I’m peering into a crib in the nursery of BabyLand General Hospital in Cleveland, Georgia. Outside, the air above the rolling hills just south of the Chattahoochee National Forest is sticky and humid, but inside BabyLand, it’s cool and scented with baby powder. Inside the crib, two “newborns” in white bonnets—Cabbage Patch Kid dolls with hand-sewn fabric faces, priced at $225 each—stare back at me blankly, as baby coos and cries play on a loop in the background.
Before I can be creeped out by the soundtrack, it is interrupted by an announcement: “Mother Cabbage is in labor! Mother Cabbage is in labor! If you would like to see Mother Cabbage give birth, please make your way to her now!”
This is the moment that the dozen or so people there have been waiting for, myself included. I turn on my heel, with embarrassing urgency, and beeline it through the “hospital”—an immaculately kept white-columned estate that is, in truth, a Cabbage Patch museum-cum-toy store. My shoes squeak on the black-and-white floor tiles. As I’m fast-walking (running seems a touch desperate, even for me) through BabyLand General, another announcement is made: “If you think you are going to get queasy during birth, you may proceed instead to the Father’s Waiting Room.”
I look around. There doesn’t seem to be an actual waiting room, so the crowd moves toward the center of the store to see Mother Cabbage—the matriarch of the world’s millions of Cabbage Patch Kids, and a towering sculpture made to look like an artificial tree that serves as the portal, i.e., birth canal, through which Cabbage Patch Kids enter the human realm.
At the height of the Cabbage Patch mania of the 1980s, children and adults lined up for hours outside the BabyLand General Hospital in New York City. (Across the country, a few adults were also involved in violent holiday toy-store riots as they battled to procure the precious dolls.) Three decades later, widespread Cabbage Patch mania has dwindled, and this BabyLand General Hospital, in the rural hometown of Xavier Roberts (the original marketer of the Cabbage Patch kids, which closely imitated “Doll Babies” created by the artist Martha Nelson Thomas) is the only one that remains. But the allure of the Cabbage Patch has not entirely faded. Every year, 250,000 people make the pilgrimage to BabyLand General, the centerpiece of which is the towering Mother Cabbage.
Mother Cabbage is a massive object—at least 12 feet tall, though she rises into a domed ceiling, giving her the appearance of infinite height. Like the drive-through trees of California’s Redwood Coast, her trunk is large enough to allow passage for BabyLand’s Licensed Patch Nurses (LPNs), who move in and about her as they work. Mother Cabbage’s many branches comprise a wide, shady canopy that protects a patch of roughly three dozen fabric cabbage heads. Tiny doll faces—mostly white, though there are a few brown ones here and there—peek out of the center of each cabbage. Under the twinkling, multicolored lights that dangle from the branches above, some of the babies’ heads turn and move, meaning you’ll occasionally find yourself in direct eye contact with one of them as it stares back at you, vacant and dumb. Or perhaps it’s staring straight into your soul.
Every year, 250,000 people make the pilgrimage to BabyLand General, the centerpiece of which is the towering Mother Cabbage.
From an upside-down, baby-bottle-shaped container filled with bubbling blue medicine, the LPN pantomimes filling a plastic syringe. “I’m going to give Mother Cabbage a dose of Imagicillin,” she explains, dabbing the tip of the syringe in various places around a head of cabbage in front of her, at the base of Mother Cabbage.
I crane my neck to try and see where exactly the Imagicillin is going—the cabbage’s spine, à la an epidural? Or perhaps amid her labia-like leaves? But alas, Mother Cabbage is too far away, and BabyLand doesn’t seem to have mapped the human female body to the cabbage/tree body in any rigorous way.
The nurse places the used syringe in an antique, white enameled medical tool tray which holds more syringes, a scalpel, and scissors.
“Don’t worry—this does not hurt or harm Mother Cabbage in any way,” she says. “It just loosens her leaves before and after her deliveries and helps her not feel any pain at all.”
As the nurse talks, I make eye contact with another mother sitting nearby. She’s with her daughter, a blonde, pig-tailed two-year-old pushing a Cabbage Patch Kid in a stroller. The mother looks back at me and laughs. We both know better.
