In Navel-Gazing, her cheekily titled memoir of pregnancy, Jennifer Matesa recounts a conversation with her midwife, Nancy. "Birth will change you," Nancy assures her. "You're not going to be the same after giving birth. This is a big deal."

Having babies has always been a big deal, but medical technology and a culture of choice afford many women the luxury of making a big deal of it. One reason pregnancy assumes such proportions is that Americans expect it to be a planned event. Though worries about biological clocks are still heard often enough, the traditional notion of a "childbearing age" is nearly obsolete, perhaps replaced by the metaphor of motherhood as maternity leave. That is, having babies does not occupy decades of female maturity, but is a project for a discrete slice of time taken off from other (often professional) pursuits. It is "intentional," in the idiom of the day.

A handful of recent books colorfully display these trends in childbearing. Written by professional women—academics, journalists, writers—they are noteworthy for their focus on "becoming" a mother—that is, on pregnancy. All reckon in some way with tensions between feminism and motherhood, simultaneously praising pregnancy and resisting the "essentialist" view of women as biologically determined baby-makers. Bookshelves already groan with works on pregnancy, dispensing advice on adding fiber to the diet, sterilizing formula bottles, and teaching baby to sleep the night. But as these writers justly lament, there is more to say about having a child, and it may be that the only way to get at this is to tell your own story.

Jennifer Matesa worked with a photographer colleague to produce Navel-Gazing. It is a diary with illustrations, mostly of the mother and her belly: pregnancy as a work of art. While the subject of her book began as an "accident," like the babies in several of these books, the notion that pregnancy is a choice so predominates that Matesa holds in reserve the possibility of a first-trimester abortion: "The idea keeps cropping up in the back of my mind that I could have an abortion. It's a relief to know that, if it gets too crazy and I discover that I'm just not cut out to do this, there are ways I could get out of it."

She doesn't abort but instead embarks on an adventure recognizable to many American women. The milestones and minor irritations of pregnancy, like food cravings, clumsiness, prenatal weigh-ins, ultrasounds, and epidurals are familiar enough in popular culture to win laughs in TV sitcoms. Last year, Friends relied on Rachel's (Jennifer Aniston) pregnancy to provide humor and move the story line along, ending the season with a special tear-jerking episode on the birth. The hospital setting of that episode reminds us that birth is usually a medical event in the United States. Academic treatments of American childbirth often excoriate this fact. The standard critique goes something like this: doctors treat the body as a machine, the female body as a defective or pathological one; hospital personnel force needless procedures in labor to keep deliveries efficient, appear indispensable, and generate profits.

Women unhappy with obstetric care can seek out a midwife instead, as Matesa and two of the other writers considered here opted to do. A leading association of midwives, the Midwives' Alliance of North America, describes childbirth as a healthy part of a woman's lifecycle and eschews unnecessary interventions in delivery. As health-care costs escalate, midwifery is gaining support in many quarters as a safe, humane way to handle low-risk pregnancies. Even some obstetricians now share their practices with nurse-midwives. (Births by midwife still make up only a small percentage of the nearly 4 million annual deliveries in the United States, but have risen from a negligible few in the 1980s to about 10 percent by 1998.)

Midwives do not promise an easier labor, since avoiding drugs is part of their model of care, but the treatment they offer seems gentler and more personal. What is so appealing to many women is midwives' respect for natural processes and traditional birthways—which patients can enjoy while knowing that the full arsenal of medical technology awaits in case of emergency. Two market-savvy birth centers in my area north of Boston capitalize on this conflicted longing: one advertises "Bed, Breakfast, & Baby," bringing to mind a kind of English manor for cozy deliveries, and another, a "Birth Cottage," boasts "blending modern day birth with old world charms." Of course, this romanticized image of birth is only attractive when stripped of the olde-worlde danger of death in childbed.

Interest in natural birth sometimes is coupled with desire for spiritual nurture in birth. Indeed, it's striking how readily several of these writers turn to spirituality, even in books not explicitly religious. Matesa doesn't have much use for "all the Catholic indoctrination" she grew up with, but muses over Kathleen Norris' meditations, attends Quaker meetings, and buys her baby a Navajo dream-catcher.

Early modern folk suspected midwives of supernatural powers, even witchcraft; we assume they are at least spiritually sensitive. The classic work of modern American midwifery is Ina May Gaskin's Spiritual Midwifery, and the appearance of a fourth edition reflects growing interest in this approach to birth.

Gaskin's story is a chapter out of the folklore of American counterculture. In 1970, her husband Stephen led a convoy of more than 200 people on a journey across the country. Their caravan of re-purposed schoolbuses traveled from San Francisco to Tennessee, with a few stops along the way to birth babies in parking lots and Dakota blizzards. Settled in their Tennessee commune, The Farm, Ina May taught herself midwifery and started a birthing center. Since then, The Farm has maintained an impressive record for safe deliveries, presiding over 2,028 births by 2000, with a cesarean section rate of only 1.8 percent in contrast to national averages of approximately 23 percent. Ina May, named "the most important midwife in the world" by a scholar of the subject, still "catches" babies and trains others in spiritual midwifery.

