Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank

by Randi Hutter Epstein

"[An] engrossing survey of the history of childbirth."—Stephen Lowman, Washington Post

Making and having babies—what it takes to get pregnant, stay pregnant, and deliver—have mystified women and men throughout human history. The insatiably curious Randi Hutter Epstein journeys through history, fads, and fables, and to the fringe of science. Here is an entertaining must-read—an enlightening celebration of human life.

Genres: Nonfiction, History, Science, Parenting, Medicine, Medical, Adult

353 pages, Kindle Edition

First published January 1, 2010

About the author

Randi Hutter Epstein, MD is a medical writer and adjunct professor at The Graduate School of Journalism, Columbia University. She is also the managing editor of the Yale Journal for Humanities in Medicine. She earned a BS from The University of Pennsylvania, MS from the Graduate School of Journalism, Columbia University; and an MD from Yale University School of Medicine. Randi worked as a medical writer for the London bureau of The Associated Press and was the London bureau chief of Physicians Weekly. Her articles have appeared in the New York Times, The Washington Post, The Daily Telegraph , Parents, More, Harpers Bazaar, among other newspapers and magazines. Randi lives in New York City with her husband, four children, two dogs, and a tortoise. Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank is her first book.

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Reviews

[Eastofoz · Rating 4 out of 5]

It’s a wonder that women have survived pregnancy and childbirth since way back when and that there are those who have lived to tell the tale because once you’ve read this book you’ll be shaking in your boots if not crossing your legs forever at some of things done in the name of « helping » a woman have a baby.

The book is packed with lots of interesting information starting around medieval times when facts and figures actually started to be recorded about childbirth according to the author. It’s told in a humorous as well as the “scare the ol’ crap right out of you” way. You’ll be going bug-eyed more than once as you flip through this one as well as scrunching your face with a few “ouches” to put it mildly. The information is presented pretty much chronologically with lots of facts and figures as backup which I appreciated. The humor of course is the author’s but the facts speak for themselves so you actually learn a thing or two. There is a very detailed, multiple page bibliography at the back for those people wanting to know more or just where the author got her info.

I really enjoyed the medieval information and the part from the 1980s on. The medieval part is so horribly gruesome. Some of the stories about how they “removed” babies that were stuck in the birth canal will just make you cringe as will the doctors who “operated” on slave women as a means to test out new techniques to help wealthy white women. The majority of the novel focuses on advances in the US however other countries’ techniques are also mentioned. From the 1800s to the 1970s I found that the book got a bit bogged down in reciting names and dates and it sometimes felt like a chart written in paragraph form. It also lost its humor at times and became more borderline academic (which was why I couldn't give it a 5), so somewhat boring for the lay person. It picked up again though around the 1980s on especially the chapters on freebirthers (that just seems way too weird to grasp but hey if it works for some and they deliver healthy babies then why not) and buying sperm and eggs through catalogs. The author made it sound like buying a pair of expensive shoes with sometimes smarmy sales people which I don’t think is quite the case for people who have to go to such extremes to have a baby. Something I found strange is that the government doesn’t keep any real statistics regarding the number of babies conceived this way and regulations are quite loose in the US as to who can be a donor and who can’t compared to other countries. It’s almost like a new fad in the same way that the X-ray machine was or certain kinds of meds were with respect to the baby business and for many it is just that.

On the whole it’s a unique kind of book for someone interested in the non-text book droning account of the history of pregnancy and childbirth and I really think it can be even more appreciated if you’ve had children yourself or were close to someone who has. The title is just perfect too –those poor little babies, they’re trying to find their way out and the big question is how much help has science really been giving them in the end? A thought provoking, overall good read and great as a gift for the expectant parent who’s already got every pregnancy book under the sun.

[Elizabeth · Rating 3 out of 5]

Studying up for Saturday's baby shower.

So far, all I can think is how much I wish Mary Roach had written this book.

