Midwives

“Mrs. Charbonneau’s baby was nine pounds, two ounces, but my mom was able to massage the vagina and stretch the muscles so the perineum didn’t tear. Most women who have babies that are around nine pounds have to have episiotomies—that’s where you cut the perineum from a lady’s vagina to her anus—but not Mrs. Charbonneau. Her vulva’s fine […] My mom says the placenta was big, too, and it’s buried right now by this maple tree Mr. Charbonneau planted in their front yard. My dad says he hopes their dog doesn’t dig it up, but he might. The dog, that is.’”

An example of the text’s use of humor, these lines also highlight Connie’s liberal upbringing. For Connie, women’s reproductive parts and labor are not taboo topics, but elements of an exciting story to tell. She calmly uses words like “vulva” and “perineum,” much to the shock of the adults around her. The detail about the dog digging up the placenta adds to the comedy of the sequence, highlighting that, for all her knowledge, Connie remains a child, blurting out details that most adults would withhold.

“I could begin my mother’s story with Charlotte Fugett Bedford’s death, but that would mean I’d chosen to open her life with what was for her the beginning of the end. It would suggest that all that mattered in her life was the crucible that made my family a part of one tragic little footnote to history.

So I won’t.

Besides, I view this as my story, too, and why I believe babies became my calling as well.”

As these lines show, Connie often draws attention to the constructed nature of narrative, implying that even a so-called “true” story is formed by its teller and their choices. It is Connie’s choice to begin this book not with Charlotte’s death but with a description of her childhood and her mother, Sibyl. The story Connie is recounting is not just a courtroom drama or a family tragedy, but the complex tale of her love for her mother and their shared love of obstetrics.

“There was a certain humor to her anti-ob-gyn bias that never came out at the trial. In one photo of her taken in 1969, she’s leaning against the back of a VW Beetle, and there by her knees are two bumper stickers: QUESTION AUTHORITY! and ONLY DUCKS SHOULD BE QUACKS. The same misgivings that she had for what she perceived to be the entrenched power of professors and college presidents, she had for physicians and hospital administrators as well.”

Connie uses vignettes from Sibyl’s past to create a vivid portrait of her mother and her politics. Sibyl’s mistrust of doctors is inextricably linked with her mistrust of institutions and authority. The joke about only ducks being legitimate quacks (for the sound the birds make) equates doctors with fraud but is ironic in retrospect, as Sibyl herself is accused of incompetence and unprofessionalism.

“ ‘She needs a mother, dammit!’ my father would snap, or ‘You’re never here for her!’ […] Against all experience, he continued to believe he could use me as a trump card to convince my mother to stay home. It never worked, which usually compelled him to change his tactics from guilt to threats:

‘I didn’t marry you to live in this house all alone!’

‘A marriage demands two people’s attention, Sibyl.’

‘I will have a wife in this world, Sibyl. That’s a fact.’”

Rand’s argument with Sibyl provides a glimpse into the gender politics of his time. Although Rand is a progressive father and husband, he is still irked by Sibyl’s focus on her career and uses every trick in his book to stop her from keeping late hours. The tragic irony here is that, though Sibyl has an unshakeable resolve to follow her calling, circumstances will force her to quit midwifery.

“I know my parents never stopped loving each other—passionately, madly, chaotically—and one or the other of them was always there for me.”

Though Sibyl and Rand have a passionate and tumultuous relationship that can sometimes exclude Connie, she notes that her parents have always stood by her. Connie’s love for her parents colors the account she is presenting, with both Sibyl and Rand emerging as flawed but sympathetic characters.

“She fell four times, she said, before she crawled on her hands and knees to her automobile, and then pulled herself to her feet by holding on to the front door’s metal handle. Yet she still planned on driving Charlotte to the hospital, and began by attempting to bring the car right up to the front steps of the house—yard and bluestone be damned—so Charlotte wouldn’t have to walk along the ice rink that had overtaken the Bedford property. As she pressed her foot down slowly upon the accelerator, the car’s tires spun in place like immobile carnival wheels, before abruptly pushing the automobile forward and then twisting it almost three hundred and sixty degrees. It slid into the remains of an ice-covered snowbank […] And although my mother’s car wasn’t damaged, she knew it would be impossible to drive to the hospital.”

