“For fans of Adam Kay’s This Is Going to Hurt and Christie Watson’s The Language of Kindness,” the blurb on my press release for Leah Hazard’s memoir opens. The publisher’s comparisons couldn’t be more perfect: Hard Pushed has the gynecological detail and edgy sense of humor of Kay’s book (“Another night, another vagina” is its first line, and the author has been known to introduce herself with “Midwife Hazard, at your cervix!”), and matches Watson’s with its empathetic picture of patients’ plights and medical professionals’ burnout.
Hazard alternates between anonymized case studies of patients she has treated and general thoughts on her chosen career (e.g. “Notes on Triage” and “Notes on Being from Somewhere Else”). Although all of the patients in her book are fictional composites, their circumstances are rendered so vividly that you quickly forget these particular characters never existed. Visceral details of sights, smells and feelings put you right there in the delivery room with Eleanor, one-half of a lesbian couple welcoming a child thanks to the now-everyday wonder of IVF; Hawa, a Somali woman whose pregnancy is complicated by the genital mutilation she underwent as a child; and Pei Hsuan, a Chinese teenager who was trafficked into sex work in Britain.
Sometimes we don’t learn the endings to these stories. Will 15-year-old Crystal have a healthy baby after she starts leaking fluid at 23 weeks? What will happen next for Pei Hsuan after her case is passed on to refugee services? Hazard deliberately leaves things uncertain to reflect the partial knowledge a hospital midwife often has of her patients: they’re taken off to surgery or discharged, and when they eventually come back to deliver someone else may be on duty. All she can do is to help each woman the best she can in the moment.
A number of these cases allow the author to comment on the range of modern opinions about pregnancy and childrearing, including some controversies. A pushy new grandmother tries to pressure her daughter into breastfeeding; a woman struggles with her mental health while on maternity leave; a rape victim is too far along to have a termination. At the other end of the spectrum, we meet a hippie couple in a birthing pool who prefer to speak of “surges” rather than contractions. Hazard rightly contends that it’s not her place to cast judgment on any of her patients’ decisions; her job is simply to deal with the situation at hand.
I especially liked reading about the habits that keep the author going through long overnight shifts, such as breaking the time up into 15-minute increments, each with its own assigned task. The excerpts from her official notes – in italics and full of shorthand and jargon – are a neat window into the science and reality of a midwife’s work, with a glossary at the end of the book ensuring that nothing is too technical for laypeople.
Hazard, an American, lives in Scotland and has a Glaswegian husband and two daughters. Her experience of being an NHS midwife has not always been ideal; there were even moments when she was ready to quit. Like Kay and Watson, she has found that the medical field can be unforgiving what with low pay, little recognition and hardly any time to wolf down your dinner during a break, let alone reflect on the life-and-death situations you’ve been a part of. Yet its rewards outweigh the downsides.
Hard Pushed has none of the sentimentality of Call the Midwife – a relief since I’m not one to gush over babies. Still, it’s a heartfelt read as well as a vivid and pacey one, and it’s alternately funny and sobering. If you like books that follow doctors and nurses down hospital hallways, you’ll love it. This was one of my most anticipated books of the first half of the year, and it lived up to my expectations. It’s also one of my top contenders for the 2020 Wellcome Book Prize so far.
A few favorite passages:
“So many things in midwifery are ‘wee’ [in Scotland, at least!] – a wee cut, a wee tear, a wee bleed, the latter used to describe anything from a trickle to a torrent. Euphemisms are one of our many small mercies: we learn early on to downplay and dissemble. The brutality of birth is often self-evident; there is little need to elaborate.”
“Whenever I dress a wound in this way, I remember that this is an act of loving validation; every wound tells a story, and every dressing is an acknowledgement of that story – the midwife’s way of saying, I hear you, and I believe you.”
“midwives do so much more than catch babies. We devise and implement plans of care; we connect, console, empathise and cheerlead; we prescribe; we do minor surgery. … We may never have met you until the day we ride into battle for you and your baby; … you may not even recognise the cavalry that’s been at your back until the drapes are down and the blood has dried beneath your feet.”
My rating: 
Hard Pushed was published in the UK on May 2nd (just a few days before International Midwives’ Day) by Hutchinson. My thanks to the publisher for the free proof copy for review.
I am usually allergic to any book that could be described as “experimental,” but I found Murmur’s mosaic of narrative forms an effective and affecting way of reflecting its protagonist’s identity crisis. There were certainly moments where I wished this book came with footnotes, or at least an Author’s Note that would explain the basics of Turing’s situation. (Is Eaves assuming too much about readers’ prior knowledge?) For more background I recommend The Imitation Game, starring Benedict Cumberbatch as Turing.
Blood Ties by Ben Crane: Artist Ben Crane has developed a passion for birds of prey, raising hawks and training as a falconer. “I saw that my feelings towards nature, and birds of prey in particular, ran in parallel with my feelings for my son,” he writes. Blood Ties accordingly cuts between the story of rehabilitating a pair of rescued sparrowhawks named Girl and Boy and a parallel story about raising his son as a part-time single father. Together these strands emphasize the common concerns that arise when caring for any creature. Crane’s descriptive language is memorably sharp. Whatever struggles his Asperger’s entails, it seems to heighten his observational skills. Pruning the travel segments would have produced a more focused memoir, but this is a powerful story all the same – of the ties that bind us, both to nature and our own families. (Full review in February 8th issue.) 
Notes for the Everlost: A Field Guide to Grief by Kate Inglis: Inglis, a Nova Scotian photographer and children’s author, has written this delicate, playful handbook – something between a bereavement memoir and a self-help guide – for people who feel they might disappear into grief for ever. In 2007, Inglis’s identical twin sons were born premature, at twenty-seven weeks. Ben lived but Liam died. Every milestone in Ben’s life would serve as a reminder of the brother who should have been growing up alongside him. The unfairness was particularly keen on the day she returned to hospital for two appointments: Ben’s check-up and a report on Liam’s autopsy. Unable to sustain the eye-popping freshness of the prose in the introduction, Inglis resorts to some clichés in what follows. But this kooky, candid book will be valuable to anyone facing bereavement or supporting a loved one through it. (Full review in March 15th issue.) 
What with the flashbacks and the traumatic labor, it takes narrator Marion over 100 pages to get born. That might seem like a Tristram Shandy degree of circumlocution, but there was nary a moment when my interest flagged during this book’s 50-year journey with a medical family starting in a country I knew nothing about. I was reminded of Midnight’s Children, in that the twin brothers are born loosely conjoined at the head and ever after have a somewhat mystical connection, understanding each other’s thoughts even when they’re continents apart.