[Kim · Rating 1 out of 5]

I am perhaps hard on childbirth histories since I've read hundreds of academic books and articles about childbirth. Usually, though, I actually rather like the books that are written for a non-expert audience on the topic. Not so this one. While there is valuable information for those who know nothing about childbirth, perhaps particularly in the later chapters about there are also extremely historically problematic aspects, and a consistently obnoxious voice. For example, the first sentence: "Eve, the first woman to become pregnant, suffered from excruciating pain during the delivery because she cheated on her diet." That would be a bad line in a comedy routine (and I'm pretty sure has already been used in a comedy routine), and is simply embarrassing in this context. When I got to this line, "Birth from antiquity through the Middle Ages was an all-girls affair orchestrated by men who had never seen a baby born (5)" I decided this would be a book to skim, rather than really read. I'm not usually not at all up-in-arms about the word "girls" for women, but in this context, it struck me as belittling--an unsuccessful attempt at a light-hearted writing style.

[Melody · Rating 2 out of 5]

I wanted something other than what I got here. I found the editing abysmal and the anecdotes distracting. There wasn't enough meat, either. For example, in the chapter about the doctor who experimented on slaves until he perfected the technique to repair fistulas, the technique itself is never explained. An oddly disjointed, surface-skimming account. Also, the author calls leeches "bugs", which lost multiple points with me.

There were interesting bits, and I did finish the book, but mostly I kept thinking how much better it could have been than it was.

[Jenn Kunz · Rating 3 out of 5]

I think if the subject wasn't something that interests me so much, I'd have rated it even lower. It jumped around chronologically and repeated itself frequently, even within the same chapter. Lots of little things that I don't blame the author for but would like to have a word with his editor about.
That said, it is a fascinating and sometimes humorous history of all the ways humans manage to screw up childbirth:)

[Julia Michaels-koenig · Rating 2 out of 5]

I'm reluctantly, reluctantly giving this a whole two stars because I think Dr. Epstein meant well. But this book was one big object lesson in the dire need, even in the age of self-publishing and automatic spell-checking, for editors.
The need for a copy editor was the most pronounced problem; there were so many glaring syntax errors that could easily have been caught if a human being had gone over the text. But I think a content editor could have served this book even better - the style changes, from dryly formal to blog-post casual, gave me mental whiplash from sentence to sentence. And certainly a content editor could have helped Epstein organize her thoughts and structure the book properly, as the whole overarching pseudo-chronological arc was just a terrible idea.
About that: don't bill your book as a history of childbirth from the (fictional) dawn of humanity to the present day if it is, in fact, a history of childbirth practices in Western Europe and America from the Middle Ages to the present. Apart from the weird are-these-supposed-to-be-funny lighthearted paragraphs about the "garden of Eden", all the content focused on the aforementioned geographical and historical span, and there's nothing wrong with that per se, but the title and introduction gave the impression that this was supposed to be a broad-spectrum view of how human beings have viewed pregnancy and childbirth throughout history, which was misleading.
Also, if Epstein had had a clearer structure in mind for the book, maybe she could have come up with a clearer point of view, as it was very hard to tell what, if anything, she thought of most of the views and events she was chronicling. And I don't mean that she was being objective, I mean that it was difficult to tell what the point of most of the anecdotes was, and why they were being related.
The references - in half-page footnotes and relentless citations - reminded me of a student with a term paper due that had a minimum source requirement, and served primarily to make me aware that there were many good books available on all the topics covered, and therefore to leave me wondering why I wasn't reading those books instead of this one.
Wow, I am in a really bad mood about this book. But it's just that I'm so disappointed; it seemed like the sort of thing I'd really love, given the subject matter, and I was just so disappointed by how superficial, and how poorly organized, it was.

[Brenda · Rating 4 out of 5]

Very interesting history of childbirth; fascinating that for thousands of years, women controlled the process, primitive as it was. Men got involved in the 18th century and that's when childbirth became really scary. Forceps, broken pelvises, terrible drugs all in the name of medical science. Wouldn't recommend this for the faint of heart.

