There is a point toward the end of Patricia Harman’s Arms Wide Open: A Midwife’s Journey (Boston: Beacon Press, 2011) when author offers us another of the many particular birth scenes that punctuate the overarching narrative. It is the late 1970s and, after nearly a decade delivering babies as a lay midwife, Harman has entered medical school to become a Certified Nurse-Midwife. She describes the labors of a woman named Carla who will eventually deliver a son whom she names Joe. As the child is about to crown, the following scene takes place:

M.R. [Mary Rose, Harman’s mentor] lets go of my hands and reaches for a pair of scissors. At first I assume she’s getting ready to cut the cord, though the head’s not out yet, but she nudges me with her elbow and forces the scissors into my hand, then injects Xylocaine into our young patient’s perineum. Now I know what she wants me to do … cut an episiotomy.

So here I sit. The head of a dark-haired infant crowning before me. I know how to get this baby out without a laceration or episiotomy in two minutes, if Mary Rose and the enthusiastic nurse would leave me alone, but I am the student, enrolled to learn.

I take the scissors and cut, feel the skin crunch between the blades, see the blood ooze … and deliver the baby. It’s not a good feeling, but it’s done. The very pink body swivels out, Mary Rose cuts the cord, and the RN takes the tiny boy to the infant warmer.

“If the heart rate’s down, you have to cut an episiotomy right away,” Mary Rose whispers, “The OBs watch us, and if you hesitate, they’ll start coming in to every delivery to supervise.” She looks at the door. “We don’t want that” (246).

This scene is, I would argue, the hinge upon which this memoir turns. Arms Wide Open is a memoir in three parts. Part one (“Little Cabin in the North Woods, 1971-1972”) and part two (“Commune on the Ridge, 1977-1978”) are episodic accounts of Patricia Harman’s decade of experiments in communal, backwoods living. From an isolated cabin outside of Duluth, Minnesota to an intentional community in South Carolina, we follow Patricia Harman, her lover, her future husband, her sons, and a motley group of fellow-minded travelers through the ups and downs of community life. “Commune on the Ridge” ends with Patricia and her husband Tom’s joint decision to pursue medical degrees (he in women’s health, her as a midwife) — a decision which took them away from the commune and back into the mainstream frameworks of institutional education, hospital-based medicine, and city life. Part three (“Cedar House on Hope Lake, 2008-2009”) jumps ahead to the present, with reflections back upon some of Harman’s training and the years she and her husband worked together running a women’s health clinic. Each section is, in some ways, in dialogue with the other sections as the reader is invited to compare and contrast each location and living arrangement Patricia and her family create for themselves with their previous and future locations and arrangements.

The strength of Arms Wide Open is the immediacy of its narrative. In recreating her personal history, Harman has drawn heavily on journals she kept during the years she describes, and the resulting text bears the marks of that internal narrative: we experience the events in the book through Patsy’s senses, and what meaning is made of those events is made less through present-day commentary than with the voice of (possibly imagined) Harman’s younger self. Arms Wide Open is executed with loving care, and provides an unvarnished look at the struggles and disillusionment, as well as the joys of communal experimentation. For anyone interested in experiencing communal life vicariously through personal narrative, Arms Wide Open comes highly recommended.

It is this very sense of immediacy, however, that contributes to what I felt was one of the book’s central weaknesses: the lack of any larger framing narrative, any strong present-day voice that would exert autobiographical force upon these episodic scenes and encourage us to understand not only how Patsy-of-the-moment made sense of her life, but how Patricia Harman presently understands her past experience. I finished the book with lots of unanswered questions about how Patsy of the backwoods commune became Patricia the Certified Nurse Midwife working in a women’s clinic. It is possible that some of those questions may be answered in Harman’s first memoir, The Blue Cotton Gown (2008). At some point I may go back and read that volume. However, the point remains that readers coming to Arms Wide Open without the background of Cotton Gown are left wondering at the underlying values and choices that led Harman first in to, and then away from, the backwoods communal life. She hints around the edges about a background in New Left political action, anti-war protests, and even some jail time. The narrative implicitly endorses a very specific vision of responsible living on the earth, of childbirth and childcare, of gender and sexuality — yet the narrator never steps back from the moment to write in more overarching ways about how her politics and values have (or have not) changed over time.

I would have been very interested to know how she sees her present-day work connected (or not) to her earlier experiences, philosophically and practically. The final section, particularly, contains a lot of sadness and sense of displacement — while Harman and her husband seem to have found ways to live out their values in a more mainstream context, there is also a pervading wistfulness and at times outright pain at the way in which their lives have not played out as they hoped or expected. There is a sense that, having given up the communal way of life, Harman is not sure how to live out her most deeply-held values in a less unconventional context. Although she describes interacting with anti-war protestors and midwives who are a generation or two her junior, she seems profoundly isolated from the counter-cultures of the present day (of which, I would argue, there are plenty!). This loss of fellow travellers within the narrative speaks to me particularly, since I have spent many hours interviewing counter-culture-leaning folks from Harman’s generation about their past and present lives … and how they do and do not forge connections across age cohorts. In such an age-stratified society such a project can be difficult — even radical — but I would argue that to tie radicalism to a particular generation or stage in life is a deadly impulse if what we want to create is lasting social change.

On a similar note (although I imagine it is not her story to tell), I would also have been interested in her children’s reflections on the experience of early childhood in a communal household — and how they feel it shaped their own values and expectations as they grew into adulthood. From passing references toward the end, it sounded as though all three of Harman’s sons had chosen outwardly conventional life paths. Outward appearances can be deceptive (I could write my own biography to sound exceedingly conventional), but I would have liked further exploration into the whys and wherefores of Harman’s family as it came of age.

Ultimately, this is recommended reading for anyone who is interested in counterculture living, midwifry and childbirth, the historical period of the 1970s, and the art of memoir. If you’ve read The Blue Cotton Gown I’d be interested to hear your views on how the two books work together, and whether any of the silences I have mentioned above continue throughout.