Actual human labor is, of course, much more difficult and unpredictable than what happens at BabyLand General, where crystals at the bottom of the Mother Cabbage exhibit begin to glow brighter as the blessed event is set in motion.
It’s also not well-understood. In fact, there still isn’t a consensus among researchers about what exactly makes a body go into labor, or why childbirth—a process essential to all human life—is so demanding and harrowing.
Throughout the ages, women’s bodies have been poorly understood—particularly as reproductive vessels—and they have often been subject to myths and wild speculations that were treated as facts. For example, it wasn’t until the early 20th century that menstruation was clearly understood to be linked to ovulation; before that, people thought that women bled for no reason, or as a way to release their emotional hysteria. (Roman historian Pliny the Elder wrote: “Contact with [menstrual blood] turns new wine sour, crops touched by it become barren … hives of bees die, even bronze and iron are at once seized by rust, and a horrible smell fills the air.”)
In fact, there still isn’t a consensus among researchers about what exactly makes a body go into labor.
When I ask Dr. Holly Dunsworth if she’s surprised that we still don’t know what causes labor, she says no—at least for now. Dunsworth, a professor of anthropology at the University of Rhode Island, studies how human anatomy, physiology, and behaviors related to growing, birthing, and raising children have evolved.
“I know enough to know how complicated this stuff is and how difficult it is to imagine how to try and figure this out,” she explains. “I don’t think it’s true we’ll never know what starts labor, though.”
In other words, yes, childbirth might be difficult to study, but so are many other things—the brain, heart function, epigenetics, erectile dysfunction—and we’ve figured out ways to do it. It’s not just that pregnancy is challenging to study; it’s that medical and scientific researchers have chosen not to. There are certainly hurdles to studying the unique and temporary state of pregnancy, in which two bodies share the same real estate. But we should know much more than we do.
During pregnancy, a woman’s body builds an entire human being (sometimes more than one) from scratch. It also grows an entirely new organ, the placenta, alongside the fetus. When it is time to give birth, a mother’s cervix must expand from zero to ten centimeters, and her uterus, through a series of increasingly strong contractions, pushes the baby down the birth canal and out the vagina, an opening that is noticeably smaller than the baby’s head. It goes on for hours, sometimes days, and it’s excruciating—that’s why we call it labor.
For the last few decades, the difficulty of childbirth has been succinctly explained by an evolutionary hypothesis put forth by anthropologist Sherwood Washburn in 1960. Washburn’s hypothesis, called the “obstetrical dilemma,” posits that when humans parted evolutionary ways with our primate cousins—when we stood up and started walking on our hind legs—our brains got bigger and our hips got smaller. Over millennia, babies’ heads and their mothers’ vaginas became an increasingly tight and complicated fit. All this meant ever-more-painful births.
“It’s got a lot going for it,” says Dunsworth, of the obstetrical dilemma. “It pulls together so many of the stars of our human evolutionary story, or the highlights: big brains, bipedalism, our helplessness as infants.” But Dunsworth, who has spent the better part of the last decade testing Washburn’s hypothesis, believes the obstetrical dilemma doesn’t hold up.
Her research reveals that the onset of the birth process has less to do with head and bone size, and more to do with something more complex: metabolism and energy. Around nine months, she explains, a fetus’s energetic needs begin to outpace what a mother’s body can supply. (Toward the end of pregnancy, mothers’ bodies are operating at a metabolic rate more than two times their usual.) A pregnant woman holds 50 percent more blood volume than normal, and her heart is pumping all that extra blood to move oxygen through her body, as well as that of the growing fetus. It’s a lot of work, and a body’s metabolism is limited by its ability to handle the extra load. In other words, there is a limit to how long the female body can operate at such a heightened level before birth will need to occur.
“There’s a point when you could eat the moon, and you still couldn’t gestate or be pregnant any longer,” Dunsworth explains. “Metabolism is more than converting calories to energy and building a fetus ... it’s everything. It’s being the flesh-and-blood home for this extra person.”