Author Chris Bohjalian uses precise vocabulary and a suspenseful, tense tone to depict the sequence where everything goes wrong during Charlotte’s labor. The detailed, step-by-step telling emphasizes that the eventual tragedy is the result of many little things going wrong, such as Asa paving his yard with slippery bluestone unsuited for Vermont winters and Sibyl’s car skidding into a snowbank. This implies that while it is easy to pin blame on a single person or event, the truth is frequently multifaceted.

“‘Nother second, ‘nother second, ‘nother second!’

‘My, oh my, you’re great, Charlotte, the best, the best!’

‘You can do this, you’re doin’ great, doin’ great, doin’ great. Doing great!’

[…] I saw my mother deliver enough babies to know she was an inspiring coach and a mesmerizingly energetic cheerleader. And I also saw the way a majority of fathers would allow my mother to provide most of the verbal confidence. My mother was just so good at it. But who said what between two A.M. and six A.M. would matter greatly to the State, and they insisted—and my mother and her attorney never denied—that Asa and Anne said most of the ‘You’re doing fines,’ while my mother said most of the ‘Little mores’ and ‘Nother seconds.’”

This passage shows how the legal system manipulates semantics and logistical details to construct a particular narrative, developing the theme of The Legal System’s Power to Define the Truth. Sibyl’s usual encouragement of “nother second” turns sinister in the context of Charlotte’s death. Tanner now insinuates that Sibyl forced Charlotte to keep pushing, despite her obvious discomfort.

“Stephen was my father’s age the summer and fall he defended my mother, and two years older than Sibyl. The men around me that year were thirty-six, the woman who was my world was thirty-four.”

Connie refers to Sibyl as “the woman who was my world,” illustrating her deep love for her mother and her childlike reliance on her mother for a sense of well-being and safety. Connie’s mature façade hides the fact that she is just a few years into her teens and rattled by the threat to her mother.

“I want to write ‘little girl.’ But she hasn’t been a little girl in years. I probably shouldn’t even think of her as a girl anymore. The person in a nightgown and slipper socks is a young woman […] the way she’s handling the bigger things right now is amazing to me. That’s when she seems like this little grown-up person. […] She was this little diplomat [with Stephen], making sure he had whatever he needed, asking him these really good questions, and telling him these really funny stories.”

This excerpt from Sibyl’s journal demonstrates her great pride in her daughter and the reality of Connie’s maturation, but it is also in contrast to Connie’s first-person glimpse into her teenage self. While Sibyl emphasizes Connie’s effortless “diplomacy” and clinically sharp intelligence, Connie’s account reflects her heightened state of fear at the time. For Connie, her actions are born of desperation; she wants to win Stephen’s favor so that he fights for their family.

“You can’t spend your entire life avoiding chance. It’s out there, it’s inescapable, it’s a part of the soul of the world […] There’s nothing that drives me crazier than when people say home birth is chancy or irresponsible or risky. My God, so what if it is? Which, in my opinion, of course, it isn’t. What’s the price of attempting to eliminate chance, or trying to better the odds? A sterile little world with bright hospital lights? A world where forceps replace fingers? Where women get IVs and epidurals instead of herbs? Sure, we can cut down the risk, but we also cut off a lot of touching and loving and just plain human connection. No one said living isn’t a pretty chancy business, Sibyl. No one gets out of here alive.”

As Cheryl Visco’s monologue shows, the debate between midwives and doctors is highly polarized, each side dismissing the other. For Cheryl, a home birth is as natural as life itself and also as prone to chance: Rejecting a home birth out of fear means rejecting every positive experience for fear of things going wrong. The novel ultimately seeks reconciliation in The Debate Between Alternative and Institutionalized Medicine by characterizing Connie’s practice as simultaneously expert and human.

“HASTINGS: Did you love her?

BEDFORD: Of course.

HASTINGS: Were you sad?

BEDFORD: Good Lord, yes!

HASTINGS: Were you very sad?

BEDFORD: Yes

HASTINGS: And was it in that frame of mind that you think you saw blood spurt?

