In October 2015, the novelist Francesca Segal met her 10-week premature twin daughters for the first time. The intensive care soundtrack was “a combination of control tower, server room and a busy canteen”. Her doll-sized daughters were too fragile for clothes so she found them naked, curled face down in oval nests of towels. When she peered at their faces, she saw little cloth hats and white Velcro sunglasses, their noses and mouths obscured by breathing masks and feeding tubes. For a few more days, their faces remained “a secret known only to each other” and she was unable to touch them. “They are half-beings in the half-light and in an instant my heart shatters, and I become half a mother, twice.”
This is the reality of early motherhood for 100,000 women in the UK each year and it’s a story that, despite the recent plethora of literature about motherhood, has rarely been told by a British mother (in the US there’s Vicki Forman’s This Lovely Life). Segal is the right person to do it. She writes with delicate eloquence, combining passion and comic understatement so deftly that this feels the only way the book could have been written. Lyricism is undercut by everyday dialogue or WhatsApp messages and marshalled into a startlingly dramatic structure. Even if we know that the babies survive, there’s something about the pacing that means we don’t quite believe it during each moment of danger. Both babies develop life-threatening infections and one is diagnosed with necrotising enterocolitis (NEC), which has a survival rate of below 50%. I don’t think I’ve turned the pages so urgently in a book about motherhood before.
The themes that emerge are universally urgent. Throughout, there are observations on the strengths and limitations of the NHS. The care in their London hospital is medically exemplary but emotionally so cold as to be almost cruel. Doctors are elusive and it takes days before Segal and her husband are given an explanation of what’s to follow. She enters the room to find nurses pinning her baby down while a “longline” (a plastic tube threaded between the wrist vein and the heart) is installed. Though medical research suggests premature babies are sensitive to pain, in 2015 the hospital hadn’t yet taken this on board and did the procedure without pain relief. Most worrying, perhaps, though also understandable in these underfunded times, is the decision to separate the twins when they’re deemed ready to move to the local hospital because only one bed is ready. When they develop infections, Segal races across London from one potentially dying baby to another, without enough time to express enough milk, constantly missed by her children who can also be assumed to be missing each other. Nonetheless, these moments of institutional callousness are understood to be necessary within an imperfect but still monumentally generous system. And in the local hospital, Segal finds the kindness she has missed.
It’s also a book about luck, and how misguided we are to take it for granted. When she’s first admitted to hospital with blood pouring between her legs, Segal is convinced that it will be fine because everything else in the past 35 years has been. Gradually, she renegotiates her relationship with the gods, so that when it turns out her baby does not in fact have NEC she sees it as “another stroke of luck. I do not, not for one moment, take it for granted.” This process of coming to understand provisionality and struggle takes place, crucially, in a community. Indeed, Segal’s implicit argument is that communal kindness is as important as expensive, skilful but coldly administered medicine in making life livable, even in moments of medical crisis. The book is as much Segal’s love letter to the solidarity of the hospital “milking shed” as to her daughters and husband. Here, as the milk drips from the women’s breasts, they confide in each other and root for one another’s children with what feels like genuine selflessness, possible because their sense of self has expanded to incorporate others.
“There has been no rivalry among the women of the milking shed, no cattiness,” Segal writes; “only sisterhood, generosity, kindness.” This might sound too good to be true, like her saintly husband, whom we only see being supportive and loving. But perhaps it is in fact possible. Perhaps innocent suffering does create saintliness in those who witness it, so that motherhood, friendship and marriage can be briefly unambivalent. Certainly this is why this book feels more hopeful than harrowing. I cried many times while reading it, more often because I was moved than sad. Segal has found a way to record love without sentimentality: love that enables the exhausted, underpaid nurses and the shattered, frightened mothers to survive.
• Mother Ship is published by Chatto & Windus (£14.99). To order a copy go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over £15, online orders only. Phone orders min p&p of £1.99.
