Love Works Like This: Travels Through a Pregnant Year, A Memoir Lauren Slater, Bloomsbury, 2003. £9.99 softback, 175 pp. ISBN: 0747562172

Love Works Like This does not set out to make comfortable reading. It details—in lyrical, compelling and occasionally disturbing detail—the experience of pregnancy, birth and the first year of childrearing of author and psychologist Lauren Slater as she attempts to navigate a course on which she feels insecure, ill-equipped, anxious and, at times, downright terrified. Feeling weakened by her history of depression she questions her ability to provide her child with the love and care she would wish, while the apparent necessity of her anti-depressive medication (Prozac) and the effect it may have on her unborn child terrify her. Early in the pregnancy she decides to stop her medication believing that any damage to her welfare is far outweighed by that of her child. However, her symptoms re-emerge and she is prescribed a pharmaco-cocktail of Prozac, Klonopin and lithium which appears to abate her depression. Despite the medical background of both Slater and her husband, the prescribing doctor dismisses their concerns (based on clinical trial evidence the doctor refers to as “bunny studies”) that the drugs may be harmful to their unborn child. Slater may have spent a substantial part of her life on medication, but she is a woman long before she is medicated and yet is presented with a response from a doctor that is at best lacking in initiative, at worst negligent and irresponsible. Her experiences raise a number of questions that, as a patient, she could surely expect to be answered. Is the prescription of potentially teratogenic substances an appropriate response to a woman already beset with the anticipations and fears that accompany a pregnancy? A pregnant woman is not after all part of a phalanx-like contingent. She is a woman at her most vulnerable and is in need of medical guidance. Should she, therefore, be presented with treatment that appears based on disregard for her physical, psychological, and emotional wellbeing and that of her child? In an age of medical alternatives there would appear to be less need for medics to remain attached to drugs known to be of potential harm to the woman and her child. Should she not at least hope to be able to place sufficient trust in a physician to provide the least invasive treatment possible based on what they would be comfortable with for themselves and those close to them? Slater’s narrative unravels and questions notions of the appropriate and expected behaviour and attitudes of a pregnant woman towards her body and her child. There is a lush and enticing quality to the way in which she describes the bodily changes that occur during pregnancy and after giving birth. (So enticing in fact that I left the book feeling more than a little broody.) Yet while Slater leads the reader gently into the physicality of pregnancy she confronts with a mentality that runs counter to that which we are taught to expect. Through subtle and not-so-subtle influence women are led to believe that they will feel overwhelming joy and adoration for their child. It may be the case that most women do, but Slater does not: her pregnancy and birth are characterised by an ambivalence that she finds hard to reconcile to her expectations of maternal love. “Motherhood’s biggest taboo may be not rage but mildness. Mother love must be intense. I am not intense. I feel a great guilt. So far, it is only my guilt that makes me a mother.” She ponders the ways in which “mother love” is created: by noticing the tiniest parts of her child, in her care and concern for her, also in her fear and her hope that she will have survived her in utero drug exposure. What, she wonders, is the meaning of pregnancy: feeling nothing other than ambivalence is she no more than the “incubator” her husband suggests? Slater’s previous works Welcome To My Country, Prozac Diary and Lying (published as Spasm in the UK) recounted her experiences, both personal and professional, with schizophrenia, depression and epilepsy, respectively. With Love Works Like This she brings to pregnancy a text that is illuminating in its frankness and bravery. If mildness is indeed motherhood’s biggest taboo, then it is an emotion not often expressed in print and one which Slater presents in a narrative that is witty, deeply affecting and entirely apposite.