Writing + Obsession, The TV Edition
The Missing Epidural Plot
I think all interesting writing occurs in the presence of obsession. Sometimes that obsession is with form or genre a particular craft decision; sometimes it’s with subject matter. But whatever it is, it’s the writer’s drive to revisit and pick apart the object of obsession that forms the beating heart of the work.
For me, obsession is also the thing that makes writing fun and keeps me coming back to the page. I know if the piece I’m working on is worthwhile if I feel taken over by the writing—if I don’t feel fully in charge of the direction it’s taking because I am begin to embody whatever it is I’m working on. Some people talk about this momentum in terms of achieving a state of flow, and I agree with that characterization, but that idea of flow states is often divorced from any particular cause. I'll posit that they arise out of obsession. When I’m trying to force a story or essay and I don’t feel that inner drive, when I’m not obsessed, then it’s a sign the piece isn’t going to work. This can be frustrating because a person can’t force an obsession, but it’s been helpful for me to recognize as I go about the drafting process.
For many years I was obsessed with birth. Honestly I still am. I wrote a memoir about my own birth experience, did deep dives into the history of labor and delivery, talked about birth ad nauseam, and just generally thought about it way more than might have been “healthy”—whatever that means. So it’s no surprise that my TV watching habits reflected that obsession too.
When it came time for me to write companion pieces for my book’s publication (aka publicity essays) I wrote one about my counterintuitive tendency to watch medical dramas after birth trauma, and my particular draw to shows or episodes about birth, and the feeling that they not only elided my particularly experience of birth and that of the so many other birthing people. It got me thinking about how our culture capitalizes on women’s pain—in the case of these shows, glorifying it and using it as a way to move the plot forward, or to shamelessly pull on the viewer’s heartstrings.
The media landscape is tough right now, so I wrote some essays that never saw the light of day. (This one was actually picked up by an editor, but the magazine folded before it had a chance to run). Now that Frontier is almost six months old(!) I figured I’d go ahead and share it here.
So, without further ado…
The Missing Epidural Plot
In the world of the hit TV series Severance, epidurals simply do not exist—a fact that dawned on me as my husband and I watched the second season earlier this year. In the show, women of means can opt to undergo the titular severance procedure to divide their consciousness in two. A severed woman simply crosses the threshold of a “birthing cabin” to transform into her “innie” consciousness, sparing her original, “outie” self the agony of childbirth (while displacing the pain on someone who has not consented to it).
This got me thinking: why aren’t there epidurals, especially given the advanced technology that abounds in this fictional world? Why are they never mentioned as a potential third option? Is there no middle road between invasive brain surgery and terrible labor pain?
The birthing cabins of Severance evoke a landscape that shares more with early nineteenth-century twilight sleep than contemporary birth. Twilight sleep, a method of sedating women with a drug cocktail for delivery, did not fully eradicate pain from the experience of birth but it did remove the memory of birth. Women in twilight sleep still experienced pain, as documented by reports of screaming and thrashing, in some cases necessitating restraints, but drugs erased any recollection.
In Severance, too, the “outie” consciousness may escape the innie’s memories and sensations, but, as in twilight sleep, the physical body still experiences pain. One can imagine these fictional women, upon exiting the birthing cabins, discovering babies in their arms with a shaky understanding of who they are or how they got there, and an out-of-narrative pain lingering in their bodies, in the same way one can imagine the women who birthed under twilight sleep emerging from the drugs to their new realities, a split down the middle of their sense of self. By portraying the women who opt for this kind of delivery as elite oppressors who knowingly create an underclass of individuals to shoulder difficult experiences, the show makes an implicit argument about the moral problem of opting to forgo childbirth pain.
Severance is no anomaly in our pop culture landscape. TV shows by and large idealizes women’s pain and often act as though epidurals don’t exist. If they do make an appearance, scripts typically treat them as the exception to the rule–no matter that, in reality, upwards of three-quarters of American women will choose an epidural for delivery.
I’ve had epidurals (or a spinal, the equivalent pain control used for a cesarean) for all three of my deliveries. I didn’t utter guttural screams while pushing on all fours, and I never cursed at my husband or nurses because my pain was so unbearable and had gone on for too long, as does seemingly every woman who gives birth on the small screen. Amongst a particular group of my close friends, all of us either had epidurals or needed cesareans. But anyone who knows birth primarily through modern television would think these experiences to be outliers.
In the wake of my unexpectedly complicated first labor and delivery, juggling bleary early parenthood with the rolling waves of panic over the future of my kid, I turned to medical dramas as an escape. The initial shock of my birth experience had faded by the time I began mainlining Grey’s Anatomy and its progeny, but I was still haunted by what I’d gone through in that sterile hospital room. It was a strange choice, mysterious even to me. I couldn’t so much as hear news about my friends’ healthy deliveries without retreating to the bathroom to dissolve into tears of combined grief, jealousy, and relief that my friends and their babies were safe. Still, I watched these shows endlessly, as a way to shut out the world around me when it overwhelmed.
If you’d asked me why I turned to medical shows—or why I found myself especially drawn to the episodes dealing with birth—I don’t think I could have come up with a cohesive answer. I knew I was obsessed with birth, that since my own tangled mess of an encounter with it I could not stop thinking about it or researching it or talking about it or writing about it. But that was as far as I got towards forging an understanding. It was only years later, with my realization about the absence of epidurals in Severance that it dawned on me. These shows gave me an escape because of the way they used labor pain to glorify childbirth, creating an ideal of it so foreign from what I had gone through it existed on another plane.
