An Exclusive behind-the-scenes look at The Birth House
from Harper Perennial.

The Birth House
by Ami McKay

About the Author
Life at a Glance
Born: 1968. Indiana, USA.

Educated: Indiana State University (Music Education and Musicology).

Career: High school music teacher. Then, freelance writer and producer of radio documentaries. Now, first-time novelist.

Family: Married to Ian. Two sons.

Lives: In an old birth house in Nova Scotia, Canada.


A Writing Life: A Conversation with Ami McKay

When do you write?
In the afternoon. Sometimes I skip dinner and keep going into the night.

Where do you write?
I have a studio in the loft of the barn.

Why do you write?
To make sense of things—past, present and future.

Pen or computer?
First, fountain pen in sketchbooks. Then I enter it into my laptop for editing.

Silence or music?
Music without words. I try to find music that will fit with the mood I’m trying to create with my writing.

What started you writing?
I was a closet writer for most of my life. It was a personal and private act of expression.
As far as writing for publication goes, it was because my husband dared me to do it!

How do you start a book?
With The Birth House, Dora was in my imagination for quite a while before I found my way to her voice. The same seems to be happening with my next novel as well. I suppose I start by trying to find the right voice to carry the narrative.

And finish?
Breaking up is hard to do … I wrote four different endings for The Birth House before I was satisfied it was over!

Do you have any writing rituals or superstitions?
I keep my grandmother’s teacup on my desk and always pour a spot for her as well. She was a fantastic reader, so I like to think she’s reading over my shoulder as I write.

Which living writer do you most admire?
Isabel Allende. Her stories feel brilliant and timeless to me.

What or who inspires you?
Beauty, chance, fate, desire, laughter, tears, hope.

If you weren’t a writer what job would you have?
I’d probably still be playing my harp for weddings and funerals. Yikes.

What’s your guilty reading pleasure?
I hate to think about feeling guilty for reading anything! But if I have to admit to something … I suppose I spend too much time reading blogs. I find some of them to be compelling and addictive!

The Birth Houseincludes all sorts of ephemera from Dora’s life: invitations, news articles, sections from The Willow Book, folk tales and advertisements. Why did you use this form, and do you see it as a particularly female structure?
When I was young, I used to watch my mother so I could learn from her. I loved sitting with her while she cooked, sewed or gardened, and even while she was putting on her makeup. One thing I remember well was her end-of-the-day ritual of emptying out her pockets onto her dressing table. A spool of thread, a note from a friend, bobby pins, a recipe card, a pine cone I’d handed her as a gift, a torn-out picture from a magazine—these treasures would sit on a mirrored tray, looking like they were ready to be presented to a queen. They were a reflection of her day, her art. When I sat down to write The Birth House, I realized that this was how I wanted to arrange my words as well, by making a literary scrapbook out of Dora’s days.

What or who were your inspirations for The Willow Bookand do you have a favorite remedy from it?
The remedies and wisdom included in The Willow Book section of the novel come from many different sources. Some items were passed down from my great-grandmother to my mother and then to me. Other remedies were from turn-of-the-century recipe books, ladies’ journals and farmers’ almanacs. What I loved most about putting these bits of wisdom together was finding a sense of practical magic in them. There’s useful information married to folklore in every entry … this is how women passed information along to one another. Some of it is just as useful today as it was in the past. For instance, many pregnant women still swear by raspberry tea!

My favorite saying came from the marginalia of one of my husband’s grandmother’s cookbooks: “No matter what you do, someone always knew you would.”

Miss B. draws her wisdom from an eclectic array of sources. Would her beliefs be typical of an Acadian? Can you say a bit more about her “roots”?

Marie Babineau is far from typical, so, as proud as she is of her Acadian heritage, she’s someone who is always shaping tradition, religion and her midwifery practice with experience and wisdom. That said, the gift of the traiteur (the folk healing tradition that Miss B. has had passed down to her from her great-grandfather) is one that is still practiced by some Cajuns (Acadians) in Louisiana today. It is a fascinating tradition, one that includes strong religious ties (usually Catholic), knowledge of herbalism and native plants, secret prayers and rituals. The history of the Acadians and their expulsion from Nova Scotia is part of my surrounding landscape, so it seemed only fitting that Marie would serve as the embodiment of that history. Her personal legend includes a trek from Louisiana to Nova Scotia and a calling to be a healer and a midwife. I won’t say too much more about it right now, but there’s more to her past and her youth to be explored one day …

Food and cooking play a major role in the novel. Do you enjoy cooking?
I love to cook. I grew up in a house where the kitchen was considered the heart of the home. Cooking and baking side by side with my mother was always filled with a bit of ritual. There’s a line in the novel where Dora is speaking about her mother and she says, “Everything I’ve learned from Mother, every bit of her truth, has been said while her hands were moving.” That’s also true of the time I spent with my mother in the kitchen and I suppose I’ve carried that into my home life as well. If you want to know who I truly am, catch me while I’m in the kitchen.

