The entire history of what can only be called bad blood between women and the medical establishment has yet to be written, but a couple of wonderfully engaging new books offer fascinating perspectives on it. Jessica Mitford’s B_The American Way of Birth_b (322 pages. Dutton. $23) looks at one of the foremost feminist battlegrounds, while Germaine Greer’s B_The Change: Women, Aging and the Menopause_b (422 pages. Knopf $24) sets the stage for a battle that has yet to take place.
Mitford’s book has been titled to evoke her great 1963 expose “The American Way of Death,” a muckraking classic that provoked the fury of funeral directors and ultimately spurred reforms in the industry. But the implied similarity is misleading: the new book isn’t an expose at all; it’s a highly personable tour through the medical mismanagement of childbirth. Mitford describes poor communities where few doctors accept welfare patients, prenatal care is almost nonexistent and poor women in the early stages of labor have to learn from morning radio announcements which local emergency room will accept them that day. Women with access to better medical care may find more technology, but there is no reliable data indicating whether or not the elaborate machinery actually benefits most mothers and babies. Mitford views the increase in trained midwives as the best news in years for pregnant women.
None of this is new; many researchers got there before Mitford (and she acknowledges their work). But it remains a story worth telling, especially from Mitford’s bracing perspective. “One theme that reverberates throughout the literature of midwives is bonding, a subject that fills me with uneasiness,” she writes. Herself the mother of four, she can readily imagine women who just don’t want a bloody, slimy newborn on their breast the moment after they deliver. “It seems obvious that those first allegedly precious moments have very little to do with the eventual relationship of mother and child,” she concludes. “True compatibility may take a lifetime, as in the development of any lasting friendship.” Nobody could ask for a more astute guide to modern mores in the delivery room.
“The Change,” by contrast, is a journey over territory that is practically uncharted. Gail Sheehy’s best-selling “The Silent Passage” touches on some of the main issues, but next to Greer’s vigorous polemic, Sheehy’s little book seems timid. (There are few resemblances, but both authors end by finding serenity and courage in nature, on hikes or on mountaintops. Bad news for menopausal women who hate camping.)
Greer, the Australian-born feminist who made her name with “The Female Eunuch” (1970), offers a wide-ranging, often biting survey of aging women in life, literature and medical history. Doctors have puzzled over menopause for centuries, she emphasizes; they still know almost nothing about it, yet they continue to advise, prescribe and operate as if they knew what they were doing. According to Greer, scientists still haven’t disentangled the symptoms of menopause from the symptoms of aging; they don’t know why some women suffer a range of discomforts and many others do not; they don’t even know how estrogen-replacement therapy works to make menopausal women feel better. “The obstacle to understanding here is the defect that disfigures all gynecological investigation: we do not know enough about the well woman to understand what has gone wrong with the sick one,” she writes. “Gynecologists are like motor mechanics who have never worked on a car that actually went.”
Greer isn’t totally opposed to estrogen-replacement therapy, but she prefers the alternatives. Tend a garden, she suggests. Give up alcohol, meat and coffee. Consider aging the old-fashioned way, by turning into a witch. (“Why not walk in the aura of magic … Why not befriend a toad today?”) OK, she’s a better historian than medical adviser. But even readers who stick with conventional therapy will find this book the best possible restorative.
