In her essay “On Being Ill,” Virginia Woolf complains that English literature has failed to find words for the experience of a headache. “English,” she writes, “which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache.” I thought of her essay often when I was pregnant for the first time and after labor, when I found myself reflecting that the problem she described still persists, and no more so, perhaps, than when it comes to childbirth.  

My own experience of pregnancy was not easy. The most important fact, for me, about the years I spent pregnant is that they produced two wished-for and miraculous babies. But I will also be reckoning, for a long time, with the aftershocks of their physical realities. I was pregnant four times in four years and gave birth to two babies. There were also miscarriages and hemorrhages; migraines and months of crippling nausea; four surgeries and hundreds of blood draws; a neural puncture and a proliferation of tumors.  

During those years, I looked to novels to help me understand and to give me company, as I had through so many other phases of life—falling in love and out, getting married and getting divorced. Time and time again, however, as I turned through the pages of the novels I loved, I was struck by the shortage of attempts to represent the experience of giving birth. There are, of course, exceptions. In my search for literary company, I found a tradition of novels describing labor from the perspective of a male character, from Leo Tolstoy’s Anna Karenina to Karl Ove Knausgaard’s My Struggle. In these depictions, the experiences range from comic to frightening, but we always see the woman undergoing it. We laugh at her and fear for her rather than inhabit her experience.

“How can other people know what they are asking of us, what we endure in the course of childbirth, if there are no words to describe it?”

There is a labor scene in Margaret Atwood’s The Handmaid’s Tale that is often described as horrifying, but it, too, is narrated from the perspective of someone other than Janine, the woman giving birth. Janine’s experience is held at a remove while our narrator and the other handmaids gather around her, hold hands, whisper among themselves and drink grape juice. It is a horrifying scene, but not because we are given to feel what Janine is feeling; it’s horrifying, instead, precisely because Janine’s experience is set off to the side. What she endures is not the main event—not while she’s giving birth and her individual experience is transformed into a collective ceremony, and not after, when her baby is handed off to the wife of a commander.

In novels that do describe the experience from the perspective of the person giving birth, the experience is often startlingly short. In Toni Morrison’s Beloved, Sethe gives birth over the course of a page. Her water breaks, she has a contraction, the head comes out, the afterbirth follows. In Those Who Leave and Those Who Stay, Elena Ferrante dispatches the experience even more quickly. Lenu’s first childbirth is summarized in a sentence: “I had atrocious labor pains but they didn’t last long.” The second childbirth gets two: “Everything went smoothly. The pain was excruciating, but in a few hours I had another girl.” In Yuko Tsushima’s Woman Running in the Mountains, a book about what it means to give birth to a child, labor is skipped over entirely. On one page the protagonist is nine months pregnant; on the next, five days later, she’s in the hospital and her baby has been born. All three of these novels are breathtakingly granular about other aspects of their protagonists’ physical and psychological lives. They are novels by writers I’ve turned to time and time again to clarify other modes of existence. And yet, when it comes to labor—or the pregnancy that precedes it—they seem to turn away.  

Read our starred review of Reproduction.

Why would this be the case? Part of the challenge in describing pregnancy and childbirth must be that it involves so much pain and sickness, and as Woolf describes it in “On Being Ill,” those states are notoriously hard to describe. “Let a sufferer try to describe a pain in his head to a doctor,” she writes in a sentence that must resonate for anyone who has ever been to a doctor, “and language at once runs dry.” Elaine Scarry expands on this point in The Body in Pain, her seminal monograph on the subject, which establishes first the inexpressibility of pain and second the political complications that arise as a result. Pain, she says, is defined by the fact that it cannot be expressed. “When physical pain is transformed into an objectified state,” she writes, “it (or at least some of its aversiveness) is eliminated.”

But why, in that case, don’t more writers try? If pain is eliminated by the act of expressing it, why wouldn’t more people who have given birth write about labor? Perhaps another part of the problem is how conditioned we are to focus on the aftermath of pregnancy—the miraculous child born as a result—as opposed to what we risk and endure, as though to give voice to the pain involved in giving birth is to unnaturally or ungenerously deflect from the miracle of the new life that follows. This conditioning both produces a shortage of language for the experience and is reinforced by the same shortage. How can other people know what they are asking of us, what we endure in the course of childbirth, if there are no words to describe it? And if they don’t know, how can they work to change our culture’s refusal to acknowledge the price of pregnancy?  

“I wanted to write a pregnancy book of my own, a labor book of my own, that fully embodied the pain and the sickness involved and held it side by side with the sweetness of a new baby.”

For some of us, pregnancy is a happy state. For many of us, however, pregnancy and labor involve not only sickness and pain, but sickness and pain that last for a very long time. They involve season upon season of an experience that longs to be expressed and can’t, and therefore confines the person experiencing it to a long state of transforming loneliness. Trapped in that state, as I felt myself to be when I was pregnant, I wished for examples of the kind of language that would transform pain into something else, but as I moved through the books on my shelves, the only example I could find that approached the length and intensity of what I was experiencing was the example of the creation in Mary Shelley’s Frankenstein, which, as Victor Frankenstein describes it, takes season upon season to unfold, requires superhuman efforts from the body of the creator, and leaves him so sick that it takes months for his fiancée to nurse him back to health.  

This “labor,” as he repeatedly calls it, is grueling and long, not only for Victor but also for the reader, who must wade through seven remarkably repetitive pages about bodily unraveling—the process involves “charnel bones,” “eyeballs . . . starting from their sockets,” “the unhallowed damps of the grave,” “a slow fever” and nerves aggravated to a “most painful degree”—in order to get to the moment when new life arrives. The language, in its brutal repetitions of grotesquerie, seems to be attempting to approximate the feeling of what it represents.  

At the same time, however, Victor insists that he is incapable of expressing the physical sensations involved in his labor. “No one can conceive of the variety of feeling which bore me onwards,” he says in one paragraph; in the next paragraph he asks, “who shall conceive the horrors of my secret toil?” The painful and isolating fear that he will not be able to accurately communicate his agony is there, but so is the desire that the reader should feel it as a “conception,” as their own process of painfully creating life. The hope, then, is that language could so fully embody a pain that it could transmit it to the reader.  

Reading these pages, I felt I had finally found it: the labor scene I was looking for. And yet, of course, the person laboring is a man, and what he makes isn’t a baby. Did Mary Shelley, who wrote Frankenstein after two labors of her own, one of which produced a child who died after two weeks, feel that the only way she could include a labor scene in literature was to make it a man’s? Did she feel that her readers would be unwilling to conceive of such pain if they imagined it took place in a woman’s body? Did she feel that the only way to allow her character the luxury of dwelling on pain long enough to describe it was to remove the idea of a miraculous baby?  

These were the questions I asked myself when I began to write Reproduction. I wanted to write a pregnancy book of my own, a labor book of my own, that fully embodied the pain and the sickness involved and held it side by side with the sweetness of a new baby. I wanted to find a language not only for the headaches and the shivers but also for the contractions and the nausea, a language that attempted, at least, to transmit my experience of pregnancy.

Photo of Louisa Hall by William Callahan.