view that

modesty expressed more than a simple
reluctance to expose the genitalia; it showed how
widespread and real was the cultural belief that
revealing the bodily condition would reveal as
well the state of the person indissolubly linked
with it. (Wertz and Wertz 91)

For women who could not afford a formal medical

education but who were called upon as midwives, the

increasing strength of professionalized medicine meant

increasing hostilities and increasing pressures to

circumscribe all but the most unavoidable practices of

female midwifery. Apparently overlooking the shortcomings

of their own institutions that Williams had pointed out, two

physicians, Arthur B. Emmons and James L. Huntington

asserted in the March, 1912 edition of the American Journal

of Obstetrics that

the midwife never has and never can make good
until she becomes a practicing physician,
thoroughly trained. . Midwives should not
be licensed save in those states where they are
so numerous that they cannot be abolished at
once. (65)

Given such hostility from the emerging medical

establishment, it is somewhat understandable that until the

publication of autobiographical accounts by midwives

practicing in the last half of the twentieth century,

earlier autobiographical documents about the craft of

midwifery have been scant. The WPA effort to document

American's depression-era, regional cultures focused some

attention on the rural midwives of America, as James Seay

Brown's Up Before Daylight: Life Histories from the Alabama

Writer's Project, 1938-39 demonstrates. "Rat Pie: Among the

Black Midwives of the South" by midwife advocate Carolyn Van

Blarcom, also appeared in Harper's Magazine in 1930. More

recent publications spurred by the midwifery renaissance of

the 1970s include Marie Campbell's Folks Do Get Born, Onnie

Lee Logan's story of her midwifery career in Motherwit: An

Alabama Midwife's Story, Mabel: The Story of One Midwife by

Elizabeth Reditt-Lyon, and A Midwife's Story by Penny

Armstrong and Sheryl Felman.

Prior to the twentieth-century, however, the one extant

published work on midwifery by a female midwife is The Diary

of Mrs. Martha Moore Ballard (1785-1812), an abridged

version of which was published in Charles Elventon Nash's

1904 History of Augusta: First Settlements and Early Days as

a Town, Including the Diary of Mrs. Martha Moore Ballard

(1785-1812) .8 According to Laurel Thatcher Ulrich, Ballad's

diary disappoints in terms of what it includes about the

"particulars of [her] methods: (we do not know, for example,

whether she applied hog's grease to the perineum or manually

dilated the cervix) [yet] it offers compelling evidence of

her skill." (29) The number of successful deliveries

recorded and her inclusion in Nash's History attest to her

high status as a valued community member.

Instead of the particulars of her art, for each

delivery, Ballard recounts

the father's name, the child's sex, the time of
birth, the condition of mother and infant, and the
fee collected. Many entries also include the time
of the midwife's arrival and departure, the names
of the attendant who assisted her, and the arrival
of the 'afternurse' who cared for the woman during
lying-in . .. (Thatcher, "Living" 29)

Otherwise, Thatcher notes, Ballard's diary is "typical" of

18th-century rural records: it offers "a laconic" account

"of weather, sermon texts, family activities, and visits to

and from neighbors." The accounts of her attendance at

childbirth are "interwoven with this larger accounting of

ordinary life . ." Still, she does denote the

significance of these birth records "by summarizing them in

the margins [and] numbering each year's birth from January

to December" (Thatcher, "Living" 29).

One assumes that other midwives like Ballard recorded

the particular circumstances of at least some of the cases

they attended in diaries and journals. As more American

women's personal writings come to light and find their way

into print, we may gain a more complex understanding of how

our foremothers experienced childbirth. Or perhaps not.

Childbirth Narratives and the Female Autobiographical
Tradition in America

I interject a note of doubt concerning any forthcoming

autobiographical representations of childbirth largely

because the entries in the current bibliographies and

anthologies of personal writing by women of the seventeenth,

eighteenth, and nineteenth centuries typically share

Ballard's perfunctoriness where details of childbirth are

concerned.9 As Scholten notes, births are frequently

alluded to in diaries, letters, and journals throughout

those centuries, but "the event itself is rarely described"

(426, fn 2).

In the domain of officially public, autobiographical

documents by American women of the early modern and pre-

industrial period--and narratives of spiritual conversion

and accounts of journeys make up the largest numbers of

these accounts--descriptions of childbirth are either absent

from or play only a peripheral role in many of these

documents. The documented conversion experience of Puritan

and Quaker women, for example, the bulk of which occur in

the mid-1700s, "contains little else of the woman's life"

beyond the requisite and formulaic stages relating to the

process of salvation (Edkins 42). According to Carol

Edkins, however, Elizabeth White's conversion narrative,

"marks one period of her spiritual progress with the birth

of a child." Edkins' survey of Puritan women's documents

identifies this mention of childbearing as a significant

source of meaning in the salvation process as "the

exception" (42) .10

In an even more extreme way than these colonial

writings, the nineteenth-century spiritual autobiographies

of African-American women imply that conjugal relations and

their offspring represented their sadly inevitable immersion

in the physical world rather than their transcendence of it.

