This article first appeared in THE WEEKENDER

21st February 2009

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JUST KEEP BREATHING: South African Birth Stories

Compiled and edited by Sandra Dodson and Rosamund Haden

(Jacana)

Some people plan their parenting very carefully; some have parenthood thrust unexpectedly upon them. Some battle for years to conceive; some find that they cannot have children. Others choose not to become parents, either to protect their lifestyle or based on a conviction that the earth is over-populated already. Yet the biological urge to procreate and nurture will not go away, and sooner or later everyone reflects on what it means to bring a life into the world.

Readers in most of the categories described above will find their experiences echoed in the pages of Just Keep Breathing: South African Birth Stories. This collection, compiled by Sandra Dodson and Rosamund Haden, stems from the editors’ perception of the paucity of “literary value” previously ascribed to the “commonplace but deeply significant experience” of birth: it is “typically regarded as being beyond the pale of the literary. ‘Serious’ literature almost invariably sidesteps the subject,” while its portrayal in popular media is “often sensationalised or given sentimental treatment”.

The stories that they have selected (or solicited) go some way towards rectifying this imbalance in local, if not global, literature. The contributors range from recognised South African authors to less well-known writers and, indeed, to those who are not first and foremost writers but nevertheless have a particular story to tell. “Birth” in this book is interpreted in its broadest sense – not just the hours of labour culminating in the arrival of an infant, but the days, weeks and months preceding and following this sacred event. There are stories from those who have given birth themselves, watched loved ones give birth, helped others give birth; and, inevitably, many of the contributors reflect on their own birth and their subsequent relationships with their parents.

The injunction to write on one’s experiences of the birth process is an interesting litmus test for a writer. Each birth story may be unique, but it is also comprised of a combination of certain basic elements: waters breaking, contraction and dilation, hospitals and home births, Caesarean sections and breeched babies and umbilical cords and placentas. So how do you avoid repetition and cliché?

Marita van der Vyver shares the “valuable lesson” she learnt (“as a writer and as a human being”) when she delivered a healthy second child after her first baby was born with severe brain damage and died: “One can’t always escape clichés and the commonplace. The banality of happiness is infinitely preferable to the particularity of despair.”

Some authors seek to establish particularity in joyful experiences by exploring personal histories, unusual relationships and quirky characterisation. Others, like Elleke Boehmer and Tanya Wilson, fuse their experiences as mothers with their academic and professional training. Boehmer, the “writer-academic”, muses on the link between birth and death (“Death is ontologically impossible, say the philosophers”, she writes; later, she interprets the “crochet hook” used during her son’s birth as a “buried signifier” of death in the moment of life). Wilson, a clinical psychologist, grapples with the impossibility of expressing the physical and emotional sensation of giving birth in abstract terms – ironically, it frustrates the “symbolic language” of psychoanalysis.

Still others dwell on the pain of birth (a transfiguring pain, explains Finuala Dowling, “a tempering pain” that bestows on women the strength they need for motherhood) or catalogue the “bloody and messy and sometimes life-threatening” details to remind the reader, as does Van der Vyver, that birth is not necessarily “easy and safe and clean” just because of modern medicine.

Nevertheless, at least half the stories in Just Keep Breathing affirm the role of medical science in, firstly, contriving conception and, secondly, keeping alive those infants that, a few decades or a century ago, would certainly have died during or soon after labour.

Susan Newham and Roxi Blake share the experience of bearing a child as a lesbian couple through insemination from an anonymous donor. Ronel Herrendoerfer and Anneke Kamfer-Sloman offer insights into the process of surrogate motherhood. Stories by Colleen Higgs and Maire Fisher describe weeks of anxious waiting at the neo-natal intensive care unit (NICU) while their babies were sustained by tubes and incubators.

Various writers are more ambivalent about the faith we place in white coats and green scrubs. Andrew Weeks recounts mixed experiences with nurses and doctors in a British hospital – some competent and emotionally generous, some indifferent and unhelpful. Dowling is delightfully acerbic in her insinuations about male medical practitioners in the “female” domain of obstetrics and gynaecology. Sarah Nuttall balances the bitterness of discovering that medical practitioners’ bland assurances have been empty – she was told repeatedly that her first baby was fine, only to see her die – with the renewal of trust in paediatricians and midwives when her second baby is delivered without complications. The irrepressible Rahla Xenopoulos, describing her twin battles against bipolar disorder and infertility, celebrates the success of Chinese medicine in achieving what Western medicine alone could not.