Your birth descriptions are very vivid. You have had children of your own but did you also attend other births for research purposes?
I have two sons. One was born in a hospital, the second was a home birth with the assistance of two wonderful midwives. I have attended births of friends, but it was at their request as support, not specifically for research. I’m also fortunate enough to have a dear friend who is a midwife. She was always kind enough to walk with me and talk through all the birthing scenes.

There is a battle in the book between traditional wisdom and modern science, the midwife versus the doctor. Was this a historical reality at the time?
Absolutely. When I began researching the history of midwifery in early-twentieth-century North America I was horrified to find how aggressive the obstetrical community had been in campaigning for the elimination of midwifery. Dr Joseph DeLee, a leading voice in obstetrics at the time stated, “The midwife is a relic of barbarism.” Doctors actively went to women’s organizations and club meetings, discrediting midwives and telling women they were bad mothers if they didn’t choose a hospital birth with a physician. Worst of all … their fear mongering worked.

In the UK, there has been a recent emphasis on a less interventionist and more “natural” approach to childbirth. Do you think this is a good thing?
It’s been proven that one medical intervention in childbirth often leads to one or more additional interventions. Too often a mother-to-be finds herself in a situation where she’s completely out of control of the birth process and in the end she’s led to feel that what happened was “normal.” I think this attitude has led many women to fear childbirth to the point where they aren’t confident in themselves or their bodies. An emphasis on a natural approach from the start helps give that confidence back to mothers and creates an atmosphere where fewer interventions are needed. I think any time the layers of fear that have surrounded our perception of childbirth are stripped away, it’s a good thing.

Modernity is seen as a positive force in some respects in the novel, particularly in terms of women’s sexuality. Is Maxine the archetypal “new woman” who has it all?
Maxine acts as Dora’s guide in many ways. Yes, she represents the “new woman” of the twentieth century, and she also shows Dora that change is possible. She’s a suffragist, she’s independent, but most importantly, she’s fearless. Dora could have sent for Wrennie and have been under Maxine’s protective wing in Boston, but in the end she chose to return to Scots Bay. She carried the best parts of Maxine back to her life in Nova Scotia and created changes in her community and a life of her own.

She opens Dora’s eyes to books she wasn’t allowed to read in Scots Bay: how did you find out what would have been in vogue?
“Banned in Boston” was a popular phrase from the time period in which The Birth House is set. It was also used as a humorous aside by playwrights, novelists and other artists. You knew you’d hit your mark if you were “banned in Boston,” if you were under attack by the Watch and Ward Society, if your books were burned at their meetings. Maxine’s reading list came from the long list of books and plays that had been banned in Boston at the time.

The biggest change for Dora came as a result of her stay in Boston, but she decided to return to Scots Bay. You moved from Chicago to Scots Bay. Have you turned your back on city life?
Not completely. While it’s true that my home in Scots Bay is the place where I feel most grounded and open to my writing, I still love the energy, variety and muscle of big cities. I visit at least a couple of my favorite cities every year just to get my fix.

Dora is supported throughout by her friends of the Occasional Knitter’s Society, especially when they look after Wrennie for her while she’s in Boston. Do you think this kind of support network is only possible in a small community where women are bound to the home? Do you rely on female friendship in your life?
I don’t think you have to be a homebody or live in a small community to have a close circle of friends. The things that pull the women of the Occasional Knitter’s Society together are the same things that hold all friendships together—supporting one another through hardship, lending an unconditional ear, and finding the laughter in life. I have a phenomenal group of women in my life. Locally, there’s a group of mothers who I hike, gab and drink tea with; they are all very creative—artists in their work and in their lives. It’s been a great source of inspiration to see other moms making art and following their dreams! Long distance, I have my touchstones—my mom, my sister, my best friends from university. We talk on the phone or see each other when we can and it always feels like “home.” These are the women who give me wings. I hope I do the same for them.

The Birth Houseends with the coming of electricity to Scots Bay. Does the advent of modern technology and communication systems mean we no longer “learn” from our friends/midwives/community leaders in the way we used to?
Life moves astoundingly fast these days and it’s not always easy to stop and find time for a chat and a cup of tea. We certainly seem to have to work harder to have traditional “kitchen table” conversations. At the same time, I think we are craving the kinds of connections and wisdom that can come from close-knit relationships more than ever. Seeing how people, and specifically women, have created new networks of connections, friendships and women’s wisdom via the internet (through websites, blogs, forums, etc.) is fascinating to me. I loved putting together my website. Hopefully I’ve created a virtual kitchen table, a space where readers can come and share their thoughts and stories with me and with each other.

What are you writing next?
Another novel about women’s lives and women’s health. It’s set in New York City in the 1870s and is inspired by the life of my great-great-grandmother. She was one of the first female physicians to graduate from medical school and practice in the city. This was at a time when women who went to medical school were considered freakish and unladylike. She was quite the woman!

