Review Essay: Bearing the Meaning of Birth
The meaning begins with the coauthorship of this review by an academic (Davis-Floyd)-one who, by profession, lives in the abstract world of ideas, and by a midwife (Luce) who lives in the embodied world of birth-a world of flesh and blood and fluids and rich smells and animal sounds and primal energy, a world as ordinary and universal as the world of academia can be rarefied and particular. What unites us to each other is our lived critique, in words and in practice, of the medicalization of birth and women's bodies-a critique that led us both, consciously and reflectively, to eschew the technological management of the birth process and give birth to our children at home, away from the technomedical gaze. Through this choice we also find ourselves connected to Robbie Pfeufer Kahn's brilliant and insightful work, Bearing Meaning: The Language of Birth, for this is a book that speaks both of our languages-the language of the body and of the mind. Its author shares our embodied experiences of pregnancy, birth, and breastfeeding and our deep desire to find a language through which we can both describe and honor those experiences.
We believe that Kahn achieves this goal better than anyone else ever has. A sociologist and a mother, she unites her academic training with her motherhood to give voice and coherence to women's reproductive embodiment and to situate birth and the maternal in their proper place in society and in the domains of knowledge. As she writes so eloquently, what unites women is our "common purpose to enable knowledge to arise from bodily processes and from touch that is mediated by consciousness" (p. 5). This work is the fruit of a lifetime of lived experience, deep reflection, and political activism; it represents an integration of knowledge across a range of disciplines refracted through the lens of the bodily experience of giving birth, of breastfeeding, and the mutually recognized bond between mother and child-a "shared subjectivity" grounded in the body, which Kahn codes as "the maialogical bond."
In the Introduction, Kahn employs language that is tightly woven and pregnant with original insights and juicy metaphors to set out her intentions: to write about her experience of giving birth to her son Levin and what she learned from it, to enter this story into recorded history, and to honor the maternal body and all it encompasses as worthy of scholarly research and inclusion in academic discourse. The intensely personal narrative of Levin's birth and growth runs like a continuous thread through the text from Chapter 1 to the Epilogue, grounding her theories in the body of this motherson relationship. A microcosm of the larger tapestry, the Introduction contains all the strands that Kahn artfully weaves through the body of the book: an analysis of attitudes toward birth found in texts from the Western tradition, from Homer forward; a description of the influence of these texts and the ideologies they contain on birth practices and our sense of the maternal body; and the counter stories, personal and textual, to the dominant ones that inform medicalized birth in our culture.
Kahn utilizes embodied experience as a tool for challenging and deconstructing the worlds of meaning contained in traditional Western texts and institutionalized in medical practice and social policy. She stakes out her own ground in relationship to feminist theory and the feminist movement, finding in the perspective of women of color a place for nature, culture, and spirituality, areas central to her own theorizing because so present in her experience of birth. She also offers a thought-provoking defense of her use of the personal narrative. In laying claim to her own voice, Kahn affirms the validity and legitimacy of the personal and experiential in the arena of academic research, and invites others to see their own experiences as worthy of deep reflection and inclusion in discourse about creating and finding meaning. She writes passionately about the significance and power of language and of the "language of birth," the subject of this 441-page work. Identifying the tools of her analysis, she critiques and expands the field of sociology as she argues for inclusion of the "point of reproduction," birth itself, as central to understanding the whole social order.
The titles of the five sections of this book speak of fashioning and refashioning a textual matrix for the binding, and then the unbinding, of the maternal body-apt metaphors for Kahn's work of freeing the maternal body from the patriarchal text of Western literary and intellectual tradition and its expression in current obstetrical practice. Unbinding the maternal body means honoring the voice of childbearing and motherhood and the lessons they teach, and drawing upon those lessons in shaping society. It also means freeing women from imprisonment in the private domain not only during pregnancy but also as we breastfeed our children, teaching and learning the "lessons of the milk" with which Kahn concludes her work, lessons that she insists have deep social and political implications.
