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Representing childbirth in literature: from third to first person

What matters in representing childbirth in literature is making it visible. In a literary tradition in which the male experience has long been the main reference for any sort of human experience, childbirth as a life event has often been kept silent, relegated to the margins of discourse, like many typically female experiences such as puberty, pregnancy or menopause. In self-life writing written by men the main foundational event is often the first sexual experience, and if we go back earlier in time, participation in the war. Childbirth has only recently become an object of literary representation in its own right.

We can nevertheless observe two main dividing lines in recent literary history. One is chronological: while we do find some representations of childbirth in 19th and 20th-century literature, it really became a prominent subject in the 21st century with the memoirs written by Rachel Cusk (2001) and Maggie Nelson (2015) as prime examples. The other dividing line runs along genres: childbirth still remains underrepresented in fiction, but it is more often to be found in autobiographic prose and poetry.

First, female writers needed to break from the strictures of medical discourse, which has colonised the way childbirth was represented, (see Adrienne Rich on the topic) and has kept women in a position of passivity, as objects to be observed. For Tess Cosslett1, who has worked on the representation of childbirth in English-language writing, medical discourse is hard to shake off: whether it is appropriated or rejected, female writers are constantly trying either to avoid it, subvert it, or make do with it. It’s almost impossible to study childbirth as a literary event without studying the relationship between the text and medical discourse, and similarly between the woman in labour and the hospital as an institution.

Making childbirth acceptable

In an article published in The Guardian, British author Jessie Greengrass wonders why so few pregnant women are represented in literature – which reminds us of the question asked by Marie Darrieussecq on the back cover of her motherhood memoir Le bébé (2013). In an article entitled “Childbirth in literature”, Carol Poston2 also tries to understand why such an overwhelming life experience is so rarely described in literature. The main reason, according to her is that the experiences of women are not considered as having a universal, and for that matter a literary, value. Because it is so closely related to sexuality, childbirth reveals the remnants of animality in the human experience, and for a long time, it was the reason why it was kept away from what deemed acceptable in literary experience. Even though the taboo on sexuality was lifted in 20th-century literature, childbirth remained clouded in mystery. She also showed that, in order for this event to be integrated in a literary representation of human experience, it was often described from the point of view of an outside observer. This was mostly true of literature written before the 20th century, but it has had an impact ever since. When the scene of childbirth is not simply eluded, it is described from a distance, or from an ajdoining room – just think of the childbirth scene in Anna Karenina (1877), which is mainly experienced by the protagonist Kitty’s husband Levin as a brutal, inhuman event. In Charlotte Perkin Gilman’s The Yellow Wallpaper (1892), which describes the main character’s post-partum depression, the scene of childibirth, as well as the baby herself, remain outside of the field of representation.

The first direct representations of childbirth appear in 20th-century literature, but even then, it is often narrated by a thid party: a relative, a nurse or a doctor. As Maria Kreppel3 remarks in her article, while it is common to read first-person accounts of a character’s death, it is hard to find first-person narratives of women giving birth, even in the modernist period. In general, the privileged point of view is that of the doctor, and the medical instution in its broader definition. The medical discourse which is used to describe childbirth makes it rational and removes its subversive edge. British sociologist Ann Oakley4 has shown how the takeover of medical discourse has served to “socialise” childbirth, that is, place it on the side not of nature but culture. Adrienne Rich has studied the way obstetrical discourse literally alienated women from their own experience of childbirth by substituting their words with those of science. Tess Cosslett says

As a central, life-changing event for many women, childbirth needs to be made visible, written about, from a woman’s perspective. Too often, the story has been taken away from women by the ‘audience perspective’ accounts of fathers, or more influentially, doctors. A ‘medicalised’ version of childbirth, in which women are objectified as machines for producing babies, has become increasingly dominant in the twentieth century. This medical discourse has taken institutional shape in the routines of hospitalised birth. Medical versions of childbirth reduce the woman to an object: to restore her subjectivity is the aim of the women writers in this study.

Tess Cosslet, Women Writing Childbirth, 2

Literary representation is in a way “tainted” by medical discourse, which imposes its point of view: what is true in the life of women is also true in writing. This became especially true when the midwife was replaced by the doctor as the main protagonist in childbirth: as an event, it is described from the outside by a patriarchal medical institution. Women are observed giving birth lying on their backs in a medicalised environment, and that is the reality most female writers will have to contend with.

