Childbirth: Fiction’s Overlooked Drama

Pamela Erens, Eleven Hours

Atlantic, 176pp, £12.99, ISBN 9781782399797

reviewed by Melanie White

Historically, war has supplied the ultimate proving ground for men: it’s arguably the most challenging test of strength and character, not to mention survival. In cultures the world over, this rite of passage has proclaimed that boys would engage in battle and emerge as men. For women, the equivalent is surely childbirth, especially in the days before modern medicine. Childbirth was once so dangerous that women in Renaissance Italy, for example, would promptly prepare a will upon discovering their pregnancy. Now, there may be dilemmas of different sorts (Vaginal or caesarian? Drugs or no drugs? Water birth or hospital bed?), but what to do in case of maternal death rarely figures in the birth plan.

This is the one potential outcome overlooked in the meticulous birthing document prepared by Lore, the main character in Pamela Erens’ third novel, hyper-focused childbirth drama Eleven Hours. In keeping with the adage about best-laid plans, Lore’s vision of drug-free natural labour does indeed go awry. With all the potential for crises, pain and danger inherent in giving birth, it’s truly bemusing that so few novelists have chosen to explore the subject. There are many, many novels about war; why so few about childbirth, when it offers so many dramatic possibilities?

A handful of novelists have written memorable birth scenes, but none as far as I’m aware have composed entire novels around the subject. The most notable scene, perhaps, features in Margaret Atwood’s The Handmaid’s Tale. In that novel’s dystopian future, infertility is pandemic and fertile women are forced to breed. Janine, one such woman, gives birth amid the chanting of her fellow handmaids:

Now Janine is restless, she wants to walk. The two women help her off the bed, support her on either side while she paces. A contraction hits her, she doubles over. One of the women kneels and rubs her back. We are all good at this, we've had lessons. […] The soft chanting envelops us like a membrane.

In some respects, despite the nightmarish context of coercion, Janine ends up better off than Erens’ Lore. Armed with a rigid determination and a birth plan that suggests an attempt to make a contract with fate, Lore enters the hospital a single-mother-to-be, her partner having defected back to an ex-girlfriend. She embarks on the ensuing battle with her own body and the torments of her mind alone but for the support of (and increasingly mystical connection with) a Haitian nurse on the labor ward, Franckline.

Erens quite brilliantly milks childbirth’s inherent agony and unpredictability to build a suspenseful tension that rivals any literary thriller, but the more deeply compelling aspect of her novel stems from her acute powers of characterisation. Her two central characters are equally fascinating, each harbouring secrets that remain unspoken yet forge a psychic bond of sympathy between the two. Erens dips from one character’s mind into the other’s, interweaving their troubled pasts with the present drama to unfurl one seamless, absorbing narrative that explores the nature of our connections with others alongside the uniquely female experience of bringing new life into the world.

The complexity of her characterisations stems from a psychologically insightful ability to come up with succinct, telling detail, as with Lore’s first impression of her erstwhile friend, Julia:

Lore had never known anyone who behaved the way Julia did, who went directly to the important thing, and enabled you to talk about it too. So that you never wanted to go back to the ordinary type of conversation, which was all mask, all a way of never figuring out what really wanted to be said.

The embedded irony here is that, of all the characters in the book, Julia is the one most certainly wearing a mask.

Erens’ powers of observation extend well beyond characterisation, sharply conjuring everything from setting to action. A suddenly empty hospital room, for example, strikes Lore as ‘a parking lot of steel and chrome.’ At one point, Franckline gives Lore ice cubes: ‘Sucking now, numbing her mouth, she draws a drop from an ice shard, holds it like a cold jewel, then swallows.’ Erens’ sentences are frequently beautiful in their precision and loaded in their evocation of emotional subtext.

As for the physical drama, Erens details the progress of Lore’s labor unflinchingly. At times, Lore would ‘like to be still but she can’t; the pain is in charge, filling her eyes with sparks.’ Eventually, as the time between contractions narrows, fate throws its wrench into Lore’s birth plan and we are confronted with ‘flesh, fat, fascia, blood,’ the gritty, teeth-clenching business of birth. (Erens’ names sometimes make pleasingly pointed allusions: that of Dr Merchant suggests the commercialised nature of a hospital birth, while Lore’s own name refers to the abundance of myth surrounding this most fundamental life, and life-giving, experience.)

Erens’ previous book, the heavily garlanded 2013 novel The Virgins, marked her out as that rare type of literary crossover: a writer who achieves critical acclaim without sacrificing the pleasures of a compulsive story. In that, she might be compared to authors like Jennifer Egan or Donna Tartt, though her focus tends to be far tighter than the latter’s. The fact that it has taken so long for a novelist to explore childbirth in this depth may be surprising, but that a writer of Erens’ considerable talents has tackled the subject at last partly makes up for the wait.