Kahn's interweaving of the personal and the analytical is captured nicely in her discussion of bonding in Chapter 1, in which she tests the feminist critique of bonding (that it is an "ideology" aimed at convincing women that their children need them in particular) against her own experience of bonding intensely with her son Levin shortly after birth, then losing that intensity of feeling during their subsequent all-night separation, and having to struggle to regain it by degrees. This acid test of theory leads her to warn against "calling ideologies what might be truths" (p. 41). Her book is a testament to the value of testing every concept against that standard of embodied experience, of running every idea through the stream of life as we live it. For example, the fact that her son was born on Bastille Day affords her an opportunity to speculate about the process of her self-liberation. In her subsequent sexual abuse by an ob/gyn drawn to her because of the special quality of her birth experience (which she aptly terms "a misfortune of goodness"), she identifies "the mark of patriarchy-the urge to violate the intact maternal body and canalize desire toward the male" (p. 37). In this manner, throughout the book she illuminates her own experience in the light of literature, sociology, history, anthropology, economics, and philosophy-and in turns both critiques and sheds new light on all of these-through a two-way mirror that enables the reader to see beyond herself in each direction without ever having to become invisible. In this liberating process, our understanding-our personal hermeneutics-becomes deeper and our vision of the world is broadened; such was the experience of these reviewers.
Transitioning from an account of Levin's birth and her early experience of motherhood, Kahn confronts the coercive power of language as she critically examines the way the female body is written about in some of the classical texts, in Marxist writings, and in women's self-help literature, with an eye to theoretical foundations for thinking about the maternal body-those that are damaging and those that might suggest more empowering waves of holding the maternal experience. Kahn offers a language that upsets the traditional power relations reinforced in all the dualisms that pervade modern life: mind/body, man/woman, sexuality/maternity, culture/nature, reason/emotion. Noting the damaging consequences of dualistic thinking that privileges one side of the duality, Kahn shows how pervasive is the devaluation and denigration of women's bodies and bodily processes. In this framework she begins to develop her theory of the three natures she sees in Western culture-the physical, the social, and the spiritual. Integrated, these provide a unified sociology. She notes that more than the cultural mis-representations of birth, the social institution of medicine is what shapes, limits, misshapes, controls, and confers meaning on women in birth.
In "The Body of Birth Reconsidered" (Chapter 3), Kahn puts forth some of her most controversial and original ideas concerning the language that arises from the body, the consciousness that accompanies birth, and the social nature of both. She privileges the body as a way of knowing, not just as the passive recipient of knowledge, and nowhere does she do this more powerfully than when arguing for a "culture of the just born" mother and child. She coins the term "maialogical" to describe the perspective that arises from this culture, and uses this perspective, which integrates the physical with the social and the spiritual, to understand culture and society.
In Part II, "The Maternal Body Bound," Kahn deals in depth with the subjugation of women in the oral and written literature of the Western tradition. From Genesis to Williams Obstetrics, from the mythological story of the Sumerian goddess Innana to the intensely feminist Our Bodies, Ourselves, Kahn traces the patriarchal cooption of the language of birth and women's reclaiming of that language, intertwining literary allusion and metaphor as she goes. She combs the literature for anything and everything that supports, challenges, ignores, celebrates, and explains women's embodied experiences of the childbearing cycle-pregnancy, birth, lactation, motherhood. Kahn makes the works of others who have written on these subjects, from Homer to Mary O'Brien, live through the passionate vitality of her own work. In Chapter 8, "Unsavory Saviours," Kahn describes how she was caught in the web of obstetrical power of which her obstetrician's sexual advances were part and parcel.
The text is marked by the events of her life and this is particularly true in the break that separates the analysis of Williams Obstetrics, the century-old pre-eminent obstetrical textbook, from that of Our Bodies, Ourselves, a feminist self-help book published in numerous editions since 1971 by the members of the Boston Women's Health Collective. Here in Part III, "Refashioning a Textual Matrix," the story line is interrupted as Kahn experiences conflicts between her roles as dutiful daughter and nurturing mother and the concentration and demands imposed by writing and serious scholarship; and as she is challenged as a thinker by feminist scholars. She bridges these gaps with a defense of the continuities she sees between human life and nature, articulating a "reflected upon" idea of natural that stands as "a counter-hegemonic notion opposing the medical model of birth," without letting go of the ideas central to her whole thesis: birth, however culturally treated, is embedded in nature, and the body teaches.