Looking at oneself from the outside

As Maria Kreppel shows, the first representations of childbirth in canon literature can be found in male authors’ work: with Laurence Sterne, in Tristram Shandy(1759), and closer to us James Joyce, Ernest Hemingway ou DH Lawrence. In their narratives, childbirth is represented as a bestial, alienating experience during which women are denied any form of agency. Only in the middle of the 20th century, did childbirth begin to be represented in literature written by women, specifically in A proper marriage by Doris Lessing (1954) and The Bell Jar by Sylvia Plath (1963). Those two novels, which have largely been shown to be autobiographical, both present the story of young women trying to break free from the social constraints of their environments. Both are promised a domestic future which they want to escape, one by choosing to join the Communist party and the other by becoming a writer. In those two novels, childbirth is experienced as a profoundly humiliating event. It is to be noted that in both Lessing and Plath’s novels, the event is represented from a distance by a third-person narrator.

In A Proper Marriage by Doris Lessing, Martha Quest experiences childbirth as a form of failure, as well as a splitting of the self

There were two Marthas, and there was nothing to bridge them. Failure. Complete failure. She was helpless with rage. She heard the pain-gripped Martha cry out, ‘Oh God, Oh God!’ and she was curious at the ancient being in her that cried out to God. Damned liar, coward, idiot! said Martha to herself from across the gulf. It only needs that you should call out ‘Mother!’ And behold, Martha, that free spirit, understood from the exquisite shore of complete, non-sensation that she had been groaning out ‘Mother, Mother, Mother!’

Doris Lessing, A Proper Marriage, 147

The character of Martha, though she is a self-proclaimed “free spirit” can see herself giving birth and crying out for help, but she doesn’t seem to be able to experience first-hand; she becomes a character of a narrative within the narrative. For Tess Cosslett, this splitting of the self is a direct consequence of the way medical discourse took over childbirth: the mother adopts the medical gaze which makes her an object to be observed. The account of Martha’s childbirth mostly revolves around her attempts to resist the normalising discourse of the medical institution, embodied by the doctors but also the nurses. In her autobiography, published in 1994 and entitled Under my Skin, Lessing relates the memories of her three deliveries in a South Rhodesian hospital in the 1950s. She talks about how she was humiliated by the medical staff, and specifically the matron, who wouldn’t let her see her baby right after he was born. But when it came to describing the moment of childbirth itself, she chose to refer the readers to her fictionalised account in A Proper Marriage, as if it were to remain and third-person event.

In The Bell Jar, Esther Greenwood, the heroine of the novel, isn’t the one giving birth in the childbirth scene, although at the time she wrote the novel, Sylvia Plath had already had that experience. Esther is brought by her boyfriend, a medical student, to watch a delivery, and on that occasion she is horrified by the ordeal of a woman who is dehumanised by the (male) doctors, and whose voice is reduced to bare groaning. Compared to an “enormous spider”, she seems to be pinned down on her bed like Kafka’s monstrous insect. Esther’s boyfriend does try to warn her against this vision: “‘You oughtn’t to see this,’ Will muttered in my ear. ‘You’ll never want to have a baby if you do. They oughtn’t to let women watch. It’ll be the end of the human race.’’ (47). For Carol Poston, this exchange shows how much the main character has integrated the exteriorised gaze of the patriarchal medical institution: just like her medical student of a boyfriend, Esther watches the woman give birth from a distance and is appalled by what she sees. Of course, this position allows Plath to express how revolted she is at the way women’s bodies are treated by the medical institution.

Speaking in the first person

Finally in the last few decades, childbirth started being represented in the first person, specifically in motherhood memoirs such as A Life’s Work: On Becoming a Mother by Rachel Cusk (2001), which has become a classic. Closer to us The Argonauts by Maggie Nelson (2015) has allowed to start a new reflection over motherhood from a critical as well as autobiographical point of view, in the context of a queer family. There have been other first-person accounts of childbirth (for example in Jane Lazarre’s 1976 memoir The Mother Knot), but I thought it would be interesting to dwell on those two accounts which pose new questions about the representation of childbirth in autobiographical literature.

