The Birth House is about Dora Rare, the first daughter born to a Rare man in anyone's memory, who grows up in Scots Bay, Nova Scotia, before, during and after the First World War. As she gets older, Dora finds herself increasingly in the presence of Mrs. B, the village midwife and mystic. Although Dora repeatedly tries to distance herself from the role of midwife-in-training, she soon discovers the importance of such a woman in the community.
Scots Bay is a village on the far side of the North Mountain, and to get to Canning (the valley town with the shops and services) it takes quite some time in a horse and buggy. Soon, though, a maternity centre opens in Canning, changing the way people in the area view both pregnancy and childbirth. The centre is billed as a place where women will have all the modern conveniences of ether and forceps during childbirth. And let me say that the scenes depicting how these conveniences are applied are quite horrifying.
But the centre does more than take the mother out of the childbirth equation - ether knocks her out and the forceps negate the need to push - it also takes away her choices. Before the maternity centre opened, childbirth was one of the only things a women controlled in her life; they had a midwife and the men were left more or less out of the birthing process. But with the arrival of a male doctor who vocally derided the role of the midwife, the men in the area started to take control of childbirth, sending the women on long dangerous trips down the mountain when they were in the throws of labour. Needless to say, this is not portrayed in a positive light in McKay's novel.
But The Birth House is as much about Dora Rare's life as it is about the history of maternal health. Dora, victim to her own desires, ends up married to an abusive and often absent man. She does get the child she wants, though, as well as the friendship of many local women. Her story does have a happy ending, although it's a twist I don't want to spoil, and the book ends just at the point that you want to know more about her and how her new life progresses.
Besides her lovely prose, McKay uses newspaper clippings from the fictional Canning Gazette, advertisements, letters, journal entries and homeopathic remedies to both tell Dora's story and give the wider context for the world she's living in. Really, McKay gives a layered history in The Birth House, on the one hand, she describes the developing science of gynecology and on the other she ties Dora's life to some of the major east coast events of the time: the Halifax Explosion and the Boston Molasses Flood.
But despite all the history KcKay bases her story on, the real focus is Dora and the village of Scots Bay. McKay lives in Scots Bay and based the story on the heritage home she moved in (formerly the home of the community midwife). Her connection to the area runs pretty clearly through her descriptions and it adds an extra level of realism to a novel that seems steeped in beautifully rendered research.
The Birth House
by Ami McKay
First published in 2007 (cover image shown from RandomHouse edition)