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Midwifery and Magic: A Review of The Birth House

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By Ami McKay (William Morrow, August 22, 2006; $24.95)

When I was asked if I would be interested in reviewing Ami McKay's The Birth House, I jumped at the opportunity. The book had received rave reviews in Canada and the publishers were touting the book as "reminiscent of the works of Annie Proulx and Chris Bohjalian;" I had loved both The Shipping News and Midwives. When the review copy of the book arrived from the publisher, I anxiously cracked the spine and started reading the introductory note: "As a child, Dora Rare, the first female in five generations of Rares, is taken under the wing of Marie Babineau, an outspoken Acadian midwife with a gift for storytelling and a kitchen filled with herbs. As she grows into adulthood, Dora becomes Mrs. Babineau's apprentice, and together the pair help the women of Scots Bay through infertility, difficult labor, breech births, unwanted pregnancies, and even unfulfilling marriages. But their idyllic community is threatened with the arrival of Gilbert Thomas, a brash medical doctor armed with promises of sterile, painless childbirth."

My heart sank. So it was going to be one of those books. Don't get me wrong, there is a time and a place for a discussion of how women have been pushed out of the birthing process by the medical community. I had read Naomi Wolf's (Mis)Conceptions and, before I had my own two children, agreed wholeheartedly that herbs, teas, yoga, time and prayer were vastly preferable to scheduled Cs, episiotomies and epidurals. But then when nature proved to be decidedly unhelpful in my quest to have a baby, I stopped putting my faith in rose quartz, moonstone, and Chasteberry tea and put it into cold, hard science. Two trips to the fertility clinic, a big dollop of synthetic progesterone, two pitocin drips to induce labor and two epidurals later, I have the family I've always desired. In other words, I'm the poster girl for Big Medicine and I did not expect that The Birth House would be my cup of organic, herbal tea.

But immediately, the book surprised me. Whereas I expected a didactic account of the history of midwifery in Canada, instead I stumbled into a fable where magic is intertwined with history. McKay begins the book by explaining what inspired her to write it. Years before, McKay had moved into an old birth house on the Bay of Fundy. While digging in the garden, she unearthed an old silver serving spoon: "It was used so often that the edge of the bowl of the spoon had been worn down to an angle. As I stood at my kitchen sink, washing the dirt out of the wheat stalk pattern in the handle, I began to daydream about the woman who had once held this spoon so many days of her life." Pregnant herself, McKay began to search for information about the midwife who had lived there years before. McKay found people who remembered her and even tracked down the midwife's adopted daughter, but she was never able to find out everything she yearned to know about the woman. Her need to fill in the gaps in the midwife's story is what inspired her to write the novel. Even if it is true, it's a magical tale: I too live in a home from the late 1800s, but the only things I've ever found while digging in the garden are ancient tulip bulbs and clumps of decades-old cat hair.

The novel itself begins with a passage from the fictional Rare family's history describing how in 1760, Annie McIssac, the daughter of a Scottish ship's captain, settled in Nova Scotia when she fell in love with a Mi'kmaq man called Silent Rare: "On the evening of a full moon in June, Silent went out in his canoe to catch the shad that were spawning around the tip of Cape Split. As the night wore on, Annie began to worry that some ill had befallen her love. . . . She walked to the cove where they had first met and began to call to him, promising her heart, her fidelity and a thousand loves to his name. The moon, seeing Annie's sadness, began to sing, forcing the waves inland, strong and fast, bringing Silent safely back to his lover. Since that time, every child born from the Rare name has been male, and even now, when the moon is full, you can hear her voice, the voice of the moon, singing sailors home." The only daughter to be born into the Rare family in five generations is the book's protagonist, Dora Rare. The people of Scot's Bay, Nova Scotia consider Dora to be touched by magic, not only because her gender broke Annie's promise to Silent, but because she was born with a caul, a thin filmy membrane covering her face, likely the remains of the amniotic sac -- considered by sailors to be a symbol of luck and protection against drowning. As in many communities governed by folklore and superstition, Dora's differences are viewed with equal parts reverence and suspicion, and she finds herself drawn to the local midwife Marie Babineau, herself suspected of being a witch. Dora accompanies Mrs. Babineau on her visits to laboring women and, in time, begins to assist with the births.