[Kathleen Garber · Rating 4 out of 5]

I bought this book from Amazon because it sounded interesting. I’ve given birth four times and I’ve read about it a lot before and after. However it was still interesting to read. This book gives a different perspective than many other books. This is not a how to give birth book. This is a cultural history. It’s not boring in any way though.

Topics Covered
The book starts with talk about early childbirth from the Middle Ages to 1899. Warning: This section is a little scary. I am so glad I wasn’t giving birth back then.

Part Two covers the twentieth century. It covers reducing maternal mortality (moms dying in childbirth), the move from home births to hospital births and early pain relievers (which were not what they seemed.)

The next part talks about Freudian views on fertility and childbirth, Lamaze and his concepts and other doctors and their ideas on childbirth. Also DES is talked about which if you don’t know is a drug that was given to prevent miscarriages but which ended up causing cancer in the babies that were born while their mothers were using it. The cancers didn’t develop until they were teens or older so it took a while for the cause to be found. Many became infertile.

The next two parts cover c-sections, freebirthers and 3-D ultrasounds and then sperm donors and embryo freezing.

Final Thoughts
It was all very interesting and I’m glad I bought the book. It certainly made the births I went through seem easy as pie in comparison. We’ve come a long way.

[Sarah · Rating 3 out of 5]

It is not a comprehensive history and not a proper history book - it's by a medical journalist - and because of the subtitle that calls it a history, I felt its scope was a bit limited / all over the place as far as topics. However, the topics that were included were fascinating and I feel more informed having read it! I learned all sorts of interesting facts about birth and birthing practices.

[Laurie · Rating 3 out of 5]

Fun and informative examination of childbirth through the ages.

[Michelle · Rating 5 out of 5]

This is a great, comprehensive history of childbirth, and how we have medicalized it - taking the power of the process away from women and letting men, in many ways, manage this, too. Told with lots of humor, this is an excellent, quick read.

[jess · Rating 4 out of 5]

I picked this up because I read a few times that it is comparable to Mary Roach's work, which I really like. And it's about childbirth through the ages, which is weird and interesting. The format is similar to Roach's books, and the style has a similar sense of humor (although not quite as hilarious as Roach). It's a good fit for those who like accessible, cheeky reviews of a wide range of scientific literature, both historic and modern.

I was concerned that a book about women's birth experiences written by a woman might come across as one-sided, but Epstein provides a balanced portrayal while not holding back on the bungling idiocy of the men who have tried to control childbirth over the years. Her characterizations of these guys brought the subject matter to life - especially her writing on Cappy Rothman, founder of California Cryobank and a real lover of sperm. At the end of the day, this is not a book about women's birth experiences so much as it is about humanity, hubris and all the uncertainty that goes into making a baby --- which leads, many times, into a far more uncertain and frightening journey, called Parenting.

Subjects include: birth from antiquity to the middle ages, the development of forceps, childbed fever, the rise of maternity wards and move away from home birth, twilight sleep (brought to you by early feminists), DES, c-sections, freebirthing, and modern reproductive technology, like sperm banks and frozen eggs. J. Marion Sims comes up several times, both for "contributions to gynecology" (horrifying years of experiments on slave women) and his prescient views on the future of reproductive medicine. He sounds like one of the more evil figures in history. I know a little bit about a lot of these subjects, but J. Marion Sims blew my mind.

And yes, I am paying a week of fines on this.

[Mieke McBride · Rating 4 out of 5]

Really interesting book. I recommend if:

1. You're having a baby-- so fascinating to read the history of childbirth, especially recent medicalization trends. If you're squeamish, maybe skip the section on difficult births pre-forceps, because that was pretty nightmarish. But interesting to hear how one family kept forceps a secret for decades.

2. You love Mary Roach (but wish her books weren't as funny). This is why this book is 4 stars, not 5. I just wish Mary Roach had written it. Roach has spoiled me with her science writing, and I wanted this book to be less serious and more amusing. Like Roach, Epstein covers a wide spectrum of subjects related to childbirth. She also doesn't shy away from really problematic origins of modern day birthing techniques (such as doctors testing risky procedures on slaves in 1800s America).

