Literary Mama writing about the many faces of motherhood
Strange Landscapes: A Review of Cynthia Marie Hoffman’s Paper Doll Fetus

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Persea, 2014
ISBN: 978-0-89255-448-5
Perfect bound, 57 pp., $15.95

Cynthia Marie Hoffman's extraordinary second poetry collection, Paper Doll Fetus, gives voice to a chorus of unusual voices: ectopic twins, a lamb's wool strap on a gurney, a mother's liver, a sketch of a homunculus, a male physician who must deliver a dead child. Part spell book, part study in the body and birth, Paper Doll Fetus inhabits a strange landscape of pregnancy, childbirth and obstetrics from medieval midwifery's superstitious practices to today's scheduled C-sections.

Readers might know Hoffman from her chapbook, Her Human Costume, which won the 2013 Gold Line Press Poetry Chapbook Competition or her first book, Sightseer, which won the 2010 Lexi Rudnitsky First Book Prize in Poetry. The latter book, like this one, works around a central project—sightseeing. In an interview with Persea Books, Hoffman says her idea for this project book came when she learned about twilight sleep—an amnesiac state induced during childbirth to reduce pain, and how many women who experienced the practice often felt detached from their newborns. What started as a plan to write a series of twilight sleep poems expanded into a layered manuscript encompassing aspects of pregnancy and birth from the dark ages to the 21st century. "A world of superstition and fantasy opened up . . . both inside and outside the womb" for Hoffman as she researched medicine and midwifery back to the dark ages.

What's central to this collection is how it harmonizes many different perspectives: Some of the voices are conventional (like mothers, male doctors and midwives);others are embryonic (the titular paper doll fetus talks in utero to its healthy twin, the phantom child in the nun’s womb). Some voices aren't even human—a flower for forgetfulness, a liver, a stone. In the haunting "No Midwives Can Do What Angels Can," the poet mashes up Cotton Mather's early 1700s maxims to illustrate how midwives were both demonized and exalted for their work during birth:

                                    Blessed be
the women swinging from the gallows, the crook

in their necks that saves you. God gives only a perfect child
into your arms. The baby kicks. The baby cries.

Many of the carefully researched poems start with epigraphs that root the reader in country and year. Hoffman's attention to detail in her research of midwifery and obstetrics helps the poems hang together tightly: old wives' tales, historical and contemporary theories like maternal impression and recapitulation, and true-to-life details about miscarriage, ectopic pregnancies, and C-sections. Several of her narrators are also male physicians, whose painful accounts of certain surgeries Hoffman renders in precise, grotesque detail. Though she portrays the intrusiveness of scientific inquiry, Hoffman affords the mothers and deformed children a modicum of dignity.

In one such poem, "I Would Not Offer to Disquiet Her"; the narrator Percivall Willughby, a very late medieval physician, must use a crochet, a long tool with a hook on the end of it for removing a dead fetus piece by piece from the mother's body to save her life: "The metal hook / warmed in my hand. I saw her eyes grow troubled." This poem gave Hoffman pause while writing it: how to treat the horror of this operation? She realized halfway through her writing that perhaps Willughby himself was loathe to perform such a gruesome, but life-saving surgery. This realization helped Hoffman complete the poem by making the second half of it a dream in which the doctor merely crochets a blanket of yarn:

Like this I pull again, pull until I see I am stitching
a child into the air warm as a crocheted blanket, and when
it is finished I place it upon her bed, and she looks
upon the bundle wherein lies a tiny wrinkled foot-
print . . .

Hoffman's research turned up many disquieting obstetric practices, including the dehumanizing aspects of scientific inquiry—for example, the child with two sets of limbs who's cut open to remove its heart, the woman who's carrying a calcified fetus. However, reading these poems, there's the sense that while often exploring the grotesque, bizarre and impersonal-ness of scientific inquiry as well as routine births, the poems, and their subjects, are invested in love and in affirming life. For example, "The Calciferous Substance Speaks to the Sleeping Fetus," the substance that binds a fetus inside its mother's body sings the dying child a lullaby:

                                                                                            And still,
I thought if you were going to stay, you would need a blanket.

I had only myself to make one of. I am not soft, I am
sorry. My particles rallied to lay themselves upon you

like stars snapping free from the sky
and everything white in this dark place

There's evidence throughout this collection that these poems were written by a woman who has experienced pregnancy and birth. In "Ultrasound," the narrator says, "Baby / take as long as you need … // We/ two are such a short time / together in this world." In "The Phantom Pregnancy Speaks From the Belly of the Nun," the phantom fetus and its chaste mother bond:

                                                      But in the evenings when we are alone
together, she gathers her woolen robes at her hips, slips her hand
to her belly beneath it, and there is a certain warmth I have grown
accustomed to and which stirs me, I would say, if I had a bone
in my body, to my very bones.