Rachel Cusk’s autobiographical account of her first years as a mother, A Life’s Work caused quite a stir in the media when it came out. She was accused of having represented her experience of childbirth and early motherhood as a succession of painful ordeals, against the grain of the usual representation of motherhood as unmitigated bliss (see her article on the topic). The real scandal, it seemed, was that she told her own story in the first person, and not through the narrative of a third-person observer. In Cusk, childbirth (and pregnancy for that matter) is experienced as a series of constraints and loss of agency, particularly because she was forced to renounce her dreams of home birth in favour of a C-section, arguably the most medicalised type of delivery. As she is giving birth, the first-person narrator is pitted against a hostile “they” representing the doctors and the nurses who are seizing upon her body.

There is some tugging and pushing and wiggling, which I feel through a thick blanket of anaesthetic. Everyone is talking. A radio is playing and a man is singing along to the music. The woman goes away. I can see my own face reflected in the broad lamp above me. I look at the clock and see that only ten minutes have passed since I left the ward. What’s happening? I say. My voice sounds preternatural coming out of my dead body. I fear suddenly that I have been forgotten, that I am going to be left dismantled, a talking head on a table. I fear that my soul is being uncaged and allowed to fly away. Nobody replies to my question.

Rachel Cusk, A Life’s Work, 31

The representation of the self being split is reminiscent of Doris Lessing’s account, with a voice losing its mooring, ready to leave its body on the operating table. The narrator gives birth surrounded by the noise made by the doctors and nurses, which she perceives as intrusive and leaving no space for intimacy. This account can be contrasted with Maggie Nelson’s in The Argonauts, in which childbirth is experienced as a personal exploration (like Jason and his Argonauts) through which she is accompanied by her midwife, who acts as an intercessor between her and the medical institution.

Commotion. I am gone but happy, something is happening. The doctor rushes in, I can see him throwing on his gear: a visor, an apron. He seems agitated but who cares. New lights come on, yellow, directed lights. People around me are moving quickly. My baby is being born.
Everybody is watching down there intently, in a kind of happy panic. Someone asks if I want to feel the baby’s head, and I don’t, I don’t know why. Then a minute later, I do. Here he comes. It feels big but I feel big enough.

Maggie Nelson, The Argonauts, 165

There is some agitation, but it is joyful, like a happy pantomime playing around the mother, who is at centre of her experience and the relation with her baby. The narrator is present, grounded within her body, in touch with her sensations and with the baby being born, while the doctor is busying himself by her side. The experience being told here is definitely intimate, and that is made possible by the absence of conflict with the medical institution, and ultimately, within herself


Although I mostly chose to study texts in prose, it is interesting to know that there are many other examples to be found in poetry. Several anthologies and even poetry collections deal with the experience of motherhood and childbirth, with authors like Toi Derricote (Natural Birth, 1983), Kathleen Jamie (Jizzen, 1999) or even Liz Berry (The Republic of Motherhood, 2018). The tension with the medical institution is also present, but verse allows to extract the narration from a linear representation of childbirth in order to make it a more impressionistic experience. The senses and impressions are blended in accounts which are really intimate renderings of this universal experience. Yet can childbirth really be considered as a universal experience? I would like to think so.

  1. Cosslett, Tess. Women Writing Childbirth: Modern Discourses of Motherhood. Manchester, Manchester University Press, 1994.↩︎
  2. Poston, Carol H. ‘Childbirth in Literature’. Feminist Studies, vol. 4, no. 2, June 1978, pp. 18–31.↩︎
  3. Kreppel, Maria. ‘Books I’ve Read: Crosscurrents in Obstetrics and Literary Childbirth’. Atlantis: Critical Studies in Gender, Culture & Social Justice, vol. 10, no. 1, 1, Oct. 1984, pp. 1–11.↩︎
  4. Oakley, Ann. ‘A Case of Maternity: Paradigms of Women as Maternity Cases’. Signs: Journal of Women in Culture and Society, vol. 4, no. 4, July 1979, pp. 607–31.↩︎

Cite this blog post
Alice Braun (2022, June 16). Representing childbirth in literature: from third to first person. Mothers and writers. Retrieved May 22, 2024, from

By Alice Braun

Maîtresse de conférences en anglais à l’université Paris Nanterre/Senior lecturer in English at the Paris Nanterre university.

3 replies on “Representing childbirth in literature: from third to first person”

Thank you for this! Having gone through 2 very different home births myself, I’d recently decided to try my hand at writing a fictionalized yet still realistic account. First I thought I’d read a few. I searched and found so very little! While searching for an explanation I found my way here. This was a much needed and informative read. I’m more determined than ever to write a thoughtful, gripping yet authentic experience!

I am very glad you have found this post useful. I hope it brings inspiration to your writing!

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