If epidurals are mentioned on TV, more often than not it’s so they can be casually dismissed. A woman in the throes of labor might yell about the fentanyl administered via the epidural as an explanation for why she needs to grip the bed rails in animal-like desperation. Or she might reference her birth plan, because good mothers of course have birth plans and of course those birth plans involve actually feeling the pain of their child’s entrance into the world.
Severance makes plain allegory from what these other shows skirt around, but ultimately propagate: the notion that women who opt out of childbirth pain are going to dystopian lengths to avoid their true calling. In other shows, there may not be multiple consciousnesses at play, but it’s implied that to ask for pain relief is to fall to severance-like lows of disconnection and emotional numbness, to willingly distance oneself from one’s baby, turning away from one’s natural calling. They sensationalize women white-knuckling it through contractions, pretending that no pain relief options exist or leaning into the notion that genuine women will reject them if offered. This is, after all, what women’s bodies are made to do.
There are exceptions to this trend. Some shows have realistic excuses for this epidural erasure. Call the Midwife takes place before the procedure was widely available and anyway, it focuses on home births. The Pitt showcases an emergent birth in the ER for which there is no time to place an epidural; the baby is crowning by the time the woman arrives at the hospital. The Bear addresses epidurals head-on in a standalone episode devoted to one character, Natalie’s, labor. Though we don’t see the epidural administered on screen, Natalie and her mother have a substantive back-and-forth about it as an option. At first, Natalie buys into the typical tropes, saying, “I don’t want to be numb.” By the end of the episode, she’s decided to request one in spite of her initial hesitation: “I definitely need the epidural, this is fucked.”
On the whole, though, TV uses women’s pain as a cheap dramatic arc, as easy entertainment. Lots of viewers (myself included) apparently enjoy watching women suffer. These shows portray women’s pain as distinct from other kinds of pain. It’s somehow palatable, even entrancing. It’s the sort of pain that invites viewers vicariously along. Women slot seamlessly into the role of the victim, in a way that aligns with the carefully denoted scripts around proper femininity. Would the camera ever linger over a man trying to pass a kidney stone? I think not.
In real life, deciding to have an unmedicated labor and delivery is a perfectly valid choice. There are plenty of good reasons to opt for that route, but it’s a route that in no way bypasses the myriad other complications dotting the delivery and postpartum landscape, nor one that makes a person a better parent or a braver, truer mother. But all that aside, women’s autonomy vis a vis medical intervention (and so much else) is not what these shows are exploring when they erase epidurals.
By defaulting to unmedicated births and elevating labor pain as distinct from other pain, these narratives buy into the deeply rooted cultural myth of women’s pain as crucial to becoming a true woman and mother. Labor pain is redemptive and formative. It’s pain with a higher calling, a quasi-spiritual dimension. Women can prove their worth as women through their encounter with this pain. If they can withstand it, if they can perform it with just the right proportions of grimacing and screaming while somehow also displaying deep joy, then they can achieve the apex of womanhood. At its core, this is a deeply retrograde understanding of women, one that sees the transition to motherhood as the one true path to self-actualization and as an emotionally straightforward undertaking.
This was the fantasy I longed to escape into as a new mother. In this fantasy, the sacrifice of birth was transient and physical. It didn’t linger after delivery, because it was squarely about the pain of contractions, about the ring of fire and the final moments of excruciating pushing. Not the lingering physical pain so many deal with long after delivery from severe tears or abdominal incisions. Not the mourning of one’s former sense of self that can accompany a birth. Certainly not the emotional scars a traumatic birth leaves behind. It was a magical pain too, a good pain, that forged connection and transcendence. This was the pain I felt had been promised but that never came to fruition.
This glorified, television version of unmedicated birth diverges so sharply from my experience, and the birth experiences of so many other women, as to be largely unrecognizable. In my eyes, birth is so many things: by turns other-worldly, horrifying, beautiful, and yes, painful (even with drugs), but above all, it’s complicated. I might have longed for something simpler, and buried myself in representations of this halcyon ideal on the screen, but ultimately it’s a dangerous myth our society has propagated, one that makes so many feel like their bodies have failed, that they have failed. Now, I also see that part of me was diving into these shows in an attempt to find some reflection of my own experience, only to come up empty-handed time and time again.
Recent/Upcoming Book Happenings:
I’m so thrilled with this recent LARB review of Frontier by Corinne Cordasco-Pak, which dovetails with my musings about women’s pain by placing the book in the context of eroding productive rights.
You can also read a piece I wrote about how my obsession with birth lead me to have another baby (actually two), in The Wall Street Journal. I mean there were other reasons too—but I’m not gonna lie; the obsession was at least a part of what fueled my decision!
I’ll be at the upcoming Barrelhouse Conversations and Connections Conference in April in DC where Frontier will be a featured book. Registration is open now. This will be my first time there, but I’ve only heard fabulous things!
Finally, I’m starting to make plans for AWP in Baltimore and am looking to collaborate on events. I can talk about hybrid books, writing about pregnancy & birth, motherhood + writing, publishing with a small press, and lots more (I’m currently working on short stories, for example). If you’re thinking about off-site readings or need someone to fill in on a panel, please reach out!
This is so good. I want more TV criticism outta you :P