Midwives (Bohjalian)

Midwives 
Chris Bohjalian, 1998
Random House
372 pp.
ISBN-13: 9780375706776


Summary
In the pastoral community of Reddington, Vermont, during the harsh winter of 1981, Sibyl Danforth makes a life-or-death decision based on fifteen years of experience as a respected midwife—a decision intended to save a child, a decision that will change her life forever.

In the midst of a brutally cold night, cut off from the area hospital and even from the rescue squad by an ice storm that has downed phone lines and made roads impassable, Sibyl Danforth feels she has no alternative except to attempt to save the baby of a woman in her care who she fears has died of a stroke during a long and difficult labor.

Later that day, however, the midwife's assistant tells the police that she believes the mother was still very much alive when the cesarean section was performed in the cold and isolated farmhouse.

The story of this tragedy and its aftermath is narrated by Sibyl's daughter, Connie, now an obstetrician, who is remembering the events that occurred the year she turned fourteen, when her mother's freedom and her family's fate rested in the hands of twelve men and women. (From the publisher.)

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Author Bio
• Birth—1960
• Where—White Plains, New York, USA
• Education—Amherst College
• Awards—Anahid Literary Award, 2000; New England Book Award, 2002
• Currently—lives in Lincoln, Vermont

Christopher Aram Bohjalian, who goes by the pen name Chris Bohjalian, is an American novelist. Bohjalian is the author of 15 novels, including New York Times bestsellers Midwives, Secrets of Eden, The Law of Similars, Before You Know Kindness, The Double Bind, Skeletons at the Feast, and The Night Strangers.

Bohjalian is the son of Aram Bohjalian, who was a senior vice president of the New York advertising agency Romann & Tannenholz. Chris Bohjalian graduated summa cum laude from Amherst College, where he was a member of the Phi Beta Kappa Society. In the mid-1980s, he worked as an account representative for J. Walter Thompson advertising agency in New York.

He and his wife lived in a co-op in Brooklyn until March 1986, when the two were riding in a taxicab in which the driver refused to let them out of the car for 45 minutes, ignoring all traffic lights and stop signs. Around midnight, the driver dropped them off at a near-deserted street in front of a crack house, where the police were conducting a raid and Bohjalian and his wife were forced to drop to the ground for their protection. The incident prompted the couple to move from Brooklyn; Bohjalian said, "After it was all over, we just thought, "Why do we live here?" A few days later, the couple read an ad in The New York Times referencing the "People's Republic of Vermont," and in 1987 the couple moved to Lincoln, Vermont.

Early career
After buying their house, Bohjalian began writing weekly columns for local newspaper and magazine about living in the small town, which had a population of about 975 residents. The Concord Monitor said of Bohjalian during this period, "his immersion in community life and family, Vermont-style, has allowed him to develop into a novelist with an ear and empathy for the common man." Bohjalian continued the column for about 12 years, writing about such topics as his own daily life, fatherhood and the transformation of America. The column has run in the Burlington Free Press since 1992. Bohjalian has also written for such magazines as Cosmopolitan, Reader's Digest and the Boston Globe Sunday Magazine.

Bohjalian's first novel, A Killing in the Real World, was released in 1988. Almost two decades after it was released, Bohjalian said of the book, "It was a train wreck. I hadn't figured things out yet." His third novel, Past the Bleachers, was released in 1992 and adapted as a Hallmark Channel television movie in 1995.

In 1998, Bohjalian wrote his fifth book, Midwives, a novel focusing on rural Vermont midwife Sibyl Danforth, who becomes embroiled in a legal battle after one of her patients died following an emergency Caesarean section. The novel was critically acclaimed and was selected by Oprah Winfrey as the October 1998 selection of her Oprah's Book Club, which helped push the book to great financial success. It became a New York Times and USA Today bestseller. Victoria Blewer has often described her husband as having "a crush" on the Sybil Danforth character. In 2001, the novel was adapted into a Lifetime Movie Network television film starring Sissy Spacek in the lead role. Spacek said the Danforth character appealed to her because "the heart of the story is my character's inner struggle with self-doubt, the solo road you travel when you have a secret."

