Books

book review

Over hours of childbirth, stories unfold of pregnant nurse and her patient in labor

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Think “childbirth literature” and likely to come to mind are pastel tomes of how-to’s and how-not-to’s, books as empty of inner life as a typical labor and delivery ward is lacking in natural light. There have been some unforgettable birth scenes in fiction — “Anna Karenina,’’ “The Handsmaid’s Tale,’’ and “Beloved’’ contain fine examples. But a novel whose very structure mirrors childbirth itself, one that begins with a woman’s contractions and ends with a baby emerging from a womb? Such a book could be brutal, even unreadable. Yet Pamela Erens achieves the extraordinary in her third novel, “Eleven Hours’’: a visceral story about an intensely painful experience that manages to be an intense pleasure to read.

“Eleven Hours’’ is a slim, taut book whose premise is masterfully contained in its opening line: “No, the girl says, she will not wear the fetal monitoring belt.” The “girl” is 31-year-old Lore Tannenbaum, who has walked alone into a New York City hospital with a many-paged, single-spaced birth plan (“I do not wish to have an epidural . . . In the event of a C-section . . . In the event that the baby is ill or handicapped . . . ”) and a habit of saying no to nearly everything her nurse asks. Her nurse, and the narrator at the opening, is Franckline, a Haitian-born woman who is herself pregnant.

The tale swings between the two women’s points-of-view, allowing us to see each in the eyes of the other. Though their initial tension might seem predictable — a nurse from a developing island nation tends with a mix of bemusement and trepidation a patient with first-world convictions on medical interventions — their individual and shared stories quickly begin to unfold and expand beyond the reader’s expectations. It is striking that while “Eleven Hours’’ is in a sense made of Lore and Franckline’s relationship, the book is not primarily about that relationship and never falls into the trap of easy revelation or spontaneous connection. Rather the women’s tethering — and the ancient task in which they are engaged, the rhythms and triumphs and terrors of labor — grounds the reader even as Erens takes us far from the hospital room, deep into her character’s pasts.

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Franckline, we learn, has been helping to deliver babies since she was 11; “[t]he villagers said she had the gift, she was what they called pon, or bridge, could bring life safely from there to here, from the womb to the world.” But at 16, she herself became pregnant, a disgrace that cost her her mother’s love and, when the baby died at three days old, left Franckline both “spoiled” and grieving. Though happily married now, Franckline has so far been unable to bring another baby to term, and every cramp she feels as she helps Lore endure her contractions fills her with dread.

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Lore has suffered her own heartbreaks and shame, most recently when she learned that Asa, her boyfriend of several years and father to her baby, had been sleeping with their mutual friend, Julia. Asa and Julia were lovers first, before Lore, of humbler origins, moved to the city, and now, as Lore labors with an unfamiliar nurse as her only companion, she pictures her friends, together again: “that he should be rising for his day, comfortable, while [Lore] would soon be twisting in pain . . . that Julia should yawn and stretch and doze again.”

Erens excels at mapping the mind’s movement between present action, memory, and back again — several passages in which the concrete illuminates consciousness and vice-versa achieve an almost Woolfian sublimity, as when Lore, looking at a painting in the hospital, hears Julia’s voice critiquing the art for being amateur and sentimental. “Enough, Lore interrupts wearily. Again she spreads a hand on her belly. Defiantly, she celebrates the little flecks of humanity going about their business, the winsome sailboat, the melodramatically fading sun.”

But for all the stylistic wonders of “Eleven Hours,’’ the book’s success depends on its quieter, structural feats: Erens has built her story with architectural rigor, manipulating plot, perspective, and pacing to build narrative tension and heighten suspense. By the time we reach the end, it’s with relief and hope, and an awareness, too, of what has been lost. It’s a little like childbirth, except with this book you want go back and do it again.

ELEVEN HOURS

By Pamela Erens

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Tin House, 165 pp., paperback, $15.95

Anna Solomon is the author of the novels “Leaving Lucy Pear,’’ forthcoming in July, and “The Little Bride,’’ and co-editor of “Labor Day: True Birth Stories by Today’s Best Women Writers.’’