The accounts of conversions and calls to ministry in The

Life and Religious Experience of Jarena Lee and the Memoirs

of the Life, Religious Experience, Ministerial Travels and

Labors of Mrs. Zilpha Elaw, for example, lack any references

to childbirth. We learn of Lee's motherhood upon the death

of her husband, who "left [her] alone with two infant

children (41). Zilpha Elaw frequently mentions her

daughter, but perhaps because her own mother died giving

birth to her twenty-second child, (55) Elaw saw no reason to

emphasize the singularity of her one experience of

parturition. In her A Brand Plucked from the Fire: An

Autobiographical sketch by Mrs. Julia A. Foote, the author's

continual attempts to cleanse her husband "from his carnal

mind" (191) implies her distaste for conjugal relations, and

she bore no children.

It is somewhat perplexing--at least for these women who

did give birth--that they do not perceive childbirth as a

simile to the formal process of salvation. Despite the

emphasis on the submission of the female will to that of the

community and ultimately to God in the conversion process,

these female writers do not recognize childbirth as a ritual

in which control has to be similarly relinquished to some

greater power. This similarity was not, however, overlooked

by Puritan ministers.11

Perhaps the relative perfunctoriness of some of these

accounts can be understood by remembering that during the

colonial period, a woman's unerring and primary duty was to

produce and morally educate legitimate heirs, just as it was

man's duty to labor in other ways. The religious ideology of

God's unerring will and of Eve's condemnation of all women

to suffer provided the only source of comfort or explanation

for the pain experienced, the birth of physically deformed

or mentally deficient children, or the death of the mother.

This matter-of-factness with which childbirth is depicted

might indicate an attitude that found it best not to reflect

too long or too deeply over matters over which women had

little control as wives--that is, in the realm of birth

control, in the birth experience itself, and in the

preordained interpretations of that event.12

This reticence, prompted further by the ideology of

female modesty, lasted well into the nineteenth century when

female autobiographies of "notable women" began to appear.

These texts, too, lack much detail where childbirth is

concerned. Their raison d'etre consists, rather, of

distinguishing their subjects from "ordinary" women:

childbirth and children were common, not special attributes

or experiences. In other words, the experience might be

mentioned, but as these autobiographies were increasingly

written by "singular" women, that is those who distinguished

themselves in the public as opposed to the private sphere,

the experience of childbirth is not prominently depicted.

The genre demands the assertion of a particularized self,

produced and defined by the achievement of things beyond the

norm of domestic activities and childbearing.13 If giving

birth to and caring for a child demand a certain amount of

selflessness, and all who have done so will attest to this

fact, childbirth and childcare are understandably

represented ambivalently, if at all, in these


As Patricia Meyer Spacks further notes, writers of

female autobiographies have, until the late nineteenth and

twentieth centuries, "been artistic performers by

profession--dancers, actresses, writers. . The

housewife," according to Spacks, "seldom offers her life to

public view" (112). Moreover, beginning in the eighteenth

and increasing in the nineteenth century, "the economy did

not require and therefore did not value productivity within

the home. . (Pomerleau 34). Therefore, a woman's

representation of her life as a notable one would most

likely position her in the valued realms of public

experience and expression, not in the materially devalued,

if publicly idolized, household.14

For example, in Elizabeth Cady Stanton's Eighty Years

and More: Reminiscences: 1815-1897 she asserts that her

autobiography will illuminate her "private life" as opposed

to her "public career":


The story of my private life as wife of an earnest
reformer as an enthusiastic housekeeper, proud of
my skill in every department of domestic economy,
and as the mother of seven children, may amuse and
benefit the reader. (qtd. in Jelinek 72)

Estelle Jelinek notes, however, that the information on

her marriage, her private life with her husband, and her

role as mother and housekeeper belie that assertion of

primacy. On childbirth or her experience of motherhood,

Stanton's revelations are slight.

Her own motherhood is barely covered and then only
after the birth of her first child, as a kind of
handbook for other new mothers; she urges them to
trust their own judgment rather than the dictates
from rigid and ignorant doctors. (Jelinek 72)

The autobiographies of other notable women who bore

children in the late nineteenth and early twentieth century

follow Stanton's lead where accounts of birth are concerned.

In her 1935 autobiography Charlotte Perkins Gilman recounts

the birth of her daughter in a brief journal entry: "This

day, about 5 minutes to 9 in the morning, was born my child,

Katherine" (88); Mary Austin's Earth Horizon notes only

that her "daughter was born Oct. 30 and called Ruth . ..

