Death in childbirth has long been a favorite fictional plotline, most recently bringing shocked viewers to tears in Sunday's episode of Downton Abbey, when Lady Sybil apparently suffered "toxemia of pregnancy" (what we now call eclampsia), after giving birth to her first baby.
Lady Sybil joins a long line of mother characters who have fallen to a similar fate, from Padme Amidala gasping her last while giving birth to Luke and Leia to Demi Moore giving up the ghost in the howlingly dreadful The Seventh Sign.
Jane Austen didn't live through our modern-day examples, but she mocked the convention as early as 1818, saying that Northanger Abbey's heroine, Catherine Morland, didn't have the makings of a heroine because:
Her mother was a woman of useful plain sense, with a good temper, and, what is more remarkable, with a good constitution. She had three sons before Catherine was born; and instead of dying in bringing the latter into the world, as anybody might expect, she still lived on.
Indeed, characters as diverse as Snow White and Lord Voldemort had mothers who died giving birth to them. The death of a mother so early in a child's life means, in literary terms, that there is considerable adversity to be overcome; that the child will struggle to make his or her way in the world; that, often as not, he or she will carry some sort of guilt or sadness. In other words, it heightens drama.
I'll confess I don't have much patience for this plot device, but not just because it's overused. Birth itself is dramatic enough when portrayed faithfully that it doesn't need to be amplified by killing off Mom. (Maybe the Downton writers could talk this over with the writers from PBS' other British import, BBC's Call the Midwife?)
The best 3D ultrasounds in the world can't diminish the fact that before birth, a baby is fundamentally unknown to her parents, while after birth, she is present to them in a completely different way. This, I think, is why Jesus and Paul liken the expectation of God's kingdom to the birth of a child: birth is hard, painful work, and while you have a dim expectation of the joy that awaits on the other side of that pain, when the baby finally emerges, it is like nothing you have ever seen or encountered before. Looking into the face of a freshly emerged baby is surprising and yet, in a way that's hard to explain, familiar. I can only think that the New Creation will be something like this. Jesus and Paul seemed to say it would. Birth is drama of the best kind.
The "death-in-childbirth" device also confirms an understanding of the female body as dangerous and diseased. Yes, women do face injury and sometimes death in the process of giving life, but that's the exception. Even when maternal mortality rates were many times what they are today, the vast majority of births ended well. One of the best pieces of documentary evidence available to us on childbirth in early America—the diary of midwife Martha Ballard of Maine (1785-1815)—lists just a single maternal death in nearly 2,000 births.
Of course, suspenseful plots depend on things going wrong. But does the drama always have to come from a woman's body malfunctioning in some way? Can't we get a little narrative confirmation for all the millions of times the body gets it exactly right? It's like all the movie plot lines centering around plane crashes, when all the while you're more likely to die in a car crash on the way to the airport. The dying-in-childbirth device exaggerates risk and unwittingly confirms, for many people, the need to give birth with a surgical crash-team in the next room.
That, for me, is the rub. Americans have great faith in the power of medical science, but lack faith in women's bodies to get the job done. Our fears are confirmed by the many fictional plotlines that kill off the mother to crank up the drama.
In reality, despite having some of the highest rates of medical induction and c-section in the world, and despite the fact that dying in childbirth is still a very remote possibility for most American women, rates of maternal mortality are higher today than they were in the late 1970s. American women are five times more likely to die in childbirth than women in Greece, and 40 other countries are ahead of the U.S. in terms of maternal health.
What's more, "near misses"—complications that nearly result in death—have increased 25 percent since 1998. Women who are poor, who are African American, who are Native American or who do not speak English are the ones most likely to die or to face grave complications. Some attribute these modern-day deaths and injuries to the overuse of medical technology. For example, a woman is as many as three times more likely to die from a caesarean.
Responding to rising maternal mortality doesn't mean advocating one kind of birth over another—it's a complicated problem requiring a multi-faceted solution. Still, with birth and new birth so near the heart of our faith narrative, Christians need to embrace maternal health, here and abroad, in real life and on our TV screens, as an issue of our common good.