Book review: Birth Day (Sloan, 2009)

6 October 2009 at 7:03 am 5 comments

*Editor’s note, as with all our posts, the opinions in the following reflect the opinions of the author only and not necessarily those of MFOM*

Ah, another book on birth. Another—highly hyped—book by another “expert” on the subject—in this case, a male pediatrician who a) was born, b) “delivered” some babies in medical school, c) attended his wife’s births, and d) hypothesized about what it will be like for his daughter to give birth. Yes, I’m talking about Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth by Mark Sloan.

First of all, in case you were in any doubt from his subtitle and from the prominent “M.D.” letters following his name on the cover, Sloan presents a by-the-numbers medical (and weirdly male-centered) model of birth here. I don’t think Sloan actually likes women or babies—his ostensible subjects—but I know he sure does like himself. Whenever possible, he discusses himself. If that’s not possible, he discusses other doctors—almost always male (he covers Virginia Apgar almost reluctantly)—and if that’s not possible, he invents an absurd analogy comparing women or newborn babies to something bizarre and, always, male—a man and a boat, a scuba-diving man, or a horse (he even acknowledges that the horse analogy is unsettling: “I have learned over the years that comparing anyone’s baby to a horse is a losing proposition, but the comparison in this case is useful: a newborn baby at its mother’s breast eats just the way a horse drinks”) (290). I have no idea how his editors let him get away with these analogies; designed to make his medical subject less pretentious and more down-to-earth for his—presumably female—readers, they give him a deliberately folksy quality that matches his use of his family’s photos as chapter dividers.

Sloan’s book covers a wide range of topics and is full of his down-home retellings of history, myth, legend, and science. He first covers standard evolutionary ground when discussing why babies have to rotate to descend through the birth canal and then moves on to a varied and loosely-connected group of subjects: pain in childbirth; Zeus; Caesar; pain in childbirth; Marie Antoinette; Queen Victoria and chloroform; pain in childbirth; Twilight Sleep; Grantly Dick-Read; pain in childbirth; Apgar and Apgar scores; couvade pregnancies; pain in childbirth; elective c-sections (where he fails to acknowledge that this “trend” does not in face exist beyond perhaps a fraction of a percent of all births); circumcisions (he performs them, but states that he doesn’t pressure his patients to have them done if they are against them); and newborn reflexes and early mother-child bonding opportunities (what he calls “scaling Mount Mama”) (247).

Not terribly surprisingly, Sloan spends a lot of time emphasizing how necessary doctors are for birth. He constantly—from the very first scenes of birth, where he is an incompetent medical student and the women are restrained and made to be passive—emphasizes medical intervention rather than the natural process of birth: “I had been lulled by the normalcy of most births into thinking that that’s all there was to it: the lady gets in the bed, you do a few examinations, and then poof—a baby falls in your lap” (31); “[a] relatively easy womb-to-world transition is typical of most modern births. The rarity of things going haywire is striking, giving the complexity of the changes at birth. . . but occasionally it isn’t that easy. For every worrisome delivery I’m called to in which I simply watch and wait and then ride off unnoticed into the hospital sunset, there’s another that puts me at the center of intense, hair-graying action. [This] textbook transition went smoothly, but it just as easily might have gone wrong” (43).

Never fear—Sloan does mention midwives, in a dismissively titled chapter called “The Gang’s All Here,” first as incompetent medieval types who administered harmful herbs (“By the Middle Ages, midwives used a wide variety of herbs, roots, and fungi. The sheer number of remedies testifies both to cultural preference and to the fact that none of them were all that effective. And not all of them were benign”) and then, of course, as drunks themselves and purveyors of alcohol (“By the time of Charles Dickens’s fictional Sarah Gamp (Martin Chuzzlewit, 1844), British midwives were notorious for ‘helping’ their patients through labor by getting them knock-down drunk”) (95). Sloan also mentions doulas, slightly less negatively (but perhaps only because no male writer, to my knowledge, has yet written a famous novel with an unflattering portrayal of a doula for Sloan to draw on), but then has an entire chapter devoted to fathers at birth. (And yes, I do mean fathers—there is no mention made of same-sex partners at all.)

Ultimately, I’m not sure what Sloan’s book really adds to the body of literature out there on birth. Read Robbie Davis-Floyd, read Naomi Wolf, read Leboyer, read Wertz and Wertz, even read Tina Cassidy—but skip Sloan.

–Christina

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Looking back at my homebirth–regrets? Breastfeeding, motherhood, hormones, and Joss Whedon. . .

5 Comments Add your own

  • 1. Mary Ellen  |  7 October 2009 at 6:30 pm

    Wow… that is one angry review! I think you completely missed the boat on this one. I read Birth Day early on after seeing a very positive review in the Washington Post, and I loved it. I recommended it to many of my friends and they loved it too. Birth Day has been out for six months and yours is the first negative review I’ve read.