I know now, of course, that Mary [Austin speaks of herself

in the third person throughout her autobiography] was not

physically constituted for child-bearing . "(239);

Margaret Sanger, the great educator of women about birth

control and reproduction, has little explicit to say about

how her children came into the world. At the birth of her

first child, she recounts only the "first, thin pains of

warning" that culminated in an "ordeal [that] was unusually

hard . (59). Comments about the births of her other

children are similarly laconic.

The twentieth-century childbirth narratives comprising

this study, therefore, represent a marked deviation from

most autobiographical retellings of life events by American

women. First, they focus on childbirth as a significant

life event; second, as the century progresses, women's

narratives become more explicit about birth. Women speak

more frankly about both their bodily experience and the

variety of emotions that accompany pregnancy and birth.

The particular historical contexts precipitating these

changes in childbirth representations will be explored in

more detail in the individual chapters of this study;

however, in general, we can attribute the new significance

with which birth is invested and the frankness with which it

is ultimately depicted to two broad sociohistorical

developments: (1) the increasing educational and


professional opportunities that opened to women at the turn

of the century and which increased over the next ninety

years, and (2) medical developments that significantly

impacted birth. The latter presented women with previously

nonexistent alternatives for how they might experience

birth. The former legitimized her public speaking and

writing about those choices and experiences. Further, when

childbearing and domestic duties no longer comprise the

totality of most women's work, childbirth acquires

significant new connotations.

However, the childbirth narratives from 1915 and from

the 70s do share a concern evinced in some earlier spiritual

autobiographies--not, unfortunately, by American women, but

those written by middle- and working-class British women in

the seventeenth and eighteenth centuries. In the American

narratives birth figures as a crises that is not only

physiological but sociological in nature. Birth uncovers

the realities of sexual inequality in much the same way as

did spiritual conversion in the earlier autobiographies.

Felicity Nussbaum describes the conflict that often

materializes in spiritual autobiographies of Quaker,

Baptist, and Methodist women: these conversion narratives

consist, in part, of an attempt to inscribe a certain

equality in the eyes of spiritual authority, both the

earthly authorities and the ultimate authority, God. In

these attempts to articulate a relationship to the latter,

the women stumble upon the reality of their unequal status

in the eyes of the former (176).

Although these women writers frequently "retreat[ed]

from the radical implications" of their discovery (Nussbaum

164), the texts from 1915 and the 1970s do not. They

emphatically state that the way in which a woman experiences

birth--her "conversion" from woman to mother--has the power

to alter such relationships of inequality. However, the

"liberating" birth methodologies chosen by these women

writers from either ends of the century are precisely

antithetical to one another.

The advocates for twilight sleep in 1915, for example,

deemd their agitations for the sleep the "most universal

'women's rights movement' ever imagined" (Tracy and Boyd

106). They believed that through the amnesiac regimes of

twilight sleep, women could be relieved of the dread of

childbearing and spared the agonies that often left her

exhausted for months or maimed for life. By placing herself

squarely into the hands of the medical profession for

relief, a woman could emerge to take her place as a far more

equal participant in the life of the community.

By the 1970s, advocates of home birth recognized the

amnesiac regimes of the sleep as part of the tradition of

male-dominated, medical control of female bodies that they

opposed. Midwife-assisted home birth, they argued, could

heal the imbalance of power between men and women by

allowing a woman to experience her innate strength and

fortitude. Taking her out of the hands of a male-dominated

medical establishment would also return birth to its former

woman-centered setting.

The narratives from the 40s and 50s largely lack this

kind of gender critique. The powerful coalition of women's

groups forged in the early decades of the century to win the

vote and influence various social policies bearing on the

welfare of women and children had, by the 50s, faded into

what Myra Marx Ferree and Beth B. Hess fittingly call the

"doldrums" of feminist mass movements (2). Post-war cultural

forces were bent on returning women to the home, as well.

In one regard, then, the stories from the prepared

childbirth movement of the 40s and 50s facilitated the


"return to normalcy" by promising to ease women's emotional

sufferings in birth and thereby ease women into motherhood

and the home. Moreover, texts about prepared childbirth

experiences revealed but did not criticize the medical

control which, more times than not, sabotaged women's

attempts at self-management.'i

Nevertheless, these texts from a latent period in

twentieth-century feminist did contribute to the activism of

the 60s and 70s. Their depictions of medical abuse did not

go unnoticed by childbirth activists who became even more

vocal by the 60s and 70s as evinced by the growth of such

organizations as the International Childbirth Education

Association, the National Association of Parents and

Professionals for Safe Alternatives in Childbirth, and the

Association for Childbirth at Home. The impetus on educating

mothers about the process of birth that these texts began in

the 50s prefigured and prepared the ground for the

educational activities of the many "consciousness-raising"

groups of the Women's Health Movement of the 60s and 70s as

well. Energized by various other counter-cultural

critiques, women discovered "gynecological oppression" as

one potent facet of patriarchy. Regaining control of

childbirth figured as a significant "blow" against a male-

dominated and technologically alienating medical "empire."


l.In her "Childbirth in Literature," Carol H. Posten
seconds Krepple's conclusions. She notes, too, that "birth
as we see it in Western literature is an "essentially
solitary act exacerbated by its being an act for an
audience, to the extent that even the woman giving birth
thinks less of herself as giving birth than being seen
giving birth" (29).