3. You enjoyed the historical parts of the Business of Being Born. I just watched this documentary last night and ended up rolling my eyes through most of it. (Ugh, the armchair theorizing that the problem with society today is too many epidurals which block oxytocin and make it so moms don't love their babies...) But there were interesting scenes talking about the history of births in hospitals-- all which are much better described in this book. (For example, the trend of using drugs to make it so women didn't remember anything from birth but also had to be strapped down because the drugs blocked inhibitions.) Also great discussion in this book of the shift from midwives to doctors.

[Robyn · Rating 5 out of 5]

This book is super entertaining. (The author is a journalist so it's written for a popular audience.) And this book is crazy. I keep getting up to read parts of it to my husband. It's like, "I can't believe they used to do that!"

I was unsure if it would be a good idea to read this while pregnant, but so far, I think it is. It's not scary; if anything, it makes me glad I'm giving birth in 2011. There's some parts that are a bit horrifying, like the way things used to be done, but I think it's okay. I also feel it's valuable to read as I think about giving birth for the first time, to feel informed in a certain way I guess. The author says in the beginning that this book is not intended necessarily to help you make decisions about how you want to deliver, but... there's something about it I find reassuring.

The author does a really good job of contextualizing all these different practices so that they make sense and seem logical. She also frames today's childbirth practices (in the U.S.) in this history, which his sort of encouraging, in part because, as she says at the end, there's always surprises. There's always things you can't control.

She also provides really good commentary. I'd be in the middle of a crazy chapter and be like "I have to finish this to get to where she contextualizes all this and makes me feel okay about it."

[Jodi Shelley · Rating 5 out of 5]

Amazingly non-boring non-fiction. It shows us how the way we give birth over the years has been just as much related to the cultural times we live in as any actual medical advances made. The ways women have given birth and the things we've asked for to help us along the way are at times amazing and shocking. The most interesting revelation is in the fact that feminist women have at the same time demanded pain-free birth as well as the freedom to birth without drugs. Speaking once again to the incredibly personal nature of birth. If nothing else, it reminded me that the women's movement has helped give us freedom over the choices in how we want to have a birth. It shows the shift from birth being in the realm of women (midwives, friends, community women) to slowly slipping into the realm of medical doctors who knew very little about gynecology (in the early days some weren't even allowed to actually LOOK at a vagina) and were always men (women weren't allowed to become doctors for a long time. The science, the gadgets, the culture of birth are cracked wide open. And she does it all without being boring in the slightest!

[Kellie · Rating 4 out of 5]

An interesting book and a very quick read on a variety of historical pregnancy and birth topics. I had already heard about some of the topics discussed but it wasn't boring in the least. One of the more engaging aspects of the book was thinking about some of these topics in the context of women and minority rights and class. The use of painkillers and twilight sleep as a woman's right to have the childbirth she wants and have a say in her medical care. The idea that upper class women were too frail to have natural vaginal births due to a delicate physical and mental constitution.

For my own future remembrance:

Ch. 2 Forceps
Ch. 3 Use of slaves in gynecological research
Ch. 4 Maternal mortality
Ch. 5 Growth of maternity wards (decline of home birth)
Ch. 6 Twilight sleep
Ch. 7 Psychoanalysis, infertility
Ch. 8 Rise of natural childbirth (discontinuance of twilight sleep)
Ch. 9 DES
Ch. 10 C-sections become an option
Ch. 11 Freebirthers
Ch. 12 X-rays and ultrasound
Ch. 13 Buying sperm
Ch. 14 Egg freezing

[Shana · Rating 3 out of 5]

Pregnancy and childbirth are topics that are bound to bring out some strong opinions and preferences. The ways in which the conversations and debates play out are largely reflections of our sociocultural expectations and hopes, and these in turn are affected by our particular place in history. Epstein takes a journey back in time to explore many trends, advancements, and controversies surrounding pregnancy and childbirth that have helped bring us to where we find ourselves today. Each chapter is dedicated to one topic and these range from twilight sleep and Lamaze to DES and sperm banks.