But what spirit is this? In places the operation has a Christian flavor. Ina May explains that the commune was founded on the model of Acts 2:44-45, a "church" with husband Stephen "functioning as pastor." Birth is "Holy," she affirms, and women were "designed by God to be self-regulating." But Spiritual Midwifery is a grab-bag of other spirits, too. Gaskin and her husband pay tribute to a Zen master in San Francisco for their enlightenment, Ina May also crediting her awakening to a Capuchin monkey. To her husband she owes "a respect for life force and holiness, [and] how to manage spiritual energy." The book is a period piece of hippie life, with earthy, beaming men and women describing their "telepathic" and "psychedelic" moments in birth. Stephen Gaskin explains that breastfed babies are nourished with "vibrations," that is, "Those sexual love vibrations are a manifestation of the Holy Spirit." Ina May instructs spiritual-midwives-in-training that "each and every birth is the birth of the Christ child," and calls them to take a vow like a yogi, monk, or nun.

Not all midwives understand their art this way, but caregivers with names like MoonDragon, Motherwood, and Mother Earth Birth, with treatments like hypnobirthing and Raindrop therapy, do represent a significant strain of midwifery. Debra Rienstra's Great With Child offers an altogether different way of spiritualizing pregnancy. It is an exceptional book, capturing wonder and joy without being maudlin, theologically grounded without being preachy.

Rienstra, an English professor at Calvin College, opens the book hoping for a third child but a miscarriage comes before the full-term pregnancy of her son Philip. Her experience carrying Philip resembles that of the other writers, but her perspective is different. Pregnancy is not about choice but assent to mystery: a "reckless yes," Rienstra calls it. She stays with obstetricians rather than choosing midwives and finds support for her pregnancy in community and literature. Family, friends, and church members offer help, cook meals, and adjust schedules, thereby paying respect in practical ways to the coming of new life, and showing that "work is love made visible," as a cross-stitch over the author's kitchen sink reminds. Rienstra observes that the changes wrought in the body during pregnancy are preparatory for the love-labors of motherhood. She shows how Christianity illuminates the creaturely experience of having children, calling her work a study in "embodied feminine spirituality."

Scripture, hymns, and medieval mysticism nourish these reflections. Significantly, literature also helps her think through pregnancy. Contemporary women poets appear here, but Rienstra draws heavily from the Great Books: selections from Homer, Augustine, Shakespeare, Spenser, Milton, and others connect the particulars of pregnancy with broadly human predicaments. Rather than a concern for women alone, childbearing amplifies themes integral to human life and central to classic literature.

While Great With Child is a book on pregnancy by an academic woman, Cristina Mazzoni's Maternal Impressions is an academic book about pregnancy, replete with authorities, endnotes, and specialized vocabulary. Though distinct in tone from the other books considered here, it resonates roundly with the group.

Mazzoni focuses on four questions: how we influence our children; how we know them and ourselves in relationship to them; how mothering changes women as subjects; and how we can speak about motherhood. Her title comes from the traditional belief that pregnant women "impress" marks on a child, so that a baby's birthmarks allude to the mother's craving, maybe in the shape of a strawberry or the color of coffee. Mazzoni offers intriguing treatment of popular texts like the fairy tale Rapunzel or Luke's account of the Visitation, but her discussions of French and Italian feminist writings are so thick with theory that, for instance, a fascinating analysis of the epistemology of "quickening" (the old term for feeling fetal movement) winds up with Luce Irigaray's conclusion that women's defining characteristic is mucous.

Mazzoni's confession that she was surprised by the "upheaval" of new motherhood would find hearty agreement from the other writers. New motherhood may be hard by definition, but this kind of surprise and isolation are the aggravating circumstances of our time and place. Just home from the hospital, moms may have visits from helpful others, but the bulk of the care for this new human being often falls to the mother alone. One's previous occupation, perhaps challenging and rewarding in its own right, does little to prepare one for the sheer work required.

British novelist Rachel Cusk outdoes the rest of the group in dramatizing how "unrelievedly shocking" motherhood is. The title of her memoir—A Life's Work—is not lightly chosen. Everything is hard for her, from newborn crying jags and endless feeding to infant playgroups. Though her descriptions are colorful and frequently funny, the metaphors offered for babies—a large rucksack, an alarm, a bomb (actually several kinds of bombs)—evidence not a little dismay at being stuck with a child. Her little Albertine appears in these pages largely as a source of crisis and trouble rather than as a person.

Readers may empathize with Cusk and the other writers, but a weakness besetting the maternity-diary books is the abundance of intimate detail. Large doses of personal narrative and photos of an author's gravid belly, even if lovely, open these books up to stereotyping as the self-absorbed musings of women overimpressed at having a baby. But to see these books as simply page-turners for the parents-magazine set is to miss the point. Cusk concedes that books like hers are "of no real interest to anyone except other mothers. … [T]he experience of motherhood loses nearly everything in translation to the outside world." Perhaps that's true about delivery-room horror stories and breastfeeding mishaps, but the concession is too broad.

Books like these speak into the space between the ubiquitous manual What to Expect When You're Expecting and the famous Lennart Nilsson photos of fetuses floating in utero, where we look in amazement at the baby whose image (and existence?) is brought to us by sophisticated medicine and technology. Critics complain that those images present a baby suspended in space, as though the mother did not exist; we're more impressed at the technology that gets her out of the way so we can see the baby. Those fetal images are breathtaking, but one cannot fully grasp the baby's becoming without seeing how the mother supports it. Paying attention to the astounding work-in-progress of pregnancy is one way to nurture a culture of life.

Agnes Howard teaches at Gordon College.

Copyright © 2003 by the author or Christianity Today/Books & Culture magazine.
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