2.For discussion of, and examples from, the male
domination of the print tradition in classical, medieval,
and early modern medicine, see Eccles; Blumenfeld-Kosinski;
and LeMay.

3.Here William Goddell refers to the story about the
summoning of Julien Clement in December of 1663 for "motives
of secrecy" to "deliver the frail and beautiful Duchesse de
la Valliere." Clement was "mysteriously conducted to a
certain house where a veiled lady lay in the throes of
labor." Moreover, "it is said the king watched the
proceedings from behind the tapestry" (56).

4.Goddell cites numerous European obstetrical texts
printed and disseminated after the discovery of printing
during the mid-fifteenth century. See especially 62-64.

5.All of these midwives and their texts are given
extensive treatment in Towler and Bramall. See also Eccles.

6.On the fate of American midwifery, see Wertz and
Wertz 1-76; Leavitt, Brought to Bed: Childbearing in
America, 1750 to 1950, 13-86; Borst; Litoff; Kobrin; Brack;
Donnison; Rosenberg and Smith-Rosenberg; and Ziegler.

7.See Corea's The Hidden Malpractice for a description
of the treatment of female medical students in America
during the nineteenth century, pp. 23-42.

8.Two volumes of Martha Moore Ballard's Diary are
housed at the Main State Library in Augusta.

9.For compilations of American women's previously
published and unpublished autobiographical writings, see
Harris; Caldwell; Culley; Davis and Joyce; Derounian-Stodola
and Levernier; and Goodfriend.

10.For another study of these early spiritual
autobiographies, see Mason 19-44.

ll.In "Vertuous Women Found: New England Ministerial
Literature, 1668-1735," Laurel Thatcher Ulrich writes that
although Puritan ministers largely refrained from stressing
"'feminine' or 'masculine' themes over a common
Christianity," (222) they did occasionally expound on
childbirth, and not always to the detriment of their female
parishioners. Noting that "a larger proportion of females
[to males] were reborn," Cotton Mather concluded "it was
probably because in childbirth the curse of Eve had turned
into a blessing." Benjamin Cotton preached that women were
more susceptible to grace because the possible mortality of
childbearing confronted them with "the Gates of Death, by
which We all receive our Life . (qtd. in Thatcher
223). Thatcher concludes that by "stressing the redemptive
power of childbirth, [these ministers] transformed a
traditional badge of weakness into a symbol of strength"

12.With each birth, the Protestant mother confronted a
prevalent ideology that interpreted anything beyond the
normal agonies as evidence of her immorality. According to
Towler and Bramall, Puritan doctrine "emphasized that
nothing happened by chance and that everything was expressly
ordained by the providence and will of God" (64). Keith
Thomas also notes that Puritan "moralists had always taught
that incest, adultery, and other forms of sexual immorality
were punished by ill-health and monstrous births" (27). One
has only to remember John Winthrop's judgment of Anne
Hutchinson, delivered of a "monstrous birth," as the
putative consequence of her "error" in challenging Puritan
orthodoxy in the Massachusetts Bay Colony (Journal 266-67).

13.See Patricia Meyer Spacks' "Selves in Hiding" for a
more complete account of the ambivalence with which notable
women, such as Emma Goldman, Eleanor Roosevelt, and Golda
Meir, represent their public accomplishments and their
private lives in their autobiographies.

14.According to Nancy Folbre, part of this devaluation
of domestic economy arose "with the apotheosis of the free-
market society reached . in the U.S. in the early 20th
[century] . ." After that, "commodities, goods that
could be bought and sold, dollar-equivalent goods
increasingly determined concepts of value" (465).

15.See Sandelowski 85-107 for a very detailed analysis
of the perspectives expressed in medical journals and in the
periodical literature during the 1930s and 40s that helped
to prepare the way for the 50s experience of prepared


In turn-of-the-century America, many secular gospels

competed with the Biblical version as the one true paradigm

illuminating human relations and human history. Certainly

the world according to Darwin and Spencer had many devotees,

as did the world according to Freud and Marx. Yet,

arguably, it was Frederick Winslow Taylor's gospel of

efficiency that most acutely transformed so many

American lives.'

