Review of "Lady's Hands, Lion's Heart" by Carol Leonard

"A midwife should have a lady's hands, a hawk's eyes, and a lion's heart."

Aristotle

This phrase on the cover of Lady's Hands, Lion's Heart: A Midwife's Saga captures the essence of Carol Leonard's memoir. An apprentice-trained home birth midwife at the beginning of the American midwifery renaissance needed courage, skill, and highly attuned powers of observation.

Several blog readers highly recommended Lady's Hands, Lion's Heart when I compiled a list of midwife memoirs. Readers said that her book was "a terrific read. Unputdownable" ... "an emotional, powerful book. The stories of the women and of the midwife are vivid, passionate and moving." This book, surprisingly, had not yet made it onto my reading list. Clearly, that needed to change.

I contacted Carol Leonard about reviewing her book, and she graciously sent me a copy. Since then, we have corresponded on and off. She sends me updates of writing pieces she's working on, elaborates on the stories from her memoir, or tells me about her newest book project The Beauty Girls.

Lady's Hands, Lion's Heart is a memoir with two intertwined stories.* The first is--not surprisingly--the tale of Carol's midwifery career in New Hampshire from 1975-1987. After the not-so-great hospital birth of her son Milan in 1975, she was so fed up with the care she received that she left AMA in the middle of the night, yelling after her doctor "I am outta here!" Yes, Carol is one feisty character, and it only gets better.

Carol began her midwifery career in an unexpected venue--supporting women having abortions in a women's health clinic. (Today, such women are called "abortion doulas.") Around the same time, she started assisting an old-time family practice physician who attended home births, the only one left in the state. Before she knew it, she was catapulted into a career as a home birth midwife. It was the right time and place; the natural childbirth, counter-cultural, and back-to-the-land movements were going strong. Home birth fit easily into all three.

The other main narrative of the book is a love story. As her first marriage is falling apart, Carol falls in love with Dr. Ken McKinney, a handsome, sensitive, dedicated obstetrician whom she works with. Although they sometimes clash over certain obstetrical practices, he proves remarkably open to changing his practice style. This is a good thing, as they eventually marry and work in tandem. Unlike most American home birth midwives, Carol has access to a sympathetic backup OB who is willing to meet her clients at the hospital, no questions asked, night or day.

As Carol and Ken's relationship deepens in the book, they face increasing challenges. Carol learns how to work as an independent midwife--sometimes learning the hard way to be more patient or more humble. She also withstands considerable opposition from local physicians and hospitals and creates landmark direct-entry midwifery legislation. Ken's physician colleagues dislike his support of home birth (and his popularity with  patients) and eventually give him an ultimatum: stop providing backup to Carol, or lose your job. He leaves his group practice and forms a solo OB/GYN practice that becomes the most successful in town.

Lady's Hands, Lion's Heart is a gripping, fast-paced read. Filled with Carol's earthy humor and raw narrative style, you become immersed in the moment-to-moment life of a home birth midwife. Women birth in urban government-subsidized apartments and in quirky off-grid cabins. Carol climbs into tiny lofts, underneath a woman suspended midair, and through a storm of feathers unleashed by a laboring woman ripping apart her pillows. All in a day's work for a baby catcher.

This passage, which makes me laugh every time I read it, conveys how home birth midwives adapt themselves to laboring women's preferences:

Because Thea is so short, she braces herself, straight armed, in the space between the washer and dryer. This leaves her feet dangling about six inches off the floor. This is how she wants to do it--suspended in midair.


I on the other hand, am lying on my side, wedged in between both appliances. I am trying my best in these cramped quarters to guide the baby out. The amniotic fluid is dripping on my head. Dryer lint is sticking in my wet hair. I am covered, head to toe, with fuzz galls. When I finally stand up, I look like a gray Yeti.

The book is told entirely in first-person present tense, which lends an immediacy to the story. (Short aside: present tense is quite difficult to sustain over a long narrative. At times it was hard to remember the correct sequence of events, as everything was told as if it were all happening right now.)

As American midwifery evolves and professionalizes, today's student midwives will likely have different formative experiences than the midwives of the 1970s. Carol Leonard's memoir preserves and documents the soul of American midwifery, including the founding of MANA. For those wishing to learn more about this rich heritage, Lady's Hands, Lion's Heart should be read in combination with Sisters on a Journey: Portraits of American Midwives.

Ladys' Hands, Lion's Heart is available through Amazon or directly from Bad Beaver Publishing. 

*Or three main story lines--after I wrote this review, I read on Carol Leonard's website Bad Beaver Publishing: 
"The story spans thirteen years--1975 to 1987-- and is told with three threads. The first thread is the home births and my apprenticeship with the wonderful old country doctor, Dr. Francis Brown, the only physician in the state who still attended births at home. He took me on as his sidekick, and we trooped around the New Hampshire countryside for years while my own practice was blossoming. The second thread is the renaissance of the profession of midwifery in the United States, despite formidable opposition from a jealous medical profession. The third thread is my love story with the impossibly handsome and brilliant obstetrician, Dr. Ken McKinney."