“What makes a mother real?” asks writer and performer Alice Eve Cohen in her newly-published play, What I Thought I Knew. In 1999, Cohen experienced the most improbably and bizarrely complicated pregnancy imaginable. Her play is a crystallization of her stranger-than-fiction pregnancy memoir that was acclaimed at its 2009 publication with book-of-the-year awards from Salon to Oprah. Cohen’s saga touches on an amazing range of twentieth-century reproductive history and politics, from the birth defects caused by the drug diethylstilbestrol (DES) prescribed to pregnant women in the 1950s, to surgical approaches to intersex, to “wrongful life” litigation. Through it all, she never lets her audience rest on their assumptions about motherhood.
The story in outline: Cohen, at 44, had long before been told by her doctors that she was infertile and had a deformed uterus because of her exposure to DES in the womb. She had an 8-year-old adopted daughter, and was engaged to the man who would become her second husband. She started to feel ill, but didn’t consider the possibility of pregnancy, and neither did her doctors. She had a CAT scan and multiple x-rays in search of the cause and took hormone replacement therapy to treat supposed early menopause. The mystery of her illness was finally solved when a second CAT scan revealed that she was 6 months pregnant.
Cohen freaked out. She considered an abortion, and was referred to George Tiller’s late-term abortion practice in Wichita, because it was the only place that would do an abortion that late. She reconsidered, and then thought she wanted to give up the child for adoption. Her southern-raised fiancé, who was excited to have a child with her, was incredibly dismayed that she would consider either option. She worried that inappropriate medical care had damaged the baby, just as she had been unwittingly damaged by DES during gestation.
And indeed, the baby appeared to have health issues. Cohen saw three sonographers who gave three different diagnoses about what appeared to be genitalia inconsistent with the baby’s female chromosomal sex and possible additional issues. Cohen and her fiancé agreed that they couldn’t give up their gender-ambiguous baby to a Christian evangelical group home, the most likely adoption possibility for a child with special needs. And yet, Cohen worried and worried about how they could possibly raise a special needs child, as two artists with inadequate health insurance.
When the baby was born, it turned out that her anatomical sex matched her chromosomal sex, so at least one worry was resolved. But it was replaced by a more difficult challenge: the diagnosis of a rare condition called Russell-Silver syndrome, in which the limbs on one side of a child’s body are much shorter than on the other side, and growth is stunted. It was treatable, but the child would spend a lot of time with medical specialists and endure complex, painful treatments. Over her husband’s protests at the distasteful premise of a “wrongful life” lawsuit, Cohen pursued a legal remedy because it was the only way they would ever be able to pay for their daughter’s medical care. Through it all, she dealt with a debilitating pregnancy and postpartum depression, and wondered if maternal care was an adequate stand-in for maternal love. Her agnostic Judaism frames her experience, and in the end, her beloved daughter is “Eliana,” or “my God has answered me.”
Cohen’s play is funny and heart-wrenching at the same time. With each improbable-yet-true plot twist, Cohen illuminates the ridiculous dilemmas thrust upon her. She plays the “straight man” to the dark humor the universe seems determined to throw her way. Unwilling to fall back on clichés of maternal sacrifice or feminist “choice,” she invites her audience to consider with her how they would, honestly, handle the complexities of modern pregnancy and parenthood when they deviate so far from modern expectations.
What I Thought I Knew would beautifully frame a college course in the history of reproduction. Every scene opens onto an important topic in this history. DES affected thousands of children of the women who were prescribed it during their pregnancies in the 1950s and 1960s, and made the hazards of prenatal drug exposures newly clear to physicians and the public. The genital surgery a physician offered for Cohen’s daughter should she be born with ambiguous genitalia ought to be situated in a long and contested history of medicalized gender “normalization.” The “wrongful life” lawsuit that resulted in a financial settlement critical for financing Cohen’s daughter’s complex medical care begs the historian to address both the history of reproductive law and of access to health care. Cohen’s interaction with George Tiller’s abortion clinic ought to be contextualized in a history of abortion debates, clinic violence, and the lived reality of late-term abortion. And there is so much more: the history of infertility; adoption; medical testing and its associated uncertainties and risks; postpartum depression as a discrete diagnosis; the rise of “intensive mothering;” definitions of birth “defects” and disability; and the role of religious background and belief in health and parenting.
The one-woman-show version of What I Thought I Knew seems particularly suited to the teaching context. Like history, plays demand interpretation. The actor is as much a creator as the playwright. How should a scene be performed? How should its associated history be written? It would be exciting to see students offer both kinds of interpretation, in tandem. Like Cohen’s play, good history makes us productively reconsider what we thought we knew.
Alice Eve