Birth Story

Let's interrupt our Women's History Month programming to consider the news. The National Institutes of Health today begins a three-day session on vaginal birth after Caesarean, a hot topic, given that this practice, which was commonplace 15 years ago, has become scarce in the United States, at the same time that the Caesarean section accounts for nearly one-third of American births.

The VBAC has some passionate champions. While it isn't for everyone, it can work for many mothers, enabling them to avoid major surgery, and perhaps also to enjoy birth as they have always imagined it. The VBAC's decline has attended a steady rise in reliance on the Caesarean section, in part because the VBAC does carry a risk of rupture to the uterus, which can be life-threatening.

So it will be exciting to see what comes out of this conference, which aims to bring the best research available to bear on determining the safety and efficacy of the practice.

The VBAC is also one subject of an article by Denise Grady in the New York Times on Sunday, about a hospital in Tuba City, Ariz., where 32 percent of women who previously had Caesarean sections delivered vaginally, compared with a national average of less than 10 percent.

The rate of Caesarean births at the Tuba City Regional Health Care Corp., where about 500 babies are born a year, is 13.5 percent, less than half the national rate of 31.8 percent. The hospital is run by the Navajo Nation and is partially funded by the Indian Health Service, and it largely serves a Native American population.

What I love about Grady's account is how well this small, poor hospital appears to be doing in addressing one of the major tensions in the modern birth story -- how to keep the blissful experience of childbirth from being swamped by the technology that has been developed to keep it safe.

Women's History Month reminds us that women have had to fight not only for the right to vote, but also to own property, control our fertility, get an education, work outside the home, keep custody of our children, have violence toward us taken seriously, and even to say what's on our minds.

Susie Essman as Susie Greene

For me, this month presents an opportunity to take a closer look at some of the advances women have made, and at some of the women who were involved in our progress in one way or another.

Most of the women I am writing about are famous for something having to do with the birth experience, but their stories also relate to the development of a woman's voice -- that is, getting to the point where expressing ourselves and asking for what we need is a normal event.

On the road from Anne Hutchinson to the belligerent Susie Greene from HBO's "Curb Your Enthusiasm," many women risked a great deal to make some part of the world safe for outspoken women.

Having a baby with a birth defect could get you killed in colonial America, and attending such a birth as a midwife was also perilous.

Anne Hutchinson, the subject of the previous post, was already in serious trouble in Puritan Boston for her unorthodox ideas when she was summoned along with another midwife, Jane Hawkins, to the childbed of her friend, Mary Dyer, who had remained loyal to Anne. On that day in October of 1637, Mary bore a deformed, stillborn baby girl.

Statue of Mary Dyer in Philadelphia

The birth of a "monster," as such a child was called in colonial America, was seen as a sign of God's disfavor, at the very least. The charge that the mother and her attendants had been consorting with the devil was always possible, and the penalty for witchcraft could be death.

Anne asked her old minister for help -- John Cotton, who had sided with the religious authorities against her. Summoning some of his old friendship for her, he advised the secret burial of the dead infant.

However, in March of 1638, when Anne was excommunicated and sent from the congregation, Mary got up and followed her. Someone at the emotional scene, perhaps a fourth woman who had been present at the birth, cried out that Mary had borne a monster. Governor John Winthrop's interest was piqued.

Winthrop interrogated Cotton, who confessed his role in covering up the birth. Winthrop had the child exhumed.

In his journal, the governor reported that the dead infant had, among other features, "four horns, hard and sharp," two mouths, and three claws per foot where her toes should have been.

The birth was, Winthrop declared, evidence of  "the Lord declaring his detestation of their monstrous errors." By this time, however, Anne and her followers, including the Dyers, were safe in Rhode Island.

In 1660, long after Anne's death, Mary Dyer was hanged on Boston Common for the crime of having become a Quaker. She had come back from Rhode Island knowing she would likely be executed, to strike a blow for religious freedom.

Anne Hutchinson, an early Boston, Mass., midwife, was a brilliant and original thinker and an ardent defender of the right of the individual to make up her own mind.

Anne Hutchinson depicted at her trial

Hutchinson and her family followed their minister, John Cotton, from Boston, England, in 1634. She was a prominent member of her Puritan community in the Massachusetts Bay Colony and a highly regarded midwife, who reportedly attended women in birth free of charge.

Religion was a major focus of her life, but Hutchinson claimed the right to forge her own relationship with God. She soon ran afoul of the Bay Colony's authoritarian leaders, and was charged with heresy.

Hutchinson's major claim to fame lies in the brilliance with which she defended herself in civil and ecclesiastical trials. At the time of her civil trial, presided over by Governor John Winthrop, she was 46 years old, the mother of 14, and pregnant. During the trial, the governor called her an "American Jezebel."

In 1638, Hutchinson was found guilty and sentenced to banishment to Rhode Island just four years after her arrival in the New World.

The leaders of the Massachusetts Bay Colony were so shaken by the quality of both her theological and legal arguments that they determined to educate their religious and civil leaders to withstand future assaults on their authority. That determination became part of the mission of Harvard College, which had been founded in 1636.

After Anne's husband, William Hutchinson, died in 1642, she left Portsmouth, taking her youngest children to the area now known as the Bronx, N.Y., then held by the Dutch. The Hutchinsons unwittingly walked into a bloody altercation between the Dutch and Native Americans that became known as Kieft's War. In 1643 Hutchinson and several of her children were murdered by Indians.

When word of Hutchinson's death reached Boston, the church bells reportedly pealed for a full 24 hours with joy that God had finally taken retribution on this troublesome woman.

Illustration by Edwin Austin Abbey