Book Review: ‘Birth Control,’ by Allison Yarrow
BIRTH CONTROL: The Insidious Power of Men Over Motherhood, by Allison Yarrow
Seventeen years ago, while pregnant with twins, I was hospitalized for pre-eclampsia before undergoing a cesarean delivery days later. I remember the joy I felt upon hearing my babies’ cries; but I also recall hearing my doctor and a resident chat with each other about weekend plans as they operated on me. After delivery, I was left alone and shivering in a separate room for easily an hour, without anyone to ask when I could hold my newborn children. At the time, I was only grateful we were all healthy; the submission and alienation the process engendered always seemed beside the point.
In “Birth Control: The Insidious Power of Men Over Motherhood,” the journalist Allison Yarrow argues that women generally expect and accept too little when they deliver in hospitals; that they have been trained to forgo a sense of agency at a moment in their lives when their bodies are at their mightiest. In a book supported by ample data and suffused with anger, Yarrow says that the trade-off so many women make — giving up autonomy for the perceived security of a highly medicalized delivery — is based on false assumptions about the risks of delivering outside a hospital, and the superiority of care inside of one. She supplements her detailed research with personal accounts of her three deliveries (two in a hospital, the third at home), elaborating on the travails she faced before and after them.
Yarrow systemically makes the case that the dominant methods of childbirth in America are the clumsy evolution of earlier medical practices that were designed to protect the privilege, status and convenience of 20th-century male doctors. Labor can be a tedious waiting game, but modern medical interventions like pitocin, a synthetic oxytocin that triggers uterine contractions to help induce labor, are often followed by a cascade of further interventions that might not have been needed otherwise. And although supine deliveries, Yarrow writes, “are associated with more perineal trauma and difficulty birthing than upright positions” (such as squatting), more than 90 percent of hospital deliveries are performed on the patient’s back, a position that “allows doctors visibility, makes it easier for them to catch babies.” She also calls out examples of some common but outrageous obstetric violations — internal rummaging and surreptitious snippings performed unnecessarily and without consent — that can haunt their patients for years to come. Yarrow convincingly recasts this country’s maternal health care system as needlessly dehumanizing, prioritizing expediency and profit over the best interests of a population of women rendered vulnerable.
Toward the end of the book, Yarrow acknowledges that there are scenarios in which a hospital birth is clearly a safer choice than birthing at home (when a woman has severe pre-eclampsia, for example, or a history of preterm birth). She also allows that it’s valid for a woman to give birth in a hospital simply because she wants to.
At other times, Yarrow seems to strain to fit her reporting into the narrow, explicitly feminist rubric her subtitle promises. Objecting to the prescription often given to women suffering from pelvic floor problems, which is simply to do Kegels, she wonders: “Could it be because of their association with tight vaginas and because they were named for a man?”
And yet by that point in the book, which does justice to the tremendous disservice so many childbearing women endure in this country, a reader will at least sympathize with the author’s general suspicion that medical “intervention is widely overused — and abused.” And she describes her own experience with a vividness that counterbalances the accumulation of facts. She gives language to the powerful forces that take over her body during an unmedicated childbirth, and memorably captures the moment in which one of her three children exits her body: “The wave thrashes forward, breaks to the surface. Foam and droplets shimmer in the air.”
For all the research and historical context she includes, it might be her account of her own home delivery that makes the strongest case for an alternative model to hospital births. Many pregnant women who read her account may be moved to consider that option, and even those who don’t will be impressed by the bravery it takes just to make that decision, given the pressures to choose otherwise.
BIRTH CONTROL: The Insidious Power of Men Over Motherhood | By Allison Yarrow | 290 pp. | Seal Press | $30