    I hope anyone who reads your review will take a closer look at the book for themselves. It’s not anti-midwife: Judith Rooks, the renowned nurse midwife who wrote “Midwifery and Childbirth in America,” wrote a very nice “blurb” on Birth Day’s book jacket. In fact, Sloan is very supportive of expanded maternal choice in childbirth.

    Your comment – “I don’t think Sloan actually likes women and babies” – is very odd. There’s nothing in the book to suggest that at all. Actually, an agenda-free reader will find just the opposite. One small example among many I could cite: he doesn’t “reluctantly” mention Virginia Apgar, as you claim. She’s featured in a chapter title, and he devotes several glowing pages to her, describing her accomplishments as a brilliant, pioneering physician and “a remarkable woman.”

    Anyone who is interested in more balanced reviews should visit blogs like:

    http://enjoybirth.wordpress.com/2009/09/26/birth-day-by-mark-sloan-md/

    http://naturalpregnancyproject.com/birth-day-book-review/

    http://blog.naturalbirthandbabycare.com/birth-day/

    …and see the dozens of favorable reader reviews at Goodreads.com and Amazon.

    It’s a great book.

    Reply
    • 2. christinamichaud  |  7 October 2009 at 6:41 pm

      Interesting–I’m always happy to hear other perspectives, and I’ll check out those reviews. Honestly, though, I didn’t go into this book “angry” or with “an agenda” at all–I heard about it somewhere, put it on my library queue, and read it eagerly, as soon as I got it. I’m sure there _are_ people who like it, but I really do think that Sloan just wanted to write a book about himself–and people who resemble himself, i.e., other male doctors.

      –Christina

      Reply
  • 3. Mary Ellen  |  8 October 2009 at 12:41 am

    So you’re saying that a book written by a pediatrician who has attended more than 3,000 births over a thirty year career lacks childbirth credibility simply because he’s a male doctor? Wow, again! If the subject were different and the genders reversed, we’d both be crying “sexism!” right now—and we’d be right.

    And how did you conclude that Sloan just wanted to write a book about “people who resemble himself, ie, other male doctors”? A quick scan of the text, index and bibliography turns up dozens of fascinating women—mothers, daughters, grandmothers, midwives, physicians, surgeons, scientists, nurses, writers, historical figures, educators, feminists, even Queen Victoria and the six wives of Henry VIII—and more than half the people he thanks in his acknowledgments, including nine of the first ten, are women.

    And by the way, Ballantine Books describes Birth Day as “part memoir, part science and history,” so the “writing about himself” part shouldn’t have come as a surprise.

    Did you actually read this book?

    Reply
    • 4. christinamichaud  |  8 October 2009 at 7:42 am

      Whoa, relax, please. I’m not sure why you’re taking this quite so personally. I did read the book–I did not like it. I’m open to reading books about birth by male doctors–Odent, Wagner, Sears, and others spring to mind as great ones. Still, Sloan begins the book with himself “delivering” babies, and throughout he depicts himself in a heroic way (“rid[ing] off. . . into the hospital sunset” or else “at the center of intense, hair-raising action”)–making women peripheral to (and the midwifery model nonexistant in) this book. If there are other people who liked the book and wrote positive reviews, then that’s great–think of mine as just another view on the matter. No personal offense is intended to anyone.

      –Christina

      Reply
  • 5. mfom  |  4 September 2010 at 7:11 pm

    *Editor’s note: the following comment is from the book’s author himself from 04 June 2010*

    A friend recently sent along your review of my book, Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth. I don’t normally comment on blog reviews of my book, as I’m a firm believer in a reader’s right to her opinion, but I find a statement made by the reviewer-“I don’t think Sloan actually likes women or babies”-puzzling and frankly offensive. It’s one thing to criticize the book; I have no problem with that. It’s quite another, though, to accuse me of hypocrisy, even misogyny, when nothing in Birth Day remotely supports such a charge.

    Birth Day has been very well received by a broad cross-section of women who care for pregnant women and babies, including Judith Rooks, who reviewed Birth Day for the Journal of Midwifery and Women’s Health, and Judy Norsigian, a founder of Our Bodies, Ourselves, who has described Birth Day as “a marvelous, well-written book from a thoughtful pediatrician.” Last spring I had the honor of being introduced by these two remarkable women at my Powell’s Books reading in Portland.

    Of the dozens of reviews Birth Day has received, yours is the only one to call my integrity into question. How in the world did your reviewer conclude that I resent the very people to whom I’ve devoted my thirty-year career?

    Mark Sloan

    Santa Rosa, CA

    Reply

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