Later career
Bohjalian followed Midwives with the 1999 novel The Law of Similars, about a widower attorney suffering from nameless anxieties who starts dating a woman who practices alternative medicine. The novel was inspired by Bohjalian's real-life visit to a homeopath in an attempt to cure frequent colds he was catching from his daughter's day care center. Bohjalian said of the visit, "I don't think I imagined there was a novel in homeopathy, however, until I met the homeopath and she explained to me the protocols of healing. There was a poetry to the language that a patient doesn't hear when visiting a conventional doctor." The protagonist, a father, is based in part on Bohjalian himself, and his four-year-old daughter is based largely on Bohjalian's daughter, who was three when he was writing the book., Liz Rosenberg of The New York Times said the novel shared many similarities with Midwives but that it paled in comparison; Rosenberg said, "Unlike its predecessor, it fails to take advantage of Bohjalian's great gift for creating thoughtful fiction featuring characters in whom the reader sustains a lively interest." Megan Harlan of The Boston Phoenix described it as "formulaic fiction" and said Bohjalian focused too much on creating a complex plot and not enough of complex characterizations. The Law of Similars, like Midwives, made the New York Times bestsellers list.

He won the New England Book Award in 2002, and in 2007 released "The Double Bind," a novel based on Fitzgerald's The Great Gatsby.

In 2008, Bohjalian released Skeletons at the Feast, a love story set in the last six months of World War II in Poland and Germany. The novel was inspired by an unpublished diary written by German citizen Eva Henatsch from 1920 to 1945. The diary was given to Bohjalian in 1998 by Henatsch's grandson Gerd Krahn, a friend of Bohjalian, who had a daughter in the same kindergarten class as Bohjalian's daughter. Bohjalian was particularly fascinated by Henatsch's account of her family's trek west ahead of the Soviet Army, but he was not inspired to write a novel from it until 2006, when he read Armageddon: The Battle for Germany, Max Hastings' history of the final years of World War II. Bohjalian was struck not only by how often Henatsch's story mirrored real-life experiences, but also the common "moments of idiosyncratic human connection" found in both. Skeletons of the Feast was considered a departure for Bohjalian because it was not only set outside of Vermont, but set in a particular historical moment.

His 2010 novel, Secrets of Eden, was also a critical success, receiving starred reviews from three of the four trade journals (Booklist, Library Journal, and Publishers Weekly), as well as many newspapers and magazines. It debuted at # 6 on The New York Times bestseller list.

His next novel, The Night Strangers, published in 2011, represents yet another departure for Bohjalian. The is both a gothic ghost story and a taut psychological thriller.

He has written a weekly column for Gannett's Burlington Free Press since February 1992 called "Idyll Banter." His 1,000th column appeared in May 2011.

Personal comments
In a 2003 Barnes & Noble interview, Bohjalian offered up these personal comments:

I was the heaviest child, by far, in my second-grade class. My mother had to buy my pants for me at a store called the "Husky Boys Shop," and still she had to hem the cuffs up around my knees. I hope this experience, traumatizing as it was, made me at least marginally more sensitive to people around me.

I have a friend with Down syndrome, a teenage boy who is capable of remembering the librettos from entire musicals the first or second time he hears them. The two of us belt them out together whenever we're driving anywhere in a car.I am a pretty avid bicyclist. The other day I was biking alone on a thin path in the woods near Franconia Notch, New Hampshire, and suddenly before me I saw three bears. At first I saw only two, and initially I thought they were cats. Then I thought they were dogs. Finally, just as I was approaching them and they started to scurry off the path and into the thick brush, I understood they were bears. Bear cubs, to be precise. Which is exactly when their mother, no more than five or six feet to my left, reared up on her hind legs, her very furry paws and very sharp claws raised above her head in a gesture that an optimist might consider a wave and guy on a bike might consider something a tad more threatening. Because she was standing on a slight incline, I was eye level with her stomach—an eventual destination that seemed frighteningly plausible. I have never biked so fast in my life in the woods. I may never have biked so fast in my life on a paved road.

I do have hobbies—I garden and bike, for example—but there's nothing in the world that gives me even a fraction of the pleasure that I derive from hanging around with my wife and daughter.

