Emily Wheater //
Recently in Synapsis, Jessica M.E. Kirwan discussed the portrayal by male, Enlightenment-era physicians of mothers in obstetric texts and images. William Hunter’s illustrations of pregnant bodies are deeply dehumanising in their presentation of butchered female bodies, and gradually stripping away the mother’s body altogether leaving just the uterus behind. What a wonderful antidote then, to read The First Breath by Olivia Gordon. Interweaving her own experiences as a ‘NICU mother’ (neonatal intensive care unit) with the story of medical advances, Gordon’s book spans the development of modern fetal and neonatal medicine and its implications.
Gordon’s pregnancy was complicated. While she was pregnant, her son was diagnosed with hydrops—a build up of fluid in the tissues—and was subsequently born preterm at 32 weeks gestation (full term is 40 weeks gestation). This was just the start of a series of medical emergencies, interventions, operations, and shocks, including a diagnosis of a genetic condition and disability. Gordon is candid in these descriptions, and deeply suspicious of sentimentality. For all her enthusiasm and gratitude for the medical institutions, teams and individuals that got her and her family through, Gordon also turns a much need critical eye onto how parents and children can be let down.
Recurring throughout the book is a sense of otherness and other-worldliness when it comes to pregnancy, fetuses and sick babies. Fetuses are apart and mysterious in the dark and watery world of the pregnant uterus. They are rendered less mysterious through ultrasounds, originally developed to enable ships to better detect the presence of ice-bergs, post-Titanic. Ultrasound was used during the First World War to detect enemy submarines. In the ’50s doctors made the connection – the fetus is also a body in water and could therefore also be seen with such a method. But, once born, the sick baby is alienated further. The life-saving incubators that keep these tiny infants warm are barriers between not only the child and the cold outside world, but also between the child and their parents. The medicalization and the efficiency of highly trained and skilled medical staff taking care of the babies’ needs keeps their parents peripheral in the care for their own children. They are further othered through the stark fact that when a baby is in a neonatal intensive care unit (providing care for babies with the highest need for support), there simply isn’t space and resources to house the parents too. This othering and a lack of privacy poses very particular challenges for parental bonding.
A comparison between her experiences in the UK, and experiences of parents at the Karolinska Hospital in Sweden comes about halfway through the book. At this hospital’s NICU, care for the child and family are much more tightly connected. Each incubator is enclosed in its own room, complete with bed for a parent and a room with a double bed for both parents nearby. The rationale is to enable the parents to be integrated early on into the child’s care, and to avoid the separation that is forced on families in the space-constrained setting of a British hospital. The parents are considered the main caregivers rather than being peripheral to the medical professionals. Up until this point in the book, Gordon has instilled the reader with wonder and admiration at the skill and care of medical professionals. This remains unchanged by the comparison, but it does perhaps expose a dehumanising legacy in the systems and institutions within which pregnant women, mother and their families receive care in the UK.
The First Breath contains a wonderfully insightful account of advances made in fetal and neonatal medicine. But it is not a litany of ‘Fathers’ (be it of fetal surgery or neonatal medicine) that sets this book apart, but the voices and stories of the mothers who are so integral to Gordon’s story-telling. These are not the saccharine fairy-tales of devoted motherhood, of strong and unwavering heroism in the face of all adversity. Gordon certainly speaks of devotion, and that emotion that is all too often associated with motherhood: guilt. But the mothers also speak of doubt, of anger, of wavering. It is giving voice to these ‘unspeakable’ feelings that ultimately makes this incredibly moving book such a panacea.
Olivia Gordon, The First Breath, 2019, Bluebird Pan Macmillan