When Arielle Greenberg of Belfast set out to write a book about home birth with longtime friend and fellow poet Rachel Zucker, she was pregnant with her second child and living in Illinois, a state where home births were, and continue to be, illegal.

“It’s home to the AMA,” she said, as though it would be obvious why the American Medical Association were to homebirthing what the National Rifle Association might be to a state with loose gun laws.

The AMA, as it turns out, opposes homebirths and has, along with the American College of Obstetricians and Gynecologists, attempted to get legislation passed that would officially identify hospitals as the safest places for births.

Greenberg and Zucker couldn’t agree less. In “Home/Birth,” they posit that hospitals and obstetricians often view their patients through the lens of pathology — as broken objects that need to be fixed — and feel threatened by the idea that a birth can occur without the use of tools and procedures, without crisis.

After the clandestine birth of her first child with one of a handful of “underground midwives” working in the greater Chicago area — a five-day labor leading to what she described as an “amazing birth” — Greenberg was also highly politicized about the medicalization of what has been a natural process for all but the last hundred years of human history.

Despite the success of her first birth, Greenberg didn’t want to dodge the laws in Illinois a second time. She had visited Maine on numerous occasions (she and her husband were married in Belfast in 2003), and she started making plans to have her baby here, with a Ellie Daniels and Donna Broderick of Morningstar Midwifery.

The couple found a house to rent for two months. When the owner of the home asked why they wanted to come for two months in the dead of winter, Greenberg’s husband Rob cautiously divulged the plan. To their surprise, the owner said she couldn’t think of a better use for her home.

The contrast between what she found in Belfast and her experience in Illinois was startling. There were as many homebirth midwives in Waldo County as in the greater Chicago area.

“It just seemed amazing to me that in this town of 7,000 people you had two certified midwives just hanging a shingle out downtown,” Greenberg said.

“Home/Birth” is structured as a fragmented succession of thoughts, recollections, slogans, facts, poetry, stream-of-consciousness riffing on pregnancy, on birth and sometimes on the state of the world. On any given page, the pieces appear only loosely connected, but throughout the book a number of themes recur at intervals, creating a number of interwoven plot lines around the larger theme of childbirth.

Much of the text involves a conversation between Greenberg and Zucker, exerpted from their actual conversations, conducted by e-mail.

Zucker, who had three children of her own, the first two born in hospitals and the most recent a homebirth, was in New York at the time, but committed to becoming a doula (someone who helps the mother during labor) for Greenberg’s birth, and in the initial chapters of the book, the friends appear to be trying to figure out how it will all work.

The style and point of view are both unusual among homebirth literature, Greenberg said. The lyric essay style was inspired by the author C.D. Wright, who used a similar montage of observations, snippets of dialog and other ephemera to write about prisoners in Louisiana in her book “One Big Self.”

“Home/Birth” was also written by “consumers,” Greenberg said, rather than healthcare providers.

“It’s not a midwife’s memoir, it’s not a how-to,” she said. “It’s a political book and a personal book, all these things at once.”

The entries in the book, which present as a rolling series of sentences and short paragraphs, are largely unattributed. By not identifying the speakers the authors are free to include dozens of other voices without formally writing characters into the story. In this way, the book aggregates the experiences of many women and presents them as a collective voice.

The anonymity also serves as a reminder of the fact that homebirths remain illegal in a dozen states, and allows the authors to include gray areas of the issue without having to bend them to a thesis.

But Greenberg and Zucker are not without a viewpoint; the subtitle of the book — a portmanteau of “poem” and “polemic” — is accurate. The authors are adamantly in favor of natural childbirth, at home. Conversely, they are alternately puzzled, heartbroken and enraged by the way the age old practice has been marginalized over the last century.

Once the norm, homebirths have become the province of religious fundamentalists, hippies and “witches,” a pejorative that Greenberg and Zucker recognize as both humorous and powerful, reclaiming it the way a homosexual might self-identify as “queer.”

“I have started to feel like there’s a conspiracy to keep women from knowing what their bodies can do. From seeing their power,” one entry reads. “I’m starting to feel like a real witch.”