He lives with his wife and daughter in Lincoln, Vermont, where he is active in the local church and the Vermont theater community—always off-stage, never on.

Writing style
Bohjalian novels often focus on a specific issue, such as homelessness, animal rights and environmentalism, and tend to be character-driven, revolving around complex and flawed protagonists and secondary characters. Bohjalian uses characteristics from his real life in his writings; in particular, many of his novels take place in fictional Vermont towns, and the names of real New Hampshire towns are often used throughout his stories. Bohjalian said, "Writers can talk with agonizing hubris about finding their voices, but for me, it was in Vermont that I discovered issues, things that matter to me." His novels also tend to center around ordinary people facing extraordinarily difficult situations resulting from unforeseen circumstances, often triggered by other parties. (From Wikipedia.)

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Book Reviews
Superbly crafted...powerful. It will thrill readers who cherish their worn copies of To Kill a Mockingbird.
People

Among the many achievements of this gripping, insightful novel is the remarkable fullness with which Bohjalian (Water Witches) writes about both the physicality and the spirituality of childbirth.

OB/GYN physician Connie Danforth looks back on the events of a wrenching summer when she was 14 and her mother, Sibyl, a Vermont midwife and ex-hippie with a "distaste for most traditional and institutional authority," was on trial for murder. Sybil has successfully home-delivered more than 500 babies, but one freezing March night, the phone line down and the roads impassable, the laboring woman she is attending suddenly suffers what appears to be a fatal stroke. Sibyl saves the child with an emergency C-section only to find herself arrested after her assistant tells police that the operation was performed on a still-living woman. Is there, in fact, blood on Sibyl's hands? Or is she just a target of the hostile New England medical community, whose persecution of midwives dates back to the 17th-century expulsion of Anne Hutchinson from the Massachusetts Bay? As Connie wrestles with increasing doubts about whether or not her mother acted correctly, the Danforth family struggles to remain intact in the face of community ostracism and unrelenting media scrutiny.

Readers will find themselves mesmerized by the irresistible momentum of the narrative and by Bohjalian's graceful and lucid, irony-laced prose. His warm, vivid evocations of child-bearing capture the wonder and terror of bringing a baby into the world. With acutely sensitive character delineation, he manages to present all the participants in this drama, from the family members to the grieving widower, as complex, fully realized individuals. This is a story with no obvious villains or heroes, which only renders the tragedy all the more haunting.
Publishers Weekly

Bohjalian (Water Witches, 1995, etc.) blends some provocative moral, medical, and political issues into a classic coming-of-age story in this To Kill a Mockingbird-like reminiscence of the murder trial of a midwife, as witnessed by her teenaged daughter.

From the day back in the '60s when Sibyl Danforth stepped forward in an emergency to help a pregnant friend give birth, she fell in love with the birthing process and dedicated herself to a calling as a lay midwife in rural Vermont. But as her obstetrician daughter, Connie, points out, Sibyl never bothered to obtain certification from the American College of Nurse-Midwives. Still, neighbors who wanted to have their babies at home felt comfortable calling on her. Among Sibyl's patients in 1981, the year Connie turned 14, was a minister's wife named Charlotte Bedford, a fragile woman whose incredibly difficult labor led to a stroke and what appeared to be Charlotte's death. Prevented by a heavy snowstorm from getting Charlotte to a hospital, Sibyl frantically tried to save the baby's life by performing an emergency cesarean on the presumably dead woman. Only after Charlotte is carted away does the question arise: Was the woman actually dead when Sibyl cut her open? In a strong, ruminative voice, Connie re-creates that terrible year when the state's attorney, Charlotte Bedford's family, the local medical community, and even members of the Danforths' small hometown seemed to conspire to put not just Sibyl but the entire practice of home birthing on trial. Connie, fearing witch-huntstyle reprisals, eventually broke the law to protect her beloved mother's freedom. But the question remains: Did Sibyl kill Charlotte for the sake of her baby?

