Like the ‘chimeras’ of the genetic technology she describes, Olivia Gordon’s The First Breath skilfully integrates multiple genres to provide a gripping tale of foetal and neonatal medicine. Part medical memoir, part motherhood memoir and part historical account, The First Breath tells of a generation of children who, even as recently as a decade ago, might not have survived past birth. It is, quite properly, an almost unbelievable and almost unimaginable story – because the procedures, techniques, and knowledge are, often, only recently imagined, and are even more recently put into practice. Gordon captures this world of motherhood sensitively, and it is overwhelmingly novel; but, as she does so, she also deploys a traditional series of metaphors to express her and others’ experience of motherhood. These metaphors serve both to anchor the extraordinary in the ordinary, and so to help us understand this other-world, and also to show how extraordinary the ordinary already is.
Gordon is a journalist and writer whose work has encompassed the subjects of medicine, motherhood and disability. Her son Joel was diagnosed before birth with complications that would mark his first five months of life as a dangerous and difficult time. With her own experiences acting as a catalyst, Gordon explores the remarkable area of foetal medicine. Six years after Joel’s birth she returns to talk with the doctors and nurses that saved her son’s life, and leads the reader into the heart of medical fields that are at the cutting-edge of medical advancements. Technical progress, and the willingness to take calculated risks, allow a range of operations to be performed whose consequences are momentous – the difference between life and death, paralysis and the ability to walk. Advancements have proliferated enormously over recent decades, and Gordon describes these branches of medicine as a ‘fledgling field’ (p. 133), in many ways similar to the ‘fledgling’ babies that they treat. Both are new to the world, and hold much potential in great uncertainty. We accompany Gordon into consulting rooms, operating theatres and hospital staff rooms to share in ‘the private backstage protocols that patients, like the audience of a play or the customers of a business, aren’t meant to see’ (p. 21). Alongside this unique insight into the most recent advancements in medicine, Gordon pulls the reader back into the history of these fields, recounting such milestones as the development of obstetric ultrasound, foetal surgery and neonatal incubation.
The world of foetal medicine is, then, awe-inspiring. Yet, threaded throughout the book, which at times tackles highly complex scientific and medical terminology, is a very human story of a mother and her child. This voice, Gordon argues, can often become obscured in medical literature and research, and her work takes care to provide a testimony of what she describes as the ‘female experience’ of pregnancy and motherhood, portraying ‘what it’s like to become a mother when pregnancy doesn’t go to plan’ (p. xii). As well as paying tribute to the excellent care she received through the NHS, Gordon raises some important challenges to the way neonatal medicine is currently practiced in the UK. In particular, Gordon laments the lack of physical contact between a mother and her baby in the Neonatal Intensive Care Unit, at a time when both need it most. Within the modern, medicalised setting of pregnancy, it can seem that for healthcare professionals, ‘the experience of mother and baby somehow eludes them’, because, Gordon notes, it ‘is not recorded in the scientific papers’ (p. 232).
That is true; randomised control trials do not account for this human, female experience. There is, though, an emerging corpus of research and criticism that aims to attend to, and recover, those female voices. Qualitative studies, as opposed to quantitative research, are more discursive in nature, posing questions to participants to elucidate their feelings in the moment. Gordon’s descriptions of her experiences, and those of others, closely align with the findings of this research. Phenomenological studies form a subset of such qualitative research, focusing on the lived experience of beings in the world. A key method for identifying different facets of a person's experiences in relation to a particular phenomenon is to examine the metaphors he or she uses to express those experiences or, more accurately, to express his or her relationship to those experiences. Metaphors enable the articulation of the previously inexpressible, creating a connection between two things (the etymology of ‘metaphor’ translates from the Greek as a ‘carrying across’). In the case of pregnancy, phenomenological studies that focus on metaphors can be used to draw out the lived experience of pregnancy, and have done so to great effect. Throughout her work, Gordon’s descriptions of her experience are resplendent with metaphorical language, as are the stories she includes of other mothers. Many of these metaphors echo the findings of methodological studies, and suggest that though these mothers find themselves in a new world, it is new world different in degree and not kind from the new worlds that mothers often find themselves in.
Continued in Part 2
Elizabeth Whitehouse, 2021