In her Taylored Lives: Narrative Productions in the

Age of Taylor, Veblen, and Ford, Martha Banta traces the

narrative mechanisms and the various discourse communities

that helped disseminate Taylor's doctrine of efficiency into

sectors of American life far removed from the factory floor,

its original focus. She "locates narratives of the

managerial ethos within diverse areas of domestic and

national activity," from "the business enterprise, the

science of households," to the "making of ready-made


garments . houses . and work environments" (4).

Indeed, as Taylor proclaimed, his vision encompassed all

forms of national activity. He aimed to correct "the

great loss which the whole country is suffering through

inefficiency in almost all of our daily acts" (7).

In the factory, scientific management significantly

modified the division of labor of the old factory system.

While that prior hierarchy--comprised of workers, bosses and

overseers--certainly designated different tasks to be

performed by different individuals, those under the old

regime were not, however, "fundamentally different from one

another" (Knapp 5). Because those who actually performed

the labor knew as much or more than the overseer or the

owner about the work being done, they retained a degree of

control over the speed at which the work was accomplished.

Taylorism targeted this locus of worker control--or

"soldiering" as it was called--describing it as

"deliberately working slowly so as to avoid doing a full

day's work" (Taylor 13). To dispose of such calculated

inefficiency, Taylor instituted a division between mental

and physical tasks, between managers, who retained the

knowledge that had been traditionally possessed by the

workers, and laborers who now simply executed "in

machine-like" fashion "plans laid down by others" (Knapp 5).

Taylor's management strategies further modified the

social relations of production. Believing that what "the

workman . most wants" is "higher wages" (10) rather than

a modicum of control over the labor process, Taylor largely

dismissed the idea of labor incentives based on personal

loyalties or personal authority. The idiosyncratic,

subjective, and emotionally-inflected judgment of the

individual could be readily replaced by "rules, laws, and

formulae . ." (37). Taylorism's obsessive time and motion

studies also demanded mechanistically choreographed work.

How the worker's body and motions were deployed in time

received intense scrutiny and regimentation in the name of

scientific efficiency.

As Banta also emphasizes, Taylor's design for a

"harmonious society of workers and bosses" through

scientific management appealed to "reformers of various

political permutations. . ." They adopted his narratives

of order and efficiency as a primary means by which to


"combat social disarray," a mission that inevitably led to

a focus on household management (10).

When applied to the household via books such as

Christine Frederick's The New Housekeeping: Efficiency

Studies in Home Management, scientific management theories

counseled women to assess and restructure the wasted spaces

in their kitchens, even if these spaces were "cozy,"

comfortable, and aesthetically pleasing. They were to

apply time and motion study techniques to their routines and

those of their servants, in order to produce a domestic

environment that mimicked the factory: "Women [should be]

skilled in managing the machinery of the house so that it

runs easily, smoothly, and with least effort" (Frederick,

Housekeeping 14). The most important requirement, however,

was the "personal attitude of the woman toward her work"

(181). She must develop a "trained, efficient attitude of

mind, taking hope, zest, and cheer in her job .

(Housekeeping 189) (her emphasis). Housewives, according

to Frederick, had a supreme role to play in creating a

seamless order between the worlds of domestic and commercial


Significantly, this enhanced efficiency was justified

not only by the order it would achieve in the domestic arena

but by the promise of emancipation into public involvement

it offered women: freed from household drudgery, they would

be able to participate more fully in the world beyond their


Some emancipatory movements of the Progressive era

certainly never mentioned Taylorism in their efforts to

reform society; many nevertheless ascribed to the values

dearest to a scientific manager's heart: order, efficiency,

and enhanced productivity. Such was the case of the

"twilight sleep uprising" of 1914-15. Born out of an

apparently democratizing impulse, supported by women from

all classes of society but primarily by upper-class women of

the Northern cities, the "uprising" facilitated a

transformation in the realm of birth similar to that

accomplished by Taylor in the factory and the home.

Overtly subversive, the "twilight sleep uprising"

represented the first instance in American medical history

where "the whole body of patients [had] risen to dictate to

the doctors" about a methodology they would have (Tracy and

Boyd xxxiii). What these women would have was "the sleep."'2

Ironically, however, their demand for a methodology they

viewed as emanicipatory facilitated the virtual hegemony of

the medical profession over birth, a situation in which

women's desires for how they will give birth are routinely

subordinated to institutional demands.3

As the texts from the twilight sleep movement

inadvertently demonstrate, particular costs accrue with

forging the docile body that would sleep and remember

nothing during labor. These costs are fundamentally

isomorphic with the "human costs" extracted in scientific

management's reformation of labor: the loss of local

knowledges on the part of the worker and the demise of a

worker's peculiarly individual contributions to the labor

process. All are sacrificed to ease, efficiency, and

increased productivity. Childbirth labor, in short,

increasingly apes the logic of industrial production.