Top Ten Favorite Novels

Northanger Abbey, Jane Austen

To Kill a Mockingbird, Harper Lee

Stories of Eva Luna, Isabel Allende

The Bluest Eye, Toni Morrison

Love in the Time of Cholera, Gabriel García Márquez

Frankenstein, Mary Shelley

Tess of the d’Urbervilles, Thomas Hardy

The Real Life of Sebastian Knight, Vladimir Nabokov

The Stone Diaries, Carol Shields

Rebecca, Daphne du Maurier

About the Book
Living in the Birth House: Inspiration behind the Book

When my partner and I moved from Chicago to Nova Scotia we bought an old farmhouse on the Bay of Fundy. While exploring an unfinished room over the kitchen, I discovered the walls had been sealed with seaweed and horsehair plaster and then covered with newspapers. Each layer of paper dated back to a different era. Advertisements for 1930s appliances were pasted over pictures of the Hupmobile Coupe … cars and washing machines gave way to testimonials for Lydia Pinkham’s female toners and home remedies.

Every time I turned a new patch of earth for my gardens, I uncovered some small relic of the past. Medicine bottles, bits of broken china, and my favourite find—an old silver serving spoon. It had been used so often that the edge of the bowl of the spoon had been worn down to an angle. As I stood at my kitchen sink, washing the dirt out of the wheat-stalk pattern in the handle, I began to daydream about the woman who had once held this spoon so many days of her life, how she must have stood over the stove, stirring, testing her work, giving tastes to a husband or child as they passed through the kitchen.

By spring I was pregnant. As word spread around the community of my “condition” and that I was looking for a midwife to assist in a home birth, neighbours began telling me tales about the history of my home, which was once a midwife’s house. I was captivated by their stories. Not only had the midwife, Mrs Rebecca Steele, travelled to other homes in the Bay, but she eventually opened her home to the women in the community as a birth house. She took them in and saw them through labour and delivery, and then both mother and child stayed in the birth house for a week or more after the birth. During this time, I was privileged to meet the midwife’s adopted daughter, Mary. Her first words to me were “My mother died when I was three days old. My father couldn’t take care of me of course, and there was no one else to care for me. The midwife, she couldn’t have babies of her own, so she took me in.” As I sat with her at the nursing home, Mary took a piece of paper from her pocket and began to read the names of all the women who had given birth in her mother’s house. The stories from the community and Mary’s memories led to a documentary and accompanying webumentary for CBC radio.

Although I enjoyed writing and producing the documentary, I had also been frustrated in my efforts to uncover the midwife’s past. Having died in 1955, she had been gone just long enough to start to fade from people’s memories. I could find no photographs of her, and although the older residents of my community could remember her kindness and her round, matronly figure, there were no traces left of her life as a young woman. A brief account in The Berwick Register mentioned that she had once taken an extended stay in the U.S. but her only child, an adopted daughter now living in a nursing home, couldn’t guess why her mother had gone away from home in the first place. Out of my need to fill in the spaces of Mrs Steele’s limited biography, The Birth House was created.


Read On
Knitters, Vibrators, and TNT

The Occasional Knitters Society
During World War I many women all across Canada joined together in the practice of knitting items for the soldiers. The Red Cross slogan “Knit Your Bit” and songs such as “I Wonder Who’s Knitting for Me” became part of the popular culture. Thrumming—a knitting technique used in Newfoundland and most of Atlantic Canada—is a process where pieces of roving are worked into mittens, hats and socks. It makes them amazingly warm and almost waterproof. (Which is why soldiers were known to trade almost anything for a pair of socks knitted by a Newfoundlander.)

A Brief History of the Vibrator
In the 1880s British physician, Joseph M. Granville, was searching for a better way to “cure” hysteria in his female patients. By 1883, he had patented the first electromechanical vibrator, a medical device that could perform “therapeutic massage” in a quick and effective manner.

Early in the twentieth century, portable home units were advertised in women’s magazines and almanacs, thus making the purchase of a personal vibrating massager through mail order a popular alternative to visiting the doctor for prescribed “treatments.”

The Halifax Explosion
On December 6, 1917, nearly 2,000 people died in the Halifax explosion, many killed instantly by the “biggest man-made explosion the world had ever seen” (Canadian Broadcasting Corporation). Some 9,000 others were injured and 6,000 were left without shelter. More Nova Scotians were killed in the explosion than were killed in World War I.
Further Reading

A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785–1812, by Laurel Thatcher Ulrich

Giving Birth in Canada, 1900–1950, by Wendy Mitchinson

The Technology of Orgasm: “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction,by Rachel P. Maines

Birth Crisis, by Sheila Kitzinger

A Room of One’s Own, by Virginia Woolf

The Female Malady, by Elaine Showalter

Interesting Websites

See Ami McKay’s own website for The Birth House at

On the history:

The Nova Scotia Museum (website for the twenty-seven museums across the Province):

The Library and Archives Canada First World War website:

The Canadian Broadcasting Corporation’s Halifax Explosion website:

On birthing practice:

Sheila Kitzinger’s website:

UK birthing website:

The National Childbirth Trust:

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