This is an easy read and ideal for someone just embarking on this study. It provides brief and basic histories for these various issues. My one major critique would be that it is very heavily focused on Western cultural perceptions of pregnancy and birth. There are no mentions outside of Europe and the United States.

[Amanda · Rating 3 out of 5]

This is one of those science/history-lite books that are a breeze to read and that offer TONS to talk about with strangers at dinner parties. Chad called me a masochist for reading it after giving birth, but it kind of made me feel better about my experience compared to the short history of Western birth that Epstein provides. The writing was a little clunky at times and the facts were at times repetitive (perhaps many of the chapters began as individual essays?), but it was interesting. I wish Epstein would provide an annotated bibliography, as THAT would be super-cool. Birth is fascinating.

[Kara · Rating 3 out of 5]

I was slightly disappointed in this book. The title is very misleading. It should be more like "A brief look at a small handful of trends that happened sometime between Eden and the Sperm Bank." It covered very little about childbirth history. Although what it did cover was interesting and written with a sense of humor. It covered a lot of American trends and what I would like to read more about are the practices and history of childbirth in a wider cultural sense.

[Jenna Sisk · Rating 3 out of 5]

This book is simply okay. It was an interesting look for childbirth, but didn't go very deep on ethics of the history of childbirth, besides the section on cruelty of slaves. Well written, could have been better (different).

[Kelly · Rating 1 out of 5]

I didn't care for this at all.

[M · Rating 1 out of 5]

A lot of this wasn't even related to childbirth especially ignorant, judgemental chapters about sperm donors and ART. And why is it so defensive of the guy doing experiments on slaves.

[Neil Pierson · Rating 3 out of 5]

This book traces the history of childbirth and fertility from ancient to modern times, seeing them as expressions of broader themes in societies. It includes interesting chapters on ultrasound, sperm banks, and reproductive technologies.

A consistent thread in the book is the struggle between men (mainly doctors and psychiatrists) and women (mainly mothers and midwives) over control of the childbirth process. That tug-of-war has made for some strange alliances.

For most of history, obstetrics were women's work and not considered worthy of a physician's specialization. Institutions called "lying-ins*" were introduced as an alternative for poor women to give birth outside the terrible tenements in which they lived. Unfortunately, until proper sanitation practices were introduced, it was probably safer to deliver in their filthy, rat-infested homes. But the institutional setting caught on, and it began to look like there could be money in the baby business. That interested doctors, who promoted their services by disparaging midwives as ignorant shamans and peasants.

When sedation became available, feminists demanded that women have access to it during births. The "twilight sleep" movement--they came up with that without a focus group!--claimed that birth could be painless. (Actually, it was no such thing, but the sedation caused women to forget the pain.) Doctors embraced sedation, because it had to be done in a facility with medical professionals. Women did what their doctors told them to. And so it went...

... until psychology and psychoanalysis became a popular subject. A man with the splendid name of Dr. Grantly Dick-Read popularized the idea that women suffered pain during childbirth because they were fearful and uptight. Their attitudes were causing their bodies to tense up and "fight" the delivery. As evidence, he noted that animals, not burdened with expectations, did not find childbirth painful. (Actually there are several physical reasons why this comparison is hooey.) He promoted mental and emotional preparation for the birth experience. His "childbirth without fear" didn't live up to its promises, but he was onto something: A woman's mental and emotional state does influence the physical process of birth.

Extending this idea, Dr. Elisabeth Bing brought Lamaze to the American public. (Dick-Read and Bing? Really?) Her idea was to give the mother some tools to face the birth experience but also allow the mother to decide for herself what pharmacological assistance she needed. Doctors, of course, didn't think that mothers were competent to make these decisions, but they got outvoted.

The history of childbirth is a gruesome story of superstition, sexism, racism, and economic class. What makes this book bearable and sometimes enjoyable is the author's writing skill. She sets a tone that is witty and conversational but never flippant.



* Not to be confused with the White House.