Before offering a detailed analysis of the consecutive versions of Our Bodies, Ourselves and the shifts in social and political consciousness they represent-the very heart of "The Maternal Body Unbound" (Part IV)-Kahn identifies the social movements and feminist expressions in Europe and the United States out of which the women's health movement and its text, Our Bodies, Ourselves, grew. Kahn reveals this book to be the primary cultural site of the unbinding of the maternal body, showing that the book is a reflection of the process through which it was created: the collective authors structured their work environment and their writing in a way that held and affirmed the cultural and individual worth of women and their bodies. With an amazing eye for nuance, Kahn observes how the unbinding progresses with each subsequent edition, particularly in the childbirth chapters, countering this woman-centered text against the intensely patriarchal and patronizing text of Williams Obstetrics. In her analysis, she demonstrates how difficult it is for even the most consciously aware to free themselves from the constraints of obstetrical ideology.
Easier for Kahn than birth was the unbounded sense of her body she achieved while breastfeeding and entering the world as mother, activist, and worker, bridging the gap between the private and public spheres with her maternal body. In "Lessons of the Milk," Kahn takes us beyond the reclamation of the moment of birth to celebrate the body-in-relation during lactation and the social significance of the knowing embodied in that relationship. Women have denied their bodies too long as a price for being in the world, she argues, as she convincingly articulates the agenda for the political and social reform that would follow if feminists would take up breastfeeding as an issue. Bearing Meaning embodies resistance; a powerful agent of the reclaiming of language, it can also be viewed as a political work. Kahn demonstrates how the politics of childbirth have significantly brought the body into the public domain, a process she continues in her writing.
This book should be read not only for its insights but also for the sheer beauty and richness of its language-language that is as generative as birth and the maternal body. Her writing is textured, braided, looped like the hair of so many women whose spirits and bodies resonate in its pages. Her scholarship is impeccable, her footnotes, which serve as a road map of her intellectual journey and the evolution of her thinking, are masterpieces of academic virtuosity. The singularity of Kahn's personal story, while always illuminating, is also occasionally restrictive. Beyond the class, racial, and ethnic limitations that are obvious and acknowledged by Kahn, her extensive use of personal narrative particularizes her own perspective to the exclusion of the perspectives of the many women whose powerful narratives, had she included them, would lay deeper foundations for her theories. The abstracting use of language-"the maternal," even as literary device-risks the temptation of all philosophy and theorizing to disembody even the most organic of experiences. Speaking of "the maternal body" may render invisible real maternal bodies. The corollary temptation is toward idealization-of "the maternal," "the maialogical bond"-which again takes us away from the visceral reality of the experiences these terms try to encode. To elevate birth and mothering to the level of academic discourse can include silencing the mothers who give birth. Kahn seems to be aware of this danger: in the Epilogue, she recounts how Levin ultimately frees himself from his construction in her narrative. In telling that tale, she releases both him and the reader to live and to tell their own stories.
A passage from Nancy Mairs, herself a ground-breaking feminist writer, branded itself on our conjoint memories: She wrote of the birth of her son, replete with technological interventions and the violence the physicians inflicted on them both, "tearing us apart at precisely the moment when he should have lain across me while we smelled and stroked and stared at each other . . . . I'll never forgive them for depriving us of that bond." She enumerates the tragedies of her life, and then declares, "Nothing wounds me like this botched pregnancy and childbirth . . . . It arouses an impermissible grief, one that has-unlike madness, illness, death-no social form to contain it." Kahn's book creates such a social form-a context and a language for understanding such violation and its meanings to the woman and to the culture she inhabits. Liberatory for women and for society, this marvelous book helps us rethink the significance of birth and the social institutions that shape it. Kahn links birth, lactation, and motherhood to the possibility for a more just and equitable social world, in harmony with the world of nature, and founded on the embodied experiences of "interconnectedness" and "mutual recognition" that constitute the maialogical bond. Such linkages-and the academic mastery behind them-give Bearing Meaning wide appeal, from general readership to teachers and students in the humanities and social sciences to perinatal health care providers. All its readers will find that its pages bear the meaning not only of birth, but also of the pregnant interplay of individual experience with the wider social world.
Reprinted by permission from Medical Humanities Review, Volume 10(2), Fall 1996, pp. 113-118.
Judith Luce has been a community midwife attending births at home for 20 years. She is presently pursuing a graduate degree in Cultural Studies at Vermont College. Robbie E. Davis-Floyd, Ph.D., is an anthropologist who has specialized in the analysis of obstetrical procedures as cultural rituals. Address correspondence to Robbie E. Davis-Floyd, Ph.D., 1301 Capital of Texas Hwy. B128, Austin, TX 78746.