Through Dora, we are introduced to a number of Scot's Bay families including Experience Ketch, her 12 children, and her drunken and violent husband Brady. The family makes its living selling homebrew and acting as guides to the wealthy trophy hunters hoping to kill the white doe that lives in the woods behind Mrs. Babineau's home. One night, Mrs. Babineau and Dora help Experience deliver her baby after a beating from her husband has put her into early labor. The baby is too weak to survive, and Brady arrives home furious to find his wife laid up in bed at Mrs. Babineau's insistence: "That Dr. Thomas, down Canning way, he'd know how to make her right. When Tommy snapped his wrist, the doc fixed it up so he could use it right away. Tied it up nice and clean, give him a few pills, and Tom was chopping wood that afternoon." When Mrs. Babineau questions how the Ketches can afford to pay the doctor, Brady boasts, "Let's just say the doc and I . . . we have a gentleman's agreement when it comes to the sweet white does everyone's always lookin' to bag."

While the use of metaphor at times seems a bit heavy handed, McKay's use of allegory to illustrate the attempts by male doctors to usurp the role of the midwife is a powerful technique and makes for some beautiful writing. Mrs. Babineau, the white doe, is cast as the Divine Feminine of myth. Throughout the text she uses herbal remedies, pagan ritual and prayers to Mary to help comfort and heal the women of Scot's Bay. She is also guardian of the garden of lost souls, a mystical burial ground hidden in the woods behind the birth house: "In the centre of a mossy grove of spruce was a tall tree stump. The likeness of a woman had been carved into it...the Virgin Mary, standing on a crescent moon, her face, her breasts, her hands all delicate and sweet. All around her, strings of hollowed-out whelks and moon shells hung with tattered bits of lace from the branches, like the wings of angels." Dr. Thomas is cast as the hunter, who seeks to destroy Mrs. B and the Scot's Bay way of life, for profit and ego gratification. On the heels of Mrs. Babineau's run in with Brady Ketch, Dr. Thomas pays her a visit at home to see if he might convince her to give up her midwifery practice and convince the local women to deliver their babies in the new Maternity hospital he is building down the mountain in the town of Canning. When Mrs. Babineau shows no interest, he begins to make inquiries about Mrs. Babineau and Dora's role in the death of Experience Ketch's baby. He pointedly reminds her that the Criminal Code of 1892 states that "failing to obtain reasonable assistance during childbirth is a crime" and that the assistance of a midwife is not considered to be "reasonable." Mrs. Babineau brushes off his threats, but Dora, hiding upstairs listening to the conversation, is suitably shaken.

Throughout the first part of the book, Dora moves between two worlds: that of the mainstream White Rose Temperance society and women like her wealthy Aunt Fran who seek to embrace the modern ways and that of the outsiders like Mrs. Babineau and the "women from away," three women originally from Newfoundland who married Scot's Bay men. Just when it looks as if her marriage to a wealthy and socially desirable man will pull her in one direction, Mrs. Babineau vanishes, and the women of the Bay need Dora's help in delivering a baby. Her wedding night is spent attending to a difficult birth which sets her on a different path than we might expect, one often at odds with an increasingly modern society.

The book, like most fables, is a battle between good and evil, a battle between modern physician-centered medicine and ancient woman-centered birthing practices. McKay skillfully uses fictional letters, newspaper clippings, advertisements, and Mrs. Babineau's handwritten notes from The Willow Book, a guidebook of sorts filled with herbal remedies and midwifery practices and prayers, to weave her story. To provide an accurate historical context, McKay includes detailed description of historical events such as the explosion of the munitions ship in Halifax's harbor in 1917 and the Great Molasses Flood in Boston in 1919. She also includes a detailed social history of the time, illustrating everything from the amount of control a husband had over his wife, to the medical use of vibrators to treat hysteria and other female ailments, to the power social hierarchy has in shaping a community. A criticism of the book would be that, save for the protagonist and Mrs. Babineau, both of whom are lovingly drawn, most of the characters are flat. Brady Ketch and Dr. Thomas, the antagonists of the story who seek to destroy the midwife's role in the community, have no redeeming features: all the villainous Brady needs to complete the picture is a set of railway tracks and a moustache to twirl. Dora's husband and her Aunt Fran represent the colonial, upper-middle class desire to embrace all things modern, and both characters are portrayed as being foolish, weak, and unfaithful. While the use of stock characters is typical in allegory, their use throughout the length of the novel was at times challenging. I found myself growing frustrated while I waited for Dora to make a mistake, or for Dr. Thomas to redeem himself somehow.

