Pregnancy can be a joyous, wondrous time. In the eyes of Naomi Wolf, it can also be a period fraught with confusion, ambivalence, and conflict with medical professionals. As she warns at the beginning of her sobering, often angry book, "Misconceptions," the experience of becoming a mother in America is "undersupported, sentimentalized, and even manipulated at women's expense."
Wolf's own journey to motherhood begins in a small town in Italy, where a pregnancy test confirms her unexpected new state. After she and her husband return home to Washington, D.C., she quickly becomes "inducted into a medical system that had very clear expectations of me - but little room for me to negotiate my expectations of it."
In the ensuing months, as her figure grows "startlingly big," those expectations shrink. She encounters dispassionate obstetricians who, she complains, seem determined to withhold information and wrest power from expectant parents. She also learns that the hospital where her baby will be born has a Cesarean delivery rate of 30 percent.
And then there are the smaller terrors of pregnancy. Wolf mourns the loss of her physical shape. She becomes "dumb with fear" when she sees a friend's stretch marks at the gym, wondering if this will be her fate, too. She despairs that she cannot find a "racy" maternity outfit. She finds herself "desperate for positive maternal role models" with whom she can identify. She wonders if she will be "reduced to sentences of five words, of one or two syllables, simply by dint of having given birth." And she yearns for the "powerful, sexual mother-goddesses" that are common in "a number of other cultures."
Which cultures? Wolf never tells us. Again and again, she falls back on vague, wistful references to the superior ways in which "other cultures" treat pregnancy and childbirth, and the ways "our culture" comes up short. But aside from a few brief mentions of Britain's National Health Service and the system of midwives in Holland and Denmark, she tends to point to obscure cultures as role models. The Trobriand Islanders of the South Pacific, for example, create ceremonial pregnancy skirts and cloaks. And rural Catholic Filipino communities treat pregnant women "with great deference."
But what about pregnant women in France, for example, or Germany, Italy, and Sweden? The book would have profited immensely by a much fuller explanation of childbirth attitudes and practices in European countries.
Not until the second half of the book, after Wolf reveals the traumatic circumstances surrounding her own delivery, does she settle into a less histrionic tone, offering a systematic explanation of the problems that can surround childbirth in America.
She describes the tension that exists between medical practitioners and midwives. Doctors, fearful of malpractice suits and eager to expedite deliveries, she says, rely heavily on routine anesthesia, fetal monitoring, and frequent Cesarean deliveries.
Medical technicians, she charges, see birth as "a medical problem to be solved." The obstetrical culture trains them "not to wait and nurture, but rather to act." That action translates into an order to women in labor: Produce a baby within 24 hours or be subjected to a Cesarean.
Most midwives, by contrast, "argue that birth is best treated as a normal and healthy process that women, as a rule, are capable of managing without undue intervention. Many midwives believe that the way doctors have medicalized normal births leaves women less able to call up the confidence and courage they need to get themselves through birth without drastic intervention."
Wolf does have good days during her pregnancy, days "filled with peace and a kind of quiet excitement." But whatever joy she and her husband experience during those nine months remains for the most part a well-kept secret.
This is a gloomy book. From pregnancy books to childbirth classes to pre-birth hospital tours, little escapes Wolf's ire. Could she find no examples of satisfied couples and successful births, and of caring physicians who could serve as examples of what can go right under the proper circumstances?
It is also a book marred by overwrought prose: "I had fallen into a primordial soup of femaleness.... I was drowning in the Lake of Fecundity." And: "The image that I was about to become someone's addiction, a cow to be trotted out of the stable, a lifeline, an oxygen tank, grew in me."
Wolf's basic message - the overmedicalization of childbirth - is an important one. She calls for changes in obstetrical practices that would give parents more control. And she pleads for more support for mothers, who often find themselves isolated both before and after a baby's birth.
How unfortunate that she works against her own best interests - and the reader's - by packaging that worthy message in a book that is too often whining and narcissistic.
Marilyn Gardner writes about family issues for the Monitor.