BEDFORD: Yes, but I was not hysterical. I’m telling you, I know what I saw.”

Connie includes inserts from her mother’s trial in her story, often presented in a courtroom dialogue format. The dialogue adds immediacy to the narrative and also illustrates the theme of the legal system’s power to define the truth. In this case, Stephen’s cross-examination of Asa implies that he cannot be considered a reliable witness to Charlotte’s operation since he would have been too numb with shock and grief.

“‘When girls are little, their dolls are likely to be babies, not Barbies.’

So said Stephen Hastings. Stephen, of course, had no children. But this didn’t stop him from having strong opinions about how children thought and what they believed. After all, he said one night when my father challenged him, he had been one himself.”

Connie’s depiction of Stephen veers between affection and cynicism. Here, she shows the slick, competitive attorney pretending to be an authority on a subject with which he is not familiar. Stephen is not a parent, yet he claims one can predict the course of a girl’s life through her choice between babies and Barbies.

“[A]s I’ve said to all those midwives […] my choice of profession was neither an indictment of my mother’s profession nor a slap at her persecutors. Clearly her cross was a factor in my decision—all my C-sections have been upon inarguably living women, each one properly anesthetized and prepared for the procedure—but as a friend of mine who’s a psychiatrist says, motives don’t matter: Most of the time we don’t even know what our motives are.”

The unknowability of the whole truth is an important subject in Midwives, as reflected in Connie’s exploration of the reason she became an obstetrician. Though her mother’s “cross” and Connie’s own desire to create a birthing experience that bridges home and clinical labor play a part in her choice of career, Connie knows trying to determine the precise reasons is futile.

“Birth is a big miracle foreshadowed by lots of little ones. Conception.

Little limbs. Lanugo. A fingerprint, hard bones. The quickening. The turning. The descent.”

Sibyl’s journal excerpt illustrates that for her, conception and labor are not just scientific phenomena but also miraculous occurrences. Rather than medical language, she uses evocative historical terms, such as the quickening—the first sensation of a fetus’s movements—to convey her impression of the magic of birth.

“He was, I can write without reservation or qualification, an exceptional cancer coach: part nurse, part dietitian, part partner and soul mate. Part Knute Rockne.”

Connie’s description of Rand as Sibyl’s caretaker is tinged with humor and affection. It also illustrates the narrative’s use of relevant cultural references. Knute Rockne was an American football player and coach who was called American football’s most respected coach in 1951. Such references ground the narrative in a particular era, contributing to its verisimilitude and contextualizing the central debate about midwifery.

“‘Set Sibyl free, let babies be!’ was the first chant we heard from the group, and we heard it the moment we emerged from our car. Of all the chants we’d hear over the next few weeks (and we’d hear many), that one was my least favorite […] Unfortunately, to this day it’s the one I hear most often in my head. The others—either doggerel that linked hospitals with laboratories, or ditties that elevated home birth to a religious rite—come back to me when I think hard about those weeks, but they don’t pop into my head today like bad songs while I’m seeing patients or brewing coffee.”

These lines illustrate the complex way in which traumatic memory works: For Connie, who began drinking coffee the summer of the trial, the scent of brewing coffee can evoke a hated slogan from outside the courtroom, demonstrating the trial’s lasting impact on her life. Connie disliked the slogan when she was a child because, in asking for Sibyl’s freedom, it suggested Sibyl was already imprisoned.

“The fly fisherman looked at specific jurors as he spoke, as if he were eulogizing a river they’d once fished together that was now dry or polluted beyond use. For emphasis, he would occasionally pause and look out the window at the storm clouds, but he always seemed to turn back toward the jury when he had a particularly dramatic point he wanted to make.”

Darkly comic, these lines show how the proceedings in the courthouse often resemble theater. Tanner uses the raging storm outside as a dramatic backdrop for his opening statement, while the extended metaphor around the fly fisherman and the river shows how Tanner tries to forge a connection with the jury, trying to convince them that they are all cleaning up a social menace together.