The use of the term “witches” conveys a lot about how feminine wisdom has be suppressed by “real” science (or maybe just men), its mysteries interpreted as evil magic. Like homebirthing, witches seem to be mostly misunderstood by a medical field that can’t quantify the spiritual stuff.

Perhaps the best expression of this is in the idea of “holding the space,”  — shorthand for giving constant emotional support — which appears in nearly every text on natural childbirth.

One speaker recounts giving birth in a hospital and begging the nurse to stay, saying that if the nurse leaves she won’t be able to do it (give birth). Another story recounts the comfort a laboring mother received from a woman who merely sat in the corner knitting. Other times it’s holding a cool washcloth to the forehead or pushing on the sacrum.

As it turns out, mothers, while undergoing the defining act of maternity, need to be mothered. Other women recognize this and they know how to do it, often by simply being there, holding the space.

Greenberg and Zucker argue that the antipathy toward homebirths and midwifery that has coincided with the rise in hospital births is partly due to a lack of information. But “Home/Birth” makes a strong argument that it is also the result of a cultural acceptance of violence toward women, what in feminist theory is termed the “rape culture.”

Doctors, typically male, are repeatedly described in “Home/Birth” as “powerful strangers.” Females in the hospital setting — nurses, but also doulas and midwives — are either complicit or powerless.

On a practical level, the authors argue that the hospital environment, with its bright lights, restrictions on eating or drinking, requirement that women labor on their backs (one speaker in the book suggests that the only more difficult way for a woman to give birth would be hanging upside down by her feet), constant fetal monitoring and the intrusive fingers of strangers all slow down labor, because they make the mother uncomfortable or fearful. And when labor slows, it’s assumed that something must be wrong.

With some exceptions, Greenberg and Zucker argue that being in the hospital in the first place is the problem. But doctors, working from the presumption that the hospital is the safest place for a birth, initiate a cascade of “fixes” that inadvertently create new problems until the only options are those that were once reserved for emergencies but are now in common practice — emergency cesarean sections, drug induced induction, manually breaking the amniotic sac or the baby’s collarbone and episiotomy, among others.

Ironically, Greenberg and Zucker note, fear drives women to hospitals in the first place, and while the authors cite statistics that homebirths are safer in most cases because the birth is less likely to result in an unnecessary surgical procedures or infection, the prevalence of hospital births has made homebirth look, to many expectant mothers, like the riskier proposition.

Those who are brave enough to buck the trend are often viewed as recklessly seeking a transcendent experience for themselves. Relatives and friends ask, “but what about the baby?”

The authors asked this themselves. “But what if something happens?” appears several times, appearing to be more of an attempt to be complete than a concern. A later chapter that begins, “We need to talk about it: sometimes babies die,” is filled with stories of births gone wrong, and the conclusion seems to be that sometimes things happen.

“The point of mainstream medicine is that nobody dies, right?” said Greenberg. “You try to avoid death at all costs.”

Greenberg ultimately miscarried at 31 weeks. The book was nearly completed and the still birth is treated in a moving afterword that recounts what happened in a less fragmented way than the rest of the book. Greenberg describes coming to Maine after learning that her baby had died and giving birth to him — a process that she said helped her reconcile the misfortune.

“It was an incredible spiritual opportunity, a time to say goodbye and make peace,” she said. “We chose to embrace and go toward what was happening instead of running away from it … We could have been shattered by that experience if we hadn’t had the care we had with those midwives,” she said. “So it reinforced my feelings about homebirth.”

The text of the afterword is interrupted at intervals by what Greenberg describes as “echoes, echoing: lines from a manuscript Rachel and I co-wrote about homebirth throughout my second pregnancy and that came back to me after the baby stopped living.”

Greenberg has since had another child, born at home, and moved to Belfast permanently. She and Zucker are scheduled to read from “Home/Birth” Saturday, Aug. 20 at 2 p.m. at The Green Store, 71 Main St. Refreshments and a discussion will follow the reading, and the authors will sign copies of the book, which will be for sale.

VillageSoup reporter Ethan Andrews can be reached at 207-338-3333 or by email to eandrews@villagesoup.com.