First applied to obstetrics by Von Steinbuchel in Graz

and substantially extended by two physicians in Freiburg,

Germany, twilight sleep was administered via injections of a

precisely calibrated morphine-scopolamine mixture; it

suspended a laboring woman in a state of amnesia, rather

than total analgesia, over the course of most of her labor.

Besides the respite from labor pains, the process garnered

support by promising to circumvent a number of other

labor-related agonies: the injuries inflicted on mother and

child during high forceps deliveries, the uncomfortable

aftereffects of etherized or chloroformed birth, and the

possible death of the mother from caesarean section.

The sleep's proponents believed that its positive

effects resonated far beyond the localized experience of

childbirth, however. Some indicted childbirth pain as the

one aspect of maternity retarding women's development into

truly productive members of society, both within and beyond

the bounds of domesticity. Two of its most vocal proponents

called the twilight sleep movement "the most 'universal

women's rights movement' . ever conceived" and saw it as

a necessary first step in establishing female equality

(Tracy and Boyd 106). They rejected the nineteenth-century,

sentimental ideology of the sacrificing mother who eroded

her body and her ambitions in strict service to the family.

Forgetting labor through the amnesiac regimes of the sleep

promised the same liberation as a scientifically-managed

household: it offered an additional means by which a woman

could begin fulfilling her desires for more influential

roles in public and private life. She could, if she so

chose, produce (more) children more easily and be more

productive inside and outside the home.

In 1915, two upper-class American women, Marguerite

Tracy and Mary Boyd, compiled an encyclopedic text on this

new methodology of painless childbirth.4 Painless

Childbirth: A General Survey of all Painless Methods with

Special Stress on Twilight Sleep and its Extension to

America, published by the prestigious firm of Frederick A.

Stokes, comprehensively outlined the methodology and

recounted the two women's adventures in bringing the

information to the American public. It articulated as well

the discontents with maternity that fueled the campaign for

twilight sleep.5 Originally commissioned by McClure's

Magazine to carry out this research on soon-to-be enemy

soil, Tracy and Boyd "disinterred" information on this

German methodology, which American doctors had summarily

tried and discarded seven years earlier, without, according

to these authors, a fair hearing.6

Three autobiographical childbirth narratives by birth

mothers, also appearing in earlier periodical form, were

compiled in one of the appendices of Painless Childbirth:

"How it Feels to take the Twilight Sleep: The Freiburg

Experiences] of Mrs. Cecil Stewart, Mrs. Mark Boyd, and

Mrs. Francis Carmody." These narratives comprise the first

published accounts of labor from the birth mother's

perspective in twentieth-century America.7 But they are, as

one might suspect, ironically abbreviated. As Tracy and

Constance Leupp assert in a June, 1914 McClure's article,

women can provide "but one testimony concerning this

Twilight Sleep. . When their pains begin, they tell you,

they went to sleep (38)

The paradox of this situation--the first public, print

articulations from mothers in the twentieth century about an

intimate experience of labor so revamped that there is

little or nothing to be said about the actual

process--points to a most fundamental isomorphism with

scientific management: the bifurcation between those who

labor and those who possess the knowledge about the labor


Given the reverence for science and rationality at the

heart of this uprising, it is, paradoxically, the romance

strategies of these overtly factual documents on twilight

sleep that facilitate this reformation of maternal labor

along the lines of scientific management. By utilizing the

conventions of a popular and peculiarly American historical

romance plot, embellished with gothic and fairy-tale

rhetoric, these writers construct a palatable fiction about

science and its technological offspring. In so doing, they

facilitate the pacification of the maternal laborer and the

efficient systemization of childbirth.

The Romance of the Sleep

Writing, on the one hand, for a medical audience, Tracy

and Boyd recognize the scholarly expectations they must

fulfill in Painless Childbirth. They compile and translate

the records of the two German Doctors who refined the

methodology--Karl Gauss and Bernhardt Kronig; interview

European and American doctors as well as "twilight sleep"

mothers; present current discussions on maternal psychology,

a history of childbirth anesthesia, as well as an analysis

of the resistance to Sir James Simpson's attempts to make

anesthesia broadly acceptable in nineteenth-century

childbirth. But they are also addressing a lay audience, one

whose support they must marshall for their cause. To appeal

to this audience, they take full, if unconscious, advantage

of the turn-of-the century popularity of romance to

chronicle their recovery of the twilight sleep methodology.

And among popular readers at the turn of the century,

romance was reigning. According to a Century editor in

1900, "the story of action, or the romantic novel appears

for the time to be in complete possession of the popular

field of fiction" ("Changes in Taste in Fiction" 476).1 The

historical romances of Sir Walter Scott were enjoying a

second surge of popularity; the supernatural tales of Robert

Lewis Stevenson, Henry James, and Mary Austin; the adventure

narratives of Rudyard Kipling and H. Rider Haggard; the

mysteries of Stephen Crane and Gilbert K. Chesterton, and

the science fiction of Jack London and H.G. Wells--all

enjoyed a popularity fueled, in part, by a readership that

had, according to T.J. Jackson Lears, grown weary of the

"limited spheres of polite society and domestic intrigue"

characteristic of turn-of-the century realist fiction (99).