“‘It’s not an aphrodisiac, I promise. I don’t think male ob-gyns go home hot and bothered, do you?…Well, you’re a pervert…Then maybe you’re all perverts! But I don’t really think so. Fortunately, the kind of men who become midwives or ob-gyns don’t have your uniquely weird one-track mind,’ she said, and for a brief moment her voice had the sparkle that once brightened most of her conversations.”

The sub-plot of the flirtation between Stephen and Sibyl shows how Sibyl draws comfort from her lawyer. In joking with him, Sibyl forgets her troubles briefly, as shown in the phone conversation where Stephen implies male ob-gyns like their work for its “perks.” Sibyl’s rebuttal underscores her nuanced approach to pregnancy and childbirth; as much as she believes in the value of midwifery, she does not write off ob-gyns—even male ones. Because the conversation is presented from the perspective of an eavesdropping Connie, it also represents her isolation from the adult world and her perceptiveness regarding it.

“It was during Anne’s testimony that the jury began growing uncomfortable, and began to steal glances at my mother. Although Anne did not begin speaking until the afternoon of the fifth day, the trial’s first Friday, and although the panel knew well the outline of what had occurred in the Bedfords’ bedroom, they had not yet heard an account from an eyewitness. And as Anne answered question after question Bill Tanner asked, I think Charlotte Bedford grew real for the first time in some of the jurors’ minds.

In all likelihood, that was Tanner’s plan.”

Tanner’s strategy in presenting eyewitnesses is meant to create a particular impact on jurors. Having heard the evidence suggesting that Charlotte’s death was unnatural, the jury has been primed to make a connection between the “victim” and the young woman, wife, and mother, which Ann’s eyewitness account provides.

“Stephen shrugged. ‘Did the woman cry out with pain?’

‘No, she was unconscious.’

‘Did the body…shudder?’

‘I didn’t see that.’

‘You didn’t see it shudder?’

‘No.’

‘It didn’t move at all, did it?’”

In light of Sibyl’s concluding journal entry, Stephen’s questioning of Anne takes on a different hue. He presses on the point about the shudder knowing that Sibyl did in fact see Charlotte flinch. Stephen may already be preparing a defense in case the journals come to light, but the gap between his line of questioning and the reality underscores the deceptive nature of the courtroom proceedings.

“But then her new clients started coming to term, and she had to start catching babies again. She discovered during her first delivery that the almost bewitching pleasure that birth had once held for her had been replaced by fear.”

Sibyl’s inability to continue practicing midwifery highlights the toll that Charlotte’s death and her own trial took on her: A job that was once joyful becomes traumatic. The use of the word “bewitching” is a subtle allusion to the connection the novel has established between midwifery and accusations of witchcraft, here reframed in positive terms. Even Connie, an ob-gyn, suggests that there is something magical about childbirth, even if Sibyl could no longer experience it.

“‘Do you know where I put the notebooks?’ my mother asked me as the toxins dripped into her arm.

‘The attic, right?’

‘Right. They’re yours if you want them. When the time comes. […] Do with them as you will.’”

The exchange between Sibyl and Connie hints that Sibyl wants Connie to present the whole truth—to the extent that the truth can be known—at the right time. Sibyl leaves her journals to Connie with the explicit instruction, “Do with them as you will.” While this seemingly leaves the choice to Connie, the implication is that Sibyl wants the truth to come to light as a form of atonement. That this takes place against the backdrop of her cancer treatment adds pathos to the situation. Despite the outcome of her mother’s midwifery practice, Connie does not shy away from highlighting the limitations of institutionalized medicine, describing her mother’s chemotherapy as “toxins.”

“Asa decided against a civil suit almost immediately because—as he was quoted as saying in one article—he was ‘not interested in knowing the monetary value of my Charlotte’s life.’ Besides, Asa was a good man and he was a minister: He knew as well as anyone to whom revenge really belongs.”

Connie’s observation of Asa illustrates the real meaning of justice. For Asa, monetary compensation is not justice, as it will not bring back his wife. Nor is justice revenge: “To whom revenge really belongs” is a reference to a hymn by 17th-century cleric Isaac Watts, its first line being, “O God, to whom revenge belongs.” The implication is that revenge is an empty pursuit, as true justice cannot come from human action.