A number of the contributors are, themselves, medical practitioners. Both Makhosazana Xaba and Ruth Ehrhardt link generations of women who, mothers themselves, have been midwives to hundreds of other women giving birth.

Mark Patrick’s harrowing story records how he and his wife Jean (both paediatricians at a hospital in KwaZulu-Natal) were thrown into a dilemma when Jean was exposed, while pregnant, to blood from the HIV-positive infant of an HIV-positive mother. Unsure of how AZT and 3TC might affect their unborn child, whom they have already named Rosemary, they decide: “We cannot take the risk. We are the only paediatricians serving a population of 1.2 million people. We are not strong enough to look after the desperately ill children entering our under-resourced health system and a seriously deformed child of our own. We decide to end Rosemary’s short life.”

This heart-breaking tale is the only one in the book that has no successful birth to depict. Other HIV-related birth stories, such as Nolubabalo Gloria Ncanywa’s “Positive”, attest to the effect of antiretrovirals in preventing mother-to-child transmission. Yet it is an indictment on our state and our society that, while each of the stories is either set in South Africa or written by an expatriate South African author, stories such as Ncanywa’s and Patrick’s are the ones most readily identifiable as “representative” of local birth experiences.

Likewise, Sindiwe Magona bears testament to the hardships encountered by many black women – not only racial oppression and poverty but, moreover, husbands and fathers who are either conspicuous by their absence or abusive in their presence. The prevalence of patriarchal customs and fallacious traditional beliefs is evidenced in Kholeka Sigenu’s throwaway comments that having a son is “something very important in our culture” and that “the birth of twins is shrouded in superstition”.

Unfortunately, Sivuyile Mazantsi betrays all-too-familiar male shortcomings in his narrative: a curious prudishness about the female body (he is shocked by a nurse palpating his girlfriend’s “private parts”); assumptions about gender roles (he is uncomfortable with a male nurse treating his girlfriend); and cowardice (“I didn’t have the courage to watch [the birth]”).

Irrespective of their attitudes, however, all men are “marginalised” – as Dodson and Haden note – to a lesser or greater degree when it comes to the birth process. Troy Blacklaws and Imraan Coovadia exploit their marginal position for humorous purposes, but Coovadia’s piece is nonetheless intellectually insightful and he puts his finger on a key element in this collection. He was living in America at the time that his Russian wife gave birth to their child, which leads him to consider how “South Africans living overseas tend to vanish into the environment, like one or another generic category ... I had no idea what sort of identity I should transmit to my son. Having a child raises the issue of tradition in its purest form”.

Cultural heritage is inevitably brought to the fore when one anticipates raising a child; one’s native country is no longer simply a “motherland” or a “fatherland”, but acts as a kind of grandparent to infant children. This causes a number of the contributors to dwell on questions of nationality and a geographical “home”.

Phillippa Yaa De Villiers attempts to exorcise her insecurity over her identity as the biological daughter of an Australian woman and a Ghanaian man, adopted by a white family in apartheid South Africa. Haden traces the branches of her own (British) and her husband’s (Xhosa) family trees, imagining which characteristics her son will inherit. Homesickness aggravates Dodson’s anxiety after having an abortion in the UK. Conversely, patriotic feelings are likely to leave some readers unconvinced by Newham and Blake’s justification for obtaining sperm from a donor in the USA.

In a collection that is consciously “representative” – the editors are explicit about this in their introduction – Epiphanie Mukasano’s story represents a different kind of exile: she is a Rwandan refugee whose teenage daughter has lived in South Africa for most of her life.  

It seems, then, that Dodson and Haden are incorrect in at least one way when they claim that birth stories offer “a narrative of the ordinary in a nation marked and shaped by the extraordinary”. The accounts in Just Keep Breathing are at least as extraordinary as our country. Alternatively, one might say, there is no such thing as an ordinary birth (Joanne Hichens’s piece demonstrates that “Doing It By The Book” is impossible): every birth is both traumatic and miraculous.