Dunsworth calls her hypothesis the “energetics of gestation and growth.” This suggests that, after 40-plus weeks of negotiations, labor is the result of an energetic stalemate between mother and child—one that, thankfully, will be resolved by the fetus opting to have its needs met outside of its mother’s body.
“A lot of people have perpetuated [the obstetrical dilemma] as fact,” Dunsworth says. “It was very difficult to even question this hypothesis until very recently. This is how science unfolds, though: we rethink assumptions that are decades old.”
Back at BabyLand General, Mother Cabbage must be checked to make sure she is dilating properly. Presumably they are checking her cervix, but I really can’t tell. No one else—not the mothers, the grandmothers, or the little girls—seems concerned, though, or interested in posing the sorts of questions I’m anxious to have answered. Like, for example, does Mother Cabbage have a mucus plug?
The nurse pulls out a pelvimeter, an actual stainless-steel, gynecological instrument that resembles the silver electronic claws used to pick up toys at arcades. “We want to make sure [Mother Cabbage] has dilated a full ten leaves apart,” she explains.
Another syringe appears and Mother Cabbage is faux-injected in her trunk with a large dose of “TLC.” (The nurse also spritzes some behind each of her ears, as though the syringe were a perfume atomizer, telling us that she likes to give herself a dose of TLC every day, too.) She then raises a pair of surgical scissors and begins to spread the leaves of Mother’s cabbage head.
My intrigue (and horror) reaches new heights. I stand on my tippy toes and grip the cabbage patch fence, trying desperately to see what is about to go down with this particular magical, mysterious crystal-cabbage-vagina-hole.
“This procedure is what’s known as an ‘easiotomy,’” the nurse explains. “We are in fact the only hospital in the entire world that performs the easiotomy, though I’m not sure why. We’ve had no bad results and never once had to perform a C-section—a ‘cabbage’ section, that is.”
“We want to make sure [Mother Cabbage] has dilated a full ten leaves apart.”
Almost against my will, I find myself laughing at the joke, a play on words hinting at the episiotomy, a once-common procedure of making a surgical incision in the perineum (the small sling of skin between the vagina and the anus) to expand the opening of the vagina. Episiotomies were performed with the belief that they could speed a baby’s delivery and prevent extensive tears during vaginal childbirth. But research has shown that the procedure’s risks outweigh its supposed benefits: the incisions risk infection, and recovery is often more complicated than it would be with a natural tear. Since 2006, the American Congress of Obstetricians and Gynecologists (ACOG) has discouraged the use of episiotomies; health-care providers have come to understand that what female bodies do naturally during birth—rip open, tear—are not merely symptoms of weakness.
“Because women are, on average, slower walkers and runners, we’re seen as ‘not as strong as men,’” Dunsworth tells me. “You encounter this idea everywhere: that women’s bodies are not as evolved, or well-built, as men’s.” To her, it’s a “logical conclusion” based on the overuse of medical interventions (such as episiotomies and C-sections), which have gone from being used only to assist mothers in dire need to commonplace practices, as if women lacked the fortitude to endure their physiology.
I’ve birthed two babies—both pulled straight from my uterus as I lay on an operating table, each after 24-plus hours of labor. When I was pregnant with my second child and hoping for a vaginal birth after a C- section, an obstetrician strongly urged me to schedule a second C-section at 40 weeks because, she said, it was likely that I have an “uncooperative cervix.” I asked her: was there a way to gently encourage it to cooperate? She didn’t answer, and repeated the only option she was offering: to give up on my cervix and opt for major abdominal surgery.
There are no doulas at BabyLand General—none of these non-medical professionals who provide continuous support to laboring mothers, to massage Mother Cabbage’s hips or bring her ice chips to chew on. The goings-on are also, notably, completely sterile and removed from the actual territory of birth: the female body. There are no mentions of body parts or fluids; even when Mother Cabbage is dilating, there are no references to uteri, vaginas, blood, placentas, amniotic fluid, or even umbilical cords.