The adult audience for J.M. Barrie's Peter Pan proved, too,

that fairy tales had found an audience among older as well

as younger readers. As Lears explains, "Adult enthusiasm

extended beyond fairy stories to include all manner of

popular legends and superstitions, gleaned from the remote

corners of Europe" (170).

Tracy and Boyd's extensive documentation of the sleep

at both the institutional and personal levels is permeated

by a fairy tale ethos. But in an even more pronounced

manner, the narrative of their recovery of information about

the sleep follows a plot line borrowing many of its elements

from a specifically American version of historical romance.

As James D. Hart describes this plot,

the most popular type presented American ways
succeeding in a foreign culture. Sometimes the
heroes and heroines were really Americans accepted
by or triumphing over Europeans, sometimes they
were foreigners possessed of those democratic,
go-getting qualities that Americans thought
peculiarly their own, but always explicitly or
tacitly readers in the US were afforded glimpses
of an aristocratic way of life that they could
vicariously share or master in the myopic eyes of
their imaginations. (186)

Following a plot line similar to the one Hart

recounts--one found in such popular romances as Richard

Carvel, When KniQhthood Was in Flower, Graustark, and To

Have and to Hold--Painless Childbirth chronicles the

adventures of two crusading female journalists who travel

abroad to war-torn Germany in order to liberate American

women by liberating information about the twilight sleep


methodology. In the process they are forced to overcome the

censorship imposed by an intransigent, aristocratic German

university hierarchy. Unearthing the information, they

return to the U.S., publishing the medical documentation

about the dammerschlaf as well as personal accounts by

twilight sleep mothers in the face of an equally resistant

medical hierarchy here. They are motivated by the desire to

provide American women with the putative key to something

that has been ideologically synonymous with America (if not

actually operant for all populations) since the eighteenth

century--equality; and the key to that equality was the

truth about the twilight sleep methodology.

Current students of historiography have discerned the

centrality of genre to historical texts, how the

relationship between the historian and his/her audience is

mediated through shared notions of genre and the

expectations those genres both enable and constrain. Hayden

White argues that

the reader, in the process of following the
historian's account . comes to realize that
the story he is reading is of one kind rather
than another: romance, tragedy, comedy, satire,
epic, or what have you. And when he has perceived
the class or type of stories to which the story he
is reading belongs, he experiences the effect of

having the events in the story explained to him
he has grasped the point of it . not in
[the history's] details, but in their functions as
elements of a familiar kind of configuration. (49)

Thus, when the women writing about "twilight sleep"

frame and penetrate their histories with recognizable

romance conventions, they are sending definite clues to

their audience about how they are reading the events and how

the audience, too, can and should read them.9

To speak about the effects of reading historical

romance in the early twentieth century is to invoke a

spirited debate about the effects on its American audience

of reading the genre in all its various permutations.0 Is

the nostalgia for a simpler, better time--a hallmark of much

romance--a symptom of a culture "ashamed of itself for its

lust of gold and blood," as William Dean Howells thought,

and therefore "anxious to get away from itself" and avoid

confronting social, economic, and political unpleasantries?

(936) The judgment of essayist Agnes Repplier in 1896

bolsters Howell's opinion, but at the same time defends such

escapism. For Repplier, reading romance offers the

opportunity to leave the present, so weighted with
cumbersome enigmas and ineffectual activity, and
to go back step by step to other days when men
[sic] saw life in simpler aspects and moved


forward unswervingly to the attainment of definite
and obvious desire. (696)

If Repplier's affirmation of romance can be considered

a statement of collectively recognizable cultural lacks--for

which romance can serve as palliative--then her nostalgia

for decisive and definitive action and, more specifically,

for "definite and obvious desire," suggests a culture that

feels it can lay claim to neither." At the very least,

historical romances imaginatively answered these desires for

effectual activity and ideological certainty, but they

represented that fulfillment as available only outside the

U.S. and in the historical past.

