Robbie Pfeufer Kahn's book Bearing Meaning: The Language of Birth is an important step toward constructing a narrative that will 'place birth in the circle of significant action'. Drawing on the main canonical texts of the Western tradition, beginning with Homerian myths, as well as contemporary texts of modern medicine, she examines the relationship between these traditions and current birth practices in the USA. She traces what she terms 'a trajectory of patriarchal thinking' as it manifests itself in writings and practices related to pregnancy, childbirth and lactation.
Drawing on social theory, psychoanalysis, feminist thought, ecological and spiritual traditions, she defines three aspects of nature, the biological, social and spiritual. In referring to physical or 'natural' processes, she further distinguishes between inner nature and outer nature. Inner nature refers to 'the inseparability of body and mind' while outer nature refers to 'humans' embeddedness in the ecosphere and our connection to other life-forms'. She also creates the word 'maialogical' to represent a 'theoretical standpoint upon the mother-child dyad', the root word of which 'derives from the same process it describes, a process of linguistic interaction built upon the maternal body'. This term represents Kahn's attempt to describe reproduction 'as an activity between the subjectivities of mother and child, grounded in the body'.
Kahn traces an interesting and informative history of Williams' Obstetrics - the 'bible' of Western obstetrical practice - and Our Bodies, Ourselves by the Boston Women's Collective. These comparative histories, while providing an interesting account of changing attitudes and perceptions toward childbirth within North American medicine and the broader culture, also demonstrate the links between modern practices and the patriarchial cornerstone texts of Western literature.
In addition, Kahn weaves these narratives with her own story and experiences 'as a mother, former childbirth activist, and now scholar in women's studies, sociology, and the humanities'. In so doing, she attempts to develop a new language of birth 'by making the intact maternal body visible in words on paper and describing the knowledge derived from it'.
There are dangers in such an undertaking, and the main one is, as Kahn acknowledges, a tendency toward biology essentialism and dualism that permeates much of Western literature and thought. Kahn struggles against the conflation of a narrative of motherhood that is synonymous with 'coercive motherhood, ideologies ... which exalt women to keep them in their place'.
Nevertheless, there are times when I found myself resisting what I perceived as sentimentality in Kahn's descriptions of her relationship with her son. Or, worse, when she describes her own birth experience in a way that could be read as dismissive of other women's experiences. Consider the following comment, 'If I hadn't pushed my son out on my own I doubt I would have discovered my woman's body since a man would have done the birth work'. Such a line dismisses the work of pregnancy and labour while privileging the delivery aspect of childbirth; it also uncritically associates a 'woman's body' and its discovery, with reproductive experience. In placing birth as central to human existence she states clearly 'By making this statement, I do not mean to slight women who cannot or choose not to have children'. In another place, she wonders 'But there must be a way of entering the terrain of women and our bodies without invoking the spectre of essentialism'.
However, despite occasional lapses into a romanticized tone, I found the book to be a useful, highly engaging, and challenging counter to our society's social and cultural concepts of birth and reproduction. Kahn's writing style is both personal and academic and, at times, a moving account of her own experiences.
Fiona Hart
Department of Sociology in Education
Ontario Institute for Studies in Education
University of Toronto