These powerful portraits show the reality of giving birth

”After much of the US went into lockdown in early March 2020, I began following midwives as they navigated new protocols caused by the COVID-19 pandemic. By photographing the midwives, I explored what it means to bear life in a time of sorrow and grief,” explains photographer Maggie Shannon, reflecting on the origins of her new photo book Extreme Pain, Extreme Joy  (published by Mother Tongue). “The midwives’ phones rang endlessly with calls from terrified women hoping to deliver safely in their homes. With hospitals flooded and many banning partners from the delivery room, the possibility of going through childbirth without a mask and in a familiar setting seemed, to these women, like the only option,” she tells Dazed.

Shannon’s tentative steps, taking pictures of the movements of midwives in the US as they attempted to provide safe home births in the face of new laws and restrictions, led to her being invited into the homes and lives of a diverse group of women as the photographic observer of their labours. Shannon explains, “Amid a COVID surge in late 2021, I started documenting midwives in West Michigan. At a time marked by separation and death, these stories of connection, care, and birth are especially healing. Childbearing and the work of midwives is not well documented; the realities of childbirth are still taboo.”

The realities of childbirth are still taboo... When a difficult process is made even harder by restrictive laws, the need to be honest about childbirth and our own bodies is even more important – Maggie Shannon

Extreme Pain Extreme Joy tenderly, though never sentimentally, documents these homebirths. Each image honours the intimate, personal space that belongs to each birthing woman but, as is often the case, her deeply personal portraits reveal how profoundly the private and the public world are interwoven. Shannon notes, “When a difficult process is made even harder by restrictive laws, the need to be honest about childbirth and our own bodies is even more important.”

Shannon’s insistence on this honest portrayal of birth and the female body at its centre requires, as her title suggests, an acknowledgement of the contradictions at the heart of this experience. The opening photograph in the book depicts the close-up of a woman in labour. The woman inhabits two states – her look of exhaustion speaks of the extreme physical demands of birth, but a different, almost serene emotion also comes through as we realise she is listening to her unborn child’s heartbeat through a stethoscope. 

The photographer explains her book aims to “explore the symbiosis of extreme pain and joy […]. The goal was to capture the constant juggling of profound emotions, which is so intrinsic to this journey. This process was a transformative experience for me, as it deepened my understanding of the human capacity to hold multiple, often conflicting, emotions simultaneously.”

Extreme Pain Extreme Joy holds these multiple and conflicting emotions between its covers. Her intimate portraits of women circled by midwives and partners; of women giving birth on all fours; women giving birth in water; of women holding their newborn babies, depict labour not only as a physical endeavour but also present a fierce argument for women’s bodily autonomy. 

It’s a project in which the personal plays out against the public, where the experience of childbirth exists against a political landscape undergoing dramatic change. “This work takes place under the shadow of an overturned Roe vs. Wade. The midwives are adamant about empowering women to make their own choices and shape their own bodily experiences by terminating a pregnancy or giving birth at home,” Shannon explains. 

The photographs comprising Extreme Pain Extreme Joy were taken during Trump’s first presidency, a term which, as Shannon notes, saw an overturn of women’s fundamental rights regarding their bodies. These images have now made their way into a world which anticipates Trump’s second term as President and a political era which will likely reinforce deeply conservative patriarchal structures and further limit women’s bodily autonomy.

“This threat remained one of the core motivations behind this project, and a deep anger at the pervasive misogyny in the United States,” Shannon declares. But in the spirit of holding multiple and conflicting experiences, she also notes, “Since I began this work, there have been remarkable cultural shifts in how we view birth, which gives me hope. However, there is still a long way to go. These stories feel more urgent than ever and it’s critical that we celebrate women and their choices rather than restrict them.”

This work takes place under the shadow of an overturned Roe vs. Wade. The midwives are adamant about empowering women to make their own choices and shape their own bodily experiences by terminating a pregnancy or giving birth at home  – Maggie Shannon

And the book suggests that this hope exists in the form of solidarity and community. If we return to its opening photograph, the symbol of connectivity lies at the centre of the image. Here, the young woman in labour sports a tattoo – a long thin line which runs from her elbow down her arm to the top of her little finger. This line is mirrored by the linea nigra – or the ’pregnancy line’ – across her stomach, and is repeated once again by the tube of the midwife’s stethoscope in the centre of the image. This symbol of the umbilical cord alludes to the importance of connectivity and solidarity as a transformative force, and the photographs in their entirety speak of midwives as elders – as women who act as guides during a time of increasing destabilisation and dismantling of health care and women’s rights. Shannon explains, “Midwives provide guidance and guardianship rooted in generational wisdom. The more time I spend immersed in this work, the more I see how central relationships and connections are to the experience, these bonds are the foundation. The stability and sense of safety that midwives provide radiates a love that is deeply moving and transformative.”

Extreme Pain Extreme Joy is a rallying cry for women: for the women at the centre of the lens, and for the community which circles them and provides the structure and support that upholds women’s rights. The photographs, as well as the creation of the book itself, insist on the impact and transgressive act of procreation – physically or artistically – in the face of profound change. Shannon concludes, “Birth, and the celebration of women’s bodies, does feel like an act of both defiance and hope. I’m deeply moved that this project has resonated with so many people. It feels like we need more stories that portray women as powerful and authentic, embracing the strength and reality of our bodies.”

Extreme Pain, Extreme Joy by Maggie Shannon is published by Mother Tongue, and is out now.