In that same Persea interview, Hoffman claimed she found certain freedom in giving voice to a fetus, the sound of a maul that cracked open a stone child or a liver because a reader likely wouldn't have an expectation for what diction, tone or message each would deliver. At their core the poems speak about relationships, as she points out: "the stone falls in love with a placenta, the dying fetus forgives his thriving twin, the deformed fetus scathingly accuses his mother." In "The Liver Speaks to the Ectopic Embryo," the liver says:

I had not understood you were meant to leave,
but I must stay. You must stay with me
in these crowded heavens where the dismal planets
now are bumping against each other, and I cannot
say if I can carry you much longer. We are not,
after all, weightless.

Many of the poem titles wind long and descriptive: "At Twenty Minutes Past Twelve by a Clock in the Queen's Apartment I Commenced to Give a Little Chloroform" and "The Aborted Fetus Lays its Tiny Hand Upon the Cheek of George Washington." In addition, Hoffman includes longer epigraphs from older texts like On Monsters and Marvels (1573) and The Earliest Known Case of a Lithopaedion (1582). A lesser poet might employ long titles or descriptive epigraphs as an easy way to root the reader in the poems. Hoffman doesn't simply rely on her titles and epigraphs; her skill as a poet fully comes to bear in the poems themselves.

The free-verse poems come in traditional, left-margin forms: coupleted poems like "Poor Christina" and "The Calciferous Substance Speaks to the Sleeping Fetus"; three- and four-line stanza poems like "The Infants in the Basin" and "The Trial of Agnes Sampson, 1591"; and prose poems like "So the Earth Was Repopulated." Many of the poems' line lengths are also long, like the titles, and enjambed, which Hoffman uses to her advantage—the reader is kept unsteady from line to line, as in "The Flower from which Forgetfulness." In other poems like "The Homunculus Speaks from the Bed of the Ovarian Dermoid Cyst," the lines rush along without punctuation ("My hair says brush me I am tangling / in the greasy spillage.") This example from "The Sound of the Maul that Cracked Open the Stone Child of Sens, 1582" shows how Hoffman uses enjambment to build suspense:

                                            A cracking sound at last. The door is now
opened to the small room. Hair on the head I can see it. A tooth
in the jaw I can see it. Now here comes the iron extractor to wrench it
free. Off lops its right hand. Fetus!

While these are motherhood poems, they're also about the human experience of our own births—and how even a fetus dead before it comes into the world can have lived a whole life. The language becomes conversational and intimate at times: "You can call me your little man if it helps when you think of me" ("The Homunculus Speaks from the Bed of the Ovarian Dermoid Cyst"). There are echoes of poet Traci Brimhall (author of Our Lady of the Ruins) in the work, that similar ability to sit the grotesque next to the gorgeous and make readers believe they're walking in a kind of post-apocalyptic paradise, as in "He Abhors Not the Virgin’s Womb":

The water rushes away from you, cold air
hits the crown of your head, prick of hay at your cheek.
I say verily, verily. In the hands of three tall shadows, something
glittering.

Hoffman's accessible, image-driven poetry employs subtle rhyme: alliteration ("basket balanced on her knees, the bundle"), assonance ("just the buzzing of our coats, the hum of static") and internal and end rhyme ("What does the tangle of blood say, the mangled" and “pop the caps off its knees and lop”). In some poems like "The Trial of Agnes Sampson, 1591" and "No Midwives Can Do What Angels Can," the poem's voice takes on the tone of the writings of the day: "Aforesaid woman Agnes Sampson was witnessed // … A demon in the grasses, she was."

The book's final poem, "The Stork," again taps into the vulnerability of the birth experience for mother and child echoing in the collection. The language here, too, image-driven and intimate, with a wild longing for that child inside:

When the beak
opens, the darkness takes
us, wipes our minds
with soot so there is
only the long fall, the
touch of human skin. Our
boundedness to earth. What
we remember.

These poems celebrate pregnancy's oddities and its perils, which saves the book idealizing motherhood, pregnancy and birth: "The stone / in your mouth is not a bird and cannot sing. You will feel / a pressure, the doctor says, and you feel a pressure" ("The Cesarean"). Instead the poems ask: Why does one twin die and another lives? What do we experience in the womb’s darkness? Is there any truth to superstition—if a pregnant woman gazes at a picture of a deformed baby, will her child be similarly affected? These poems contemplate the human body's workings, through spiritual and scientific lenses. And the voice throughout remains sympathetic and understanding, guiding the reader through a raw emotional landscape about what it means to be mortal.


Nicole Rollender’s work has appeared or is forthcoming in Alaska Quarterly Review, Best New Poets, The Journal, Radar Poetry, Salt Hill Journal, THRUSH Poetry Journal, West Branch, and others. Her first full-length poetry collection, Louder Than Everything You Love, is forthcoming from ELJ Publications. She’s the author of the poetry chapbooks Absence of StarsArrangement of Desire and Bone of My Bone, a winner in Blood Pudding Press’s 2015 Chapbook Contest, forthcoming this year. She’s the recipient of poetry prizes from CALYX Journal, Ruminate Magazine and Princemere Journal.


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