For me, the most interesting part of the book deals with how women mother. True to her archetypical nature, Mrs. Babineau has no biological children but instead mothers all of the women of Scots Bay. It is Mrs. Babineau to whom they turn to alleviate the pains of labor, to terminate unwanted pregnancies, to discuss their problems, and to heal their sick children. Mrs. Babineau is a surrogate mother to Dora who does not have a strong bond with her own mother. It is through Dora's eyes, as daughter and as midwife, that we view mothering, and at first she seems to hold the judgmental view of one who has never mothered. At the book's beginning, she is understandably upset when Experience Ketch refuses to hold her dying son: "I couldn't stand it. I took him from Mrs. B and pulled him close. I whispered in his ear, 'I'll take you home with me. I'll take you for my own.'" When she carries the baby's body to the burying ground, she tries to "make up for his mother not loving him." But surprisingly, she does not judge Mrs Ketch and realizes that perhaps she was hoping that refusing to hold her son would dull the pain of his loss. Dora observes, "It's a disgusting mess we come through to be born, the sticky-wet of blood and afterbirth, mother wailing, child crying . . . the helpless soft spot at the top of its head pulsating, waiting to be kissed. Our parents and teachers say it's a miracle, but it's not. It's going to happen no matter what, there's no choice in the matter. How a mother comes to love her child, her caring at all for this thing that's made her heavy, lopsided and slow, this thing that made her wish that she were dead . . . that's the miracle."

As Mrs. Babineau's heiress apparent, Dora too is unable to bear children of her own in spite of her desperate desire to have a family. When Iris Rose Ketch, Experience and Brady's badly abused daughter, dies in childbirth, Dora keeps the baby girl, concocts a story about a foundling left at her door, and raises the girl she names Wrennie as her own. When Experience arrives at Dora's door a few months later, Dora is terrified that she wants to take Wrennie, her biological granddaughter, home. Experience has no interest in the baby, however; what she wants is Dora's help in terminating her pregnancy. Although according to the Willow Book, she is too far along for Dora to intervene, Dora feels she cannot turn her away and does what she can to help her. Not only is this episode critical in terms of the book's plot, but it is also the point where Dora takes on the full mantle of motherhood. In spite of her pragmatic nature, Dora wears rose colored glasses when it comes to mothering Wrennie: "when she's older, when she's learning to stand on her own, when she clings to my legs, hides her peek-a-boo face in my skirts, she should find herself wrapped in the colour of sunshine, the blue of cornflowers. She should see that her mother is not afraid to laugh, that's she's not afraid of anything. This is how to raise a child to be happy, to be the girl that everybody loves." Her experience with Mrs. Ketch unnerves her and she thinks back to an incident from her childhood involving her own mother. Her brother Charlie had let the family dog out while she was in heat, and the dog had given birth to her second litter of puppies that year. Dora's father was angry and insisted that Charlie get rid of the puppies so he would see the consequences of his negligence, a decision Dora's mother supported. Dora watched her mother and brother gather up the pups and take them to the river: "Mother watched as Charlie knelt down by the deepest part of the brook. She grabbed the sack before Charlie could plunge it into the water. I could hear the tears in her voice as she told him, 'Go on, Charlie, just go on home.' She didn't turn to watch him run away. She just sat and waited until she couldn't hear his footsteps, and then she closed her eyes and pushed the sack into the stream, leaning in up to her elbows, holding it down with sadness and duty. I never understood why she had to do it, why she felt Father was right to want to kill those pups. I went on after that day believing my mother was not who I'd always thought she was, that her face was less beautiful, that her arms gave less warmth than before. I wonder if Wrennie can feel the coldness in me that comes when I think of Mrs. Ketch, the chill that runs right through me, to my fingers and down to my toes." Dora understands that motherhood is complicated. That maternal love is complicated. That the caring that comes along with mothering -- be it biological, adoptive or the way a local midwife mothers her community -- is not always easy.

The Birth House is a powerful illustration about a dark period in our history when men and commerce tried to wrestle even the birthing process away from women. In a time when a woman's reproductive rights continue to be subject to debate, it serves as a cautionary tale. In the end, it did not change my views about modern medicine and mothering, but as with all good fables, my underlying point of view did not render me immune to its charms.


Jen Lawrence is an MBA and former banker who left the world of finance for the world of sippy cups and goldfish crackers. She writes about her experiences on her blog MUBAR (Mothered Up Beyond All Recognition). She is an Editorial Assistant for Literary Mama’s Reviews section and also contributes to the Literary Mama blog. Her work has appeared in The Philosophical Mother. She lives in Toronto, Canada with her husband and two children.


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