Linda L. Layne
New York: Routledge, 2003

Reviewed by Susan E. Bell, A. Myrick Freeman Professor
of Social Sciences, Bowdoin College

Motherhood Lost is an ambitious and richly rewarding book that makes visible and meaningful a subject that, as Linda Layne puts it, is “taboo” in twentieth century U.S. – pregnancy loss – and sets a feminist agenda for scholars and activists in the years ahead. She links her work to a dizzying field of studies, from the obvious (studies of reproduction, science and medicine, death, and social movements) to the less obvious (consumption, consumer culture, and gift exchange, memory and commemoration).

Layne’s analytic strategy is a familiar one to feminists: She brings pregnancy loss from the margin to the center of her analysis and asks what this lens does for understanding the experiences of women. She locates herself in the text in a brief first chapter (“My Miscarriage Years”), endnotes, and points along the way. She had seven miscarriages and two sons (one adopted). Her own narrative of pregnancy losses changed during the fifteen years of listening to, reading, and reciting others’ narratives of pregnancy loss from the beginning to the end of the project.

The book is organized in ten chapters. First, Layne explores the meaning of words (“pregnancy loss” is a lay term, and probably emerged simultaneously with pregnancy-loss support groups). She then traces the emergence of pregnancy-loss support groups in the US during the 1970s, their rapid growth through the mid-1990s (to more than 900), and their decline by the turn of the century (to 700). Layne connects the growth of these self-help groups to the more general trend for mutual aid groups and changing patterns of childbearing, and their decline to the introduction of web-based support (which decreased the need for face-to-face pregnancy loss support) and to more hospital-based support systems. “Pregnancy loss” groups include people who share the experience of not having a baby, everything from an early miscarriage to the death of a newborn baby.

In the second chapter, Layne introduces the three pregnancy-loss support groups in New York and New Jersey where she was a participant observer, which comprise the bulk of the data for her analysis. The three are “ecumenical and include Jewish, Catholic, and Protestant members,” and over-represent second and third trimester and neonatal losses (49, 51). The oldest group, UNITE, was founded in 1974-75 by several nursery nurses, sponsors support groups and distributes a newsletter. SHARE Pregnancy and Infant Loss Support, Inc, was founded in 1977 by Sister Jane Marie Lamb at St. John’s Hospital in Springfield Illinois and also publishes a bimonthly newsletter for 2000+ people. A rabbinical student and a social worker at Mt. Sinai Hospital in New York began a support group of the National Council of Jewish Women in 1982-83. Most of the members and authors of texts in the newsletters are women. Layne cautions here and elsewhere in the book that these three organizations, and the experiences of women in pregnancy-loss support groups, cannot be assumed to represent the experiences of pregnancy loss generally. She rightly points out the class and racial/ethnic limitations of her sample. However, I would have liked to have seen more attention given to this limitation, especially in later chapters where, as she points out, the discourses of gift-giving and receiving, and of memorializing, map closely to Judeo-Christian structures and belief systems, including the use of irony and paradox. What about experiences of women in other religious traditions and in other racial/ethnic or class positions? How might they be different? And how might these differences matter for a feminist understanding of pregnancy-loss?

Chapters 4-9 look carefully at what women (and some men) write and say about their experiences, drawing liberally from the poetry, letters, and photographs published in the newsletters. Together, these chapters establish a vast and deep discourse of pregnancy loss, showing how women (and to a lesser extent men) make lost babies real through material and symbolic means. Pregnancy loss narratives challenge assumptions of linear progress in popular culture and both orthodox and alternative medicines (Chapter 4). Chapter 5 advances feminist scholarship about how a woman’s location influences her experience of fetal-visualizing technologies and pregnancy tests. Most striking is the frequent use of snapshots (of ultrasound images or of dead babies) by mothers and fathers to help prove that a child existed and now is lost. Gift-giving and receiving are also instrumental in the construction of fetal and neonatal personhood and consequently of parenthood.

Chapters 6 and 7 work together, the former exploring the role of consumer goods as gifts and the latter exploring spiritual gifts. Narrative descriptions of baby things are most common, but so are gifts given to a baby after its death, in memory of a baby, or to memorialize a baby. Giving these gifts reinforces dominant constructions of babies but also challenges the prevailing notions about what (or who) qualifies for inclusion in this narrative structure of gift giving and receiving. Paradoxically, pregnancy loss is also depicted as a spiritual gift. The spiritually infused rhetoric of the gift enables women and men to respond to the threats to their identities as moral and capable individuals posed by a failed pregnancy or dead baby. This discourse is particularly laden with Christian understandings and begs for more discussion than Layne gives to it. Are these narratives representative of dominant discourses in the US or are they representative of the three organizations she studied in depth?

Whereas in Chapter 7 the key word is “paradox” in Chapter 8 it is “irony.” Here Layne draws from scholarship about WWI, which explores how soldiers dealt with untimely death and the loss of innocence. Layne depicts and explains how members of pregnancy loss groups come to terms with the irony of things working out unexpectedly: instead of a wanted pregnancy resulting in the birth of a baby, it ends in death. The penultimate chapter explores how the experiences of people losing pregnancies compare with trauma and memory more generally, and how they use consumer culture (memory boxes) and postwar commemorative culture (listing names, lighting candles, etc.) to create and retain memories.

Layne concludes that pregnancy-loss support groups have been successful in making pregnancy loss somewhat more visible and the plight of people suffering pregnancy loss somewhat better recognized. But there is much work still to be done, and she takes feminist scholars and activists to task for reproducing taboos surrounding pregnancy loss. The trick for feminists is to find ways to “acknowledge pregnancy losses without undermining women’s right to terminate unwanted pregnancies, or over-pathologizing pregnancy, or suggesting that women’s only source of values is their reproductive capacity” (246). This is a trick that others have identified but that takes on new meaning after Motherhood Lost. Her calls for a better feminist theory of gestation and the integration of pregnancy loss into the “chronology” of prenatal education and into manuals on pregnancy and birth are clearly connected to her analysis of pregnancy-loss support group narratives and nicely put.

Layne’s treatment of trauma and fetishism is less successful than of gift-giving, commemorating, and personifying. In addition, she uses too few examples outside the US/western Europe to do more than suggest that there are other systems of personifying, remembering, and commemorating lost pregnancies. These weaknesses aside, the book is an excellent addition to the fields of reproduction, kinship, and memory. It would work well in undergraduate or graduate cultural anthropology and medical anthropology or sociology courses.

Susan Bell’s work on women’s health, narrative, and the development of medical technology has appeared in a wide range of social science publications. A long-time feminist health advocate, she is the senior author of “Birth Control” in The New Our Bodies, Ourselves (1984, 1992) and Our Bodies, Ourselves for the New Century (1998). Bell is currently writing a book about the experiences of DES daughters.

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