If you’re squeamish, look away now. In fact, avoid this book like the plague. Never have I read in such visceral detail about how foul and terrifying childbirth, illness and death can be. Not to mention the awful tragedy of stillbirth. Midwives will appreciate Julia’s technical skill at dealing with prolapses, perineums and poo, but for mere mortals it’s hard to stomach. Those who make it as far as the lively post-mortem scene will be rewarded with yet more medical realism.
As anyone who has read Donoghue’s internationally bestselling novel Room – inspired by the grotesque Josef Fritzl case – will know, she is quick to draw the reader in. After only four short sentences, we can already smell the “dung and blood” of the Dublin streets as nurse Julia Power cycles to work at an understaffed hospital in the city centre. Donoghue’s prose is visceral, and the sense of peril in the cramped, tiny ward is compelling. The first part of the story takes place over 14 hours as women weakened by flu contort themselves in labour. There is tenderness and even beauty amid the horror, as nurses manoeuvre the expectant mothers into bizarre positions to accelerate labour and thus save lives.
However, I must admit that Donoghue does deliver with The Pull of the Stars. While the final part is abrupt and clumsily plotted (I question the fast-tracked editing process the novel must have undergone in order to accommodate its early release), Donoghue’s narrative of a nurse in the midst of a pandemic is enticingly written with the not-a-minute-to-waste pace of Dr Lynn.
Its modern parallels do trigger uneasiness (as do its numerous and gloriously explosive birth scenes) but those parallels are what ultimately make The Pull of the Stars a felicitous comment on our new times.
Donoghue has written a lot of historical fiction in the past, and has clearly done extensive research into the eye-popping nitty-gritty of First World War maternity care. Feverish pregnant women are given whisky, chloroform or morphine and there are gory, blow-by-blow birthing accounts (this book should include a health warning for pregnant women). Donoghue writes with such brilliant relish that during one particularly detailed account of Julia sticking her hand into the uterus of a woman to scrape out the afterbirth, having only ever practised on an orange, I realised that I was actually reading through splayed fingers and moaning a little. This is all undeniably fascinating and resonant, but by the time Julia is walking us step by graphic step through the autopsy of a mother and her unborn 29-week-old foetus, there is a definite feeling that complex or nuanced character development has taken a back seat.