It is quite common and natural for pregnant people to feel nervous about labor and delivery. Many people worry about the health of the baby, the potential shifts in their existing relationships, and being a good parent to their child. For an increasing number of birthing people in the United States, among these worries is a deep-seated fear—the fear of dying, or becoming severely injured, during childbirth.
Rather than irrational anxiety, this fear speaks to a harrowing reality about maternal health conditions as they stand in the United States. Award-winning journalist, speaker, author, and mother Ali Yarrow leans on the power of the pen in her book Birth Control: The Insidious Power of Men Over Motherhood to attribute these conditions to a multitude of factors that paint a glaring picture: the United States’ maternal health landscape is a product of our nation’s deeply-entrenched misogyny and racism. Through extensive journalism, research, and storytelling, Yarrow unveils how the United States’ birthing structures and systems chip away at the humanity and dignity of birthing people during, but most importantly, before, pregnancy and childbirth.
The storytelling starts with a narrative from the author herself. In stylistic prose, Yarrow details her birthing experience with her third child—one of great power, doubt, and at the end, relief. Within Yarrow’s introduction is an assertion. Childbirth is supposed to be one of the most powerful moments of a birthing person’s life, and the United States’ tumultuous maternal health landscape prevents, rather than facilitates, this.
Among her powerful observations is one about the noxious messaging surrounding the conditions of birth within the United States. The issue of maternal morbidity and mortality are all too real, and yet, we’ve structured a harmful conception of normalcy surrounding hospital births: as long as many women and birthing people experience birth trauma, then birth trauma must be natural, and therefore acceptable. Yarrow’s book is a testament to the ability of storytelling to illuminate the chasm between the empowering birthing experience that all women and birthing people want for themselves, and the disheartening reality.
Aptly titled Welcome to Pregnancy, the first chapter starts at a formative period that, for many women and birthing people, comes years before the first pregnancy. Honing in on the perspectives of ten year olds Sloane, Valerie, and Olivia, Yarrow unveils the entwinement of misogyny with early teachings about the female body. When we teach young girls and menstruators about periods in the United States, we infuse our narratives with an air of taboo. At the point of a period, the female body is a pathology that requires management. This frame of understanding sounds eerily familiar for a reason. The mechanism by which misogyny weaves itself into medical interactions are at play long before women and birthing people interface with hospital systems.
Yarrow goes on to highlight the implications of this framework in the book. She identifies and tackles the pervasive narratives underpinning birth trauma: the belief that childbirth is inherently dangerous, and that hospitals are inherently safe. In other words, medical gaslighting creates a reality where women, birthing people, and their families leave hospital settings with the understanding that medical interventions were necessary for their survival. As they reflect on their birthing experiences, many fail to realize that in the case that a mother and infant are safe, the medical establishment’s production of survivors, rather than empowered, satisfied parents, is an issue.
Yarrow returns to her personal narrative to detail how these beliefs manifest in her own life and women and birthing people’s desires for their pregnancies. When coupled with widespread narratives about pregnancy, childbirth, and the scope of when and where it can occur, these beliefs form an illusory cocktail that bars pregnant people from knowing the full range of possibility. In the United States, what should be a baseline—a safe, dignified, and empowered birth—becomes a distant, idealistic fantasy for women and birthing people. And pregnancy and childbirth are merely pieces of a larger puzzle. Once families bring their infants home, they must gear up to tackle pervasive assumptions about and barriers to breastfeeding. The book stands as an in-depth exploration of the mechanisms through which this happens, unpacking faulty, yet widespread assumptions about pregnancy, childbirth, and early parenting, and the air of normalcy surrounding cesarean sections.
Interspersed within the novel are odes to models of care that our nation made the mistake of abandoning with the professionalization of birth work. Yarrow hones in on the ancestral wisdom underpinning midwifery and other forms of birth work, and the implications of the United States’ departure from what is now pushed as the saving grace of the maternal health sphere.
Ali Yarrow grounds her compelling introduction in a midwife’s observation about the empowering nature of childbirth: birth is when a woman meets herself. In the United States, pregnancy, labor and delivery instead hold up a mirror to society and divest birthing people of the ability to sense it. Through Birth Control: The Insidious Power of Men Over Motherhood, Ali Yarrow groundbreakingly gives clarity to what seems like a muddled picture, and ushers in a long-awaited awakening.