It’s a vision of a “good birth” that is familiar, although perhaps a bit dated, and it gets me thinking about Shulamith Firestone, the feminist theorist who, in her 1970 book The Dialectic of Sex, imagined artificial reproduction as a possible means for achieving gender equality and feminist revolution. “To free women from their biology would be to threaten the social unit that is organized around biological reproduction and the subjection of women to their biological destiny, the family,” she wrote.
At the time, Firestone’s ideas were widely dismissed as absurd (the New York Times called her “brilliant” but also “preposterous”). But on many issues—including the dissolution of the traditional marriage model and the drastic change in social relationships that would be brought about by machines surpassing humans in problem-solving, which she called “cybernetics”—she was almost prophetic, particularly in her observations that reproductive science and medicine did not actually prioritize women.
“The money allocated for specific kinds of research, the kinds of research done, are only incidentally in the interests of women, when at all,” she wrote in Dialectic of Sex. “For example, work on the development of an artificial placenta still has to be excused on the grounds that it might save babies born prematurely.”
In other words, the fact that an artificial placenta could improve the mother’s life was not really a good reason to do it. The same standards have not been applied to, say, the development of medication to improve erections.
Mother Cabbage is close to giving birth and, the nurse says, she is tense and very anxious. The nurse asks those of us in the audience to help Mother with her breathing. Loudly and slowly, at the nurse’s request, we take three deep breaths in and out, in and out, in and out, for a minute or so. It works. Mother is now ready to push.
“Everybody yell, ‘Push!’” the nurse instructs.
“PUUUUUUUUSSSSHHHHH!” we scream in unison.
And just like that, the baby is here. How exactly the baby’s pliable, vinyl head and limp, fabric body are pulled out of Mother Cabbage’s hole is once again obscured by distance, an artificial fence, and so many green leaves. The baby is raised up in the air triumphantly and even begins “waving” at its many admirers. (The nurse acts as a puppeteer.) “It’s a girl,” the nurse then announces, dangling the doll upside down by its ankles, and patting it firmly on the butt.
Mother Cabbage’s baby—Campbell Ella, a girl named after a toddler in the audience—is then swaddled in a pink blanket and taken to the nursery by an LPN to be weighed and measured. Most of the audience has followed, and little girls wait to have their picture taken with the freshly born Cabbage Patch Kid.
Watching from the bench next to me is Amber McConnell, a native of Cleveland who has been coming to BabyLand General since she was a little girl. She’s now 41 years old and pregnant with her fifth child. McConnell sighs happily after the completion of the birth.
“This is actually just like labor and delivery,” she tells me.
“How?” I ask.
“Well, the nurses and everybody in the room helps Mother with her breathing. And breathing is very important, and you need a lot of people helping and encouraging you.”
I can’t argue with that, though I tell her it still seems quite different to me.
“Watching Mother Cabbage give birth gets to the easier, magical side of things,” explains McConnell, who has brought a friend here for fun to witness her first birth. “When your five-year-old asks where babies come from, you don’t want to lie, but you don’t want to go into all that other stuff. Here, it’s in a more delicate form.”
“You really get to see that Mother went through a lot to get the baby here,” she adds.
We should see all the work women do to get the babies here, I tell her. Because you have to be really strong to do it.
“Oh, sure,” she says, nodding. “No man alive would be able to go through it.”
That’s what makes labor exceptional: the almost-superhuman power required to do it. The uterus, an entirely female organ, is a profoundly forceful muscle ball capable of exerting over a pound-and-a-half of pressure on every square inch of a little fetal skull. The force not only moves a baby down the birth canal, it also thins the cervix and shrinks the placenta, simultaneously squeezing all the blood into the fetus so it can get what it needs to take its first breath outside of its mother’s body.
And then there are the 40 or so weeks preceding labor, during which the uterus grows exponentially, both in volume and size. A pregnant uterus expands to over 45 times its usual capacity, growing—to use the fruit-size comparisons favored by pregnancy websites—from the size of an orange that sits deep in the pelvis to a watermelon that will need to displace the stomach and lungs, and eventually graze the rib cage.
As Holly Dunsworth says, “Let’s call the whole pregnancy ‘labor.’ It is all the work of making humans.” Even when the mother is a cabbage.