[Samantha Garner · Rating 5 out of 5]

Only ten pages in I recommended this book to friends, both ttc and not ttc. The first chapter was literally laugh out loud funny, such as: "A penis was called a yard, as in a 36-inch stick. Definitely wishful thinking," or, when describing Medieval notions about the correlation between digestion and fertility, "It's a wonder how men approached the subject of bowel movements on the first date."

In later chapters, as the history of fertility, pregnancy, and birth moves into the more modern age, the humor gets lost. Mostly because the early chapters on Greek, Roman, and Medieval history seem so unreal, but as you read the more recent beliefs and practices it's hard not to cringe. Not that the early stuff isn't super wrong and downright stupid. It just feels too far removed to be real. But when you're reading about practices in the last hundred years even...yikes.

Dr. Hutter Epstein writes with humor and seriousness, empathy and scientific perspective. What an interesting read!

[M Burke · Rating 4 out of 5]

This is a difficult book to read. The first half is gruesome, both in the torture done to women’s bodies in the name of progress and in the attitudes of men toward childbirth. For much of history, women were deemed inferior to farm animals because the latter labored without apparent complaint. Men didn’t consider that cows had proportionally larger pelvises and smaller heads. I found the second half of the book more interesting (though equally ugly in terms of patriarchy), in its deep dives into poor science and capitalism surrounding pregnancy in the twentieth century. For example, synthetic estrogen was given to pregnant women for 20 years after it was demonstrated in multiple studies to cause cancer in their daughters. Similarly, fetal x-rays continued for decades after demonstrated harm. The final chapter on sperm banks and egg freezing is a somewhat lighter, almost optimistic conclusion to this otherwise disturbing history.

[Margherita Melillo · Rating 3 out of 5]

When I became a mother and struggled with all the dilemmas and uncertainties of this new phase of my life, I started wondering how women dealt with this in the past. I looked for books that could tell me more about the history of motherhood, and this is one of the few I could find. I did not love the book as much as I thought I would, but, very importantly, I learnt why we know so little about it. There are simply no primary sources. Getting pregnant, bearing children, giving birth, breastfeeding etc have been taboo until a few decades ago.

This book does not really attempt to answer how women were feeling. It is a nice medical history of childbirth. However, I do not feel it was the best I read.

[Laura Cobrinik · Rating 5 out of 5]

The first book by Randi Hutter Epstein, "Get Me Out: A History of Childbirth," I had the opportunity to re-read after I completed Epstein's second book, "Aroused: The Historyof Hormones And How They Control Just About Everything."

"Get Me Out: A History of Childhood" is a book which every woman should be required to read, not just those who are pregnant. It begins describing the "hysterical women" of the Victorian age, and to the present where women are required to leave the hospital as soon as 24 hours after their delivery.

A fantastic read. Highly recommended!!
Laura Cobrinik,
Boonton Township, NJ

[Tammy Buchli · Rating 3 out of 5]

I enjoyed this brief history of childbirth. It seemed to striving for a Mary Roach style treatment of the material and almost achieved it, although the author doesn't have quite Roach's talent for science writing that is both funny and poignant. The major disappointment was the editing, though. I caught 3 incorrect dates - and we all know that editing errors are like cockroaches: for every one you notice, there are 10 that you don't. This book would have gotten 4 stars from me if it had been properly edited.

[Patricia Kitto · Rating 3 out of 5]

I enjoyed learning about the history of childbirth and modern fertility treatments. It was an easy and quick read - not too scholarly (i. e. dry) but clearly well researched. Since it was written in 2010, it left we wondering what new advancements have been realized since then (I would've loved an addendum addressing them!). I wouldn't recommend this book to pregnant women however as some of the descriptions are a bit harrowing if you were soon to be in labor!

[Judy Longo · Rating 5 out of 5]

Interesting!

This book takes you through what women have endured throughout history to deliver a baby. Some of the experiences are ridiculous and/or frightening from a 21st century view. That does not diminish the facts. Childbirth is a painful but wonderful miracle! As a woman who has borne children, raised them and now enjoy grandchildren I found this to be an interesting read and if you read it expect to feel a variety of emotions.