Book Review: The Blue Cotton Gown

The Blue Cotton Gown: A Midwife’s Memoir
By Patricia Harman
Beacon Press, 2008
Hardcover, 290 pages
ISBN: 978-0807072899

Reviewed by Molly Remer

Patsy Harman is a CNM in West Virginia. She runs a busy women’s health practice with her husband Tom, an OB-GYN. Though obstetrics was once a rewarding part of their practice, they’ve stopped attending births due to unaffordable malpractice insurance rates. In addition to tales from the office, this compelling narrative follows Patsy through struggles with the IRS, fears over potential lawsuits, family complications, and uterine cancer. Since I usually come from a consumer advocate’s perspective, it was very interesting to have this intensely personal look at the other side of the coin—the deep fear obstetric professionals have of lawsuit.

The author told me in advance that this is not a book of birth stories, "it is about women giving birth to themselves." This is true—-there are almost no birth stories in the book (and in one of the few there is, I was surprised to read that the mother was induced with misoprostol!). However, this is actually what gives the book its absorbing edge. In it, you get to see another side of midwifery—-the "with woman" side that extends before and after pregnancy and childbirth. This is a side of midwifery that I haven’t yet seen explored in memoir format and it was incredibly engaging. Patsy’s clientele are women who have STDs or yeast infections, who need pap smears or well-woman exams, or who need a pregnancy diagnosed, but her care for them goes beyond the physical. The women’s lives are complicated, as is her own. Some of the stories are very sad and others are uplifting. If you are looking for birth stories, look elsewhere, if you are looking for a skillfully written and emotional look at the practice of nurse-midwifery and its dominating role in a woman’s multifaceted life, you will find a treasure in The Blue Cotton Gown. As it came to an end, I found myself wishing for Part Two.