In a study that closely parallels my own, Amy Kaplan

has discerned how the apparently escapist ethos that so

disturbed Howells in fact served American imperialist

designs. She analyzes a series of historical romances that,

by "looking back with nostalgia at a lost wholeness .

created fanciful realms on which to project the country's

desires for unlimited global expansion," a desire actually

being played out by American forces on foreign soil at the

century's end (666). While Kaplan explores the way these

romance plots dovetail with the popular political narratives


of the Spanish-American war, her analysis of female readers

and of female roles in the romance is particularly relevant


Both the increasing female readership for historical

romances and the "New Woman" role that heroines such as

those in Richard Carvel and When Knighthood Was in Flower

embodied lead Kaplan to conclude that these novels used

female discontent to legitimize the politics of imperialism:

by identifying with the assertive women in these romances,

female readers "are invited to imagine themselves

participating in the adventures of empire as a means of

rejecting traditional roles." But as these novels typically

end with the hero marrying a willing heroine, "women's

discontents" are recouped by reaffiliating them with their

male counterparts" in the traditional domain of the home

(Kaplan 675). In short, Kaplan suggests that these novels

ultimately conserve the traditional roles of women while

exploiting their discontents to justify American expansion


Tracy and Boyd's use of various romance plot elements

to promote twilight sleep follows a similarly dual dynamic.

They emphatically reject a traditional female

expectation--suffering in childbirth--to promote female

equality; but in the process, these texts firmly solder

women's desires for easier and greater productivity in and

outside the home to the contemporary economic logic of

scientific management. Like the exploitation of female

discontents to legitimize American imperialism, Tracy and

Boyd's texts reproduce a decidedly economic logic in the

domain of birth as they deny the traditional sacrifices of

maternal labor per se.

The choice of romance as the generic shape for their

chronicle of recovering information about the sleep must

have seemed inevitable to Tracy and Boyd, given the promises

immanent in the twilight sleep methodology itself. As

Northrop Frye characterizes it, at the most transhistorical

level romance is the search for a transformed world, one

that recoups a lost and prior Edenic existence. More

specifically, the quest romance--of which Tracy and Boyd's

text is representative--is "the search by the libido or

desiring self for a fulfillment that will deliver it from

the anxieties of reality but will contain that reality"

(193). Twilight sleep promised the attainment of biological

motherhood while attenuating the anxiety, pain, and the

knowledge that the experience had traditionally entailed.

On a less diachronic level of genre, Tracy and Boyd

utilize some of the same elements of the historical romance

that Kaplan has identified in fin-de-siecle texts. These

romances typically involve "a chivalric rescue mission that

in turn rejuvenates the [male] liberator." Opening with the

future hero's "lament for the closed frontier of America,"

the texts emphasize his "discontent with the dwarfed

opportunities of his contemporary society." Pricked by this

lack of opportunity, he "seeks adventure on a primitive

frontier abroad" where he "saves [a] kingdom from falling to

its barbaric enemies." Significantly, this barbarism is

often localized in the mistreatment of women. The romance

concludes when the hero "modernizes and liberates the

heroine from outdated class constraints by marrying her," an

opportunity she herself seizes because, like her hero, she

too is "ahead of [her] time" (Kaplan 666, 672).

To unearth the knowledge about twilight sleep, Tracy

and Boyd travel to Germany. Their quest, like the typical

romance hero's, is motivated by a particular kind of "closed

frontier"--one imposed on female potential by maternity.


"Women have always been handicapped by childbearing," Tracy

and Boyd assert (41). Their chapter entitled "Fear and Pain:

The Psychology of Maternity" enumerates the effects wrought

by the fear of pregnancy, effects that spiral out from the

individual women suffering in confinement to cripple the

family and thus destabilize society.

In Painless Childbirth, pregnancy is represented as "a

real nine-month's brooding on a painful and perhaps

dangerous ordeal." But even before pregnancy occurs,

acquiring knowledge about the potential for suffering and

death in childbirth "poisons youth. . ." Raised to

participate in the maternal ideal via the institution of

marriage, matrimony places women in a desperate double-bind

(33-34). To achieve the maternal ideal is to live with a

concept of childbirth that is "as certain and often as

dreaded as death," its joys "as hard-won as the joys of

paradise" (38). To drive home the seriousness of their

point, Tracy and Boyd recount the stories of two expectant

women so overwrought by the prospect of labor that they take

their own lives. Many others, they note, take less desperate

measures but fabricate ways to avoid conception altogether.

Those who do survive the ordeal of birth often find

their ability to be good wives and mothers compromised: "the

subjective traumatic shock of childbirth . extends

after the first child's birth throughout married life,"

creating "aversion for husband and children" (Tracy and Boyd

34-38). Even those mothers who had not given into the

apprehension of birth and had approached it courageously

often find that "their nerve has been broken exactly as has

that of the engineer who had been in a railroad wreck"

(Tracy and Boyd 36). These debilities thus had the power to

fragment familial bonds. Given that the family was regarded

as the locus of moral education, counterbalancing the

pernicious effects of the competitive arena hypothetically

beyond it, maternal disabilities threatened to compromise

the very social fabric of the country.

Aside from the social dysfunction caused by this

lingering invalidism, childbirth, according to these

twilight sleep adherents, mentally disabled women: "the very

quality of the mind is itself sometimes affected by

childbirth," depriving women of a fuller intellectual

participation in the life of the community. After

childbearing, Tracy and Boyd assert, many women "become