Rich in moral ambiguity, informative to a fault on the methods and politics of childbirth, and perceptive regarding the whipsawing desires and loyalties of a perfectly normal teenaged girl: a compelling, complex novel and the strongest yet from the talented Bohjalian.
Kirkus Reviews

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Discussion Questions
1. By the time Sibyl was of college age, her daughter says, "She had already developed what was then a popular distaste for most traditional or institutional authority" [p. 31]. How does Sibyl continue to maintain an "anti-establishment" stance throughout her life? How does the legacy of the sixties continue to shape the lives, and the self-images, of Sibyl, Rand, and Stephen?

2. "My mother never came quickly or lightly to the decision that one of her patients should go to a hospital" [p. 62]. Why not? What does the act of home birth symbolize for Sibyl, her patients, and the other midwives?

3. Does Anne Austin do the right thing by calling Dr. Hewitt, or does she act out of hostility towards Sibyl? Why doesn't she call Sibyl before talking to the doctor? Should she have done so?

4. Sibyl notes that bankers, lawyers, doctors, and architects choose to have babies at the hospital rather than at home. What point is she trying to make?

5. Tom compares doctors with "pack animals" [p. 95]. Stephen, at the trial, says, "The whole idea that a midwife can do what they do—and do it better—drives some of them crazy, and so they're persecuting my client" [p. 232]. Are these accusations fair, or unfair, to doctors?

6. After Charlotte's death, Tom says to Connie, "So, they're going to have to blame someone" [p. 101]. Do you think this is true? Is Sibyl blamed because people must blame someone? Should someone be held accountable for every death of this sort, or can some be simply attributed to tragic accident?

7. Sibyl carries Pitocin and Ergotrate in case of emergencies during labor. For a lay practitioner to do so is illegal, "but," as Connie states, "every midwife carried them. My mother wasn't unique" [p. 64]. How does this affect midwifery's position as a natural way of delivery? Does the fact that every midwife does so make it all right, or should use of these drugs be limited, as the law prescribes, to licensed doctors and nurses?

8. How alike, basically, are Rand and Sibyl? Has Rand changed more or less than Sibyl from their hippie days? How compatible is he with Sibyl and what she stands for? Do you see their marriage as essentially happy?

9. Do you think that the relationship that develops between Sibyl and Stephen is simply a flirtation, or is it more than a flirtation? What role do Rand's behavior and attitude during the trial play in fostering this relationship?

10. Some of the male and female reporters who cover Sibyl's trial try to avert their eyes from the breasts of the many nursing mothers in the courtroom [p. 213]. Does this reflect to you an essential discomfort with the human body in our culture? Might such a discomfort explain society's disapproval of people like Sibyl Danforth?

11. In the final analysis, do you think that Sibyl behaves irresponsibly during Veil Bedford's birth? Should she, as the prosecution claims, have been more alert to potential weather problems and to Charlotte's health history? Is she precipitate in performing the cesarean section without checking Charlotte's life signs a final time after Asa and Anne returned with the knife, or is it imperative that she rush in order to save the child's life?

12. Do you believe that Connie makes the right choice in shielding her mother from the law? "My mother's conviction would not bring back Charlotte Bedford. It would merely destroy a second woman," Connie reflects [p. 295]. What about the principle involved? Should Sibyl in fact have been allowed to continue to practice as a midwife?

13. "My choice of profession was neither an indictment of my mother's profession nor a slap at her persecutors," says Connie [p. 143]. Is this true? What does Connie mean when she says that "atonement," "reparation," "compensation," and "justice" entered into her decision to become an obstetrician [p. 303]?

14. Did Sibyl's final diary entry [pp. 309-310] change any of the opinions you formed during the course of reading about the trial? If you had any firm ideas about home versus hospital birth, have they been changed by reading this book? Do you think that lay midwives should be allowed to practice? Would you trust yourself to the care of a midwife, or would you go to a hospital for delivery by a doctor?

15. Connie quotes physicians as saying: "But we've lost our collective memory of the fact that although labor is natural, it's dangerous. Let's face it, there was a time when women and babies died all the time in labor.... A hospital is like an infant car seat: If something unexpected should occur and there's some kind of collision, we have the tools to pull the baby out of the oven" [p. 18]. The midwives argue: "What's the price of attempting to eliminate chance, or trying to better the odds? A sterile little world with bright hospital lights?" [p. 123]. By which of the two points of view do you find yourself persuaded?
(Questions issued by publisher.)

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