It was absolutely predictable that Naomi Wolf would write a book about motherhood. She belongs to a generation of women, which is also my generation, for whom becoming and being a mother have undone every comfortable feminist certainty we ever had, and whose trademark response is to write about it. Reared on a weirdly neutered brand of feminism, you regarded motherhood as just a vague idea to keep up your sleeve in case it came in handy later. Children were things you left as late as possible, then farmed out to minders and nurseries while you concentrated on the all-important task of being equal. During those decades of active, angry, acquisitive feminism, motherhood was expunged from the official doctrine, cast as an old-fashioned habit best ignored. "Our great romance was with the belief in equality itself," as Wolf puts it.
Misconceptions is Wolf's fourth book. It is interesting not so much for what it has to say about the journey to motherhood, a story which has been told rather better elsewhere, but for how it fits into a wider publishing phenomenon, recently dubbed "mummy lit". The term may be trivialising; the rapidly amassing body of fiction and nonfiction that it describes is anything but. Taken individually, these books vary greatly in style, approach and quality; taken together, they represent something substantial and unignorable.
Wolf writes plaintively of the "collision between expectation and reality" which creates "a kind of statelessness for many women" when they become mothers. In exile from old convictions, we are in the process of discovering ways to talk and write about this collision and its consequences, whether that's the acidic introspection of Rachel Cusk's A Life's Work, the wry humour of Susan Maushart's The Mask of Motherhood or the warm-hearted insightfulness of Maureen Freely's What About Us?, to name three contributors to the genre.
Through the prism of publishing trends we are witnessing feminism in the process of reinventing itself, struggling to draw from the wreckage of an outmoded idealism about gender equality some clues and fragments from which a less grandiose, more realistic - holistic even - feminism may be constructed, one that encompasses rather than denies the centrality of not just our productive, but our reproductive selves.
I have nothing but admiration for Wolf's determination to get up there on her soapbox and tell us how wrong the world is, how badly it uses women. Misconceptions, however, is not a particular success, marred by too many hackneyed revelations about pregnancy, too many unstartling insights about motherhood. A self-indulgent torpor embues the writing for the most part.
Wolf recovers her usual table-thumping pizzazz only when she turns her attention to anatomising the American medical profession.
She depicts the American birth industry as a remorseless machine geared to maximising profit and minimising liability. In the sleek world of private health- care, time is money; patients are merely the means to a lucrative end. Since the 1970s, the Caesarean rate in the United States as a whole has risen from 6 per cent to 25 per cent (compared to 5 per cent in some European countries). In private hospitals in America, however, the rate for healthy, middle-class women stands at 50 per cent. "In other words," says Wolf, "women whose health plans can afford to reimburse the hospital for a Caesarean section are more likely to be told they must have one."
As her pregnancy progresses, Wolf is drawn into a web of obscure silences, misleading statistics and obfuscating procedures. In a New York consulting room, a leading obstetrician hisses that she will be risking her unborn child's life if she resists medical intervention. Only later does she realise he was probably just covering his ass. The gleaming Alternative Birthing Center in the smart Washington hospital where she is due to deliver turns out to be little more than a cynical showpiece, pretty bait for women just like Wolf who, in reality and on the flimsiest pretext, will be shunted to the unglamorous birthing rooms below. There, epidurals, episiotomies and surgery are as routine as flossing teeth. The many, considerable risks associated with each of these interventions are starkly itemised.
Private obstetricians and hospitals make substantially more money from a Caesarean than a vaginal delivery. Wolf points out that American hospitals would lose $1.1bn in revenue each year if they performed Caesareans only when absolutely necessary.
With one eye on their hourly rate and the other on the cost of litigation, obstetricians pressurise women into unnecessarily hi-tech births that frequently end in emergency Caesareans. Even entirely problem-free labours are routinely "speeded up" with the help of epidurals and Caesareans, if deemed by obstetricians to be taking too long. In comparison with this monstrous piece of profiteering, the creaky old NHS emerges as little short of a birthing idyll.
Rebecca Abrams's most recent book is Three Shoes, One Sock and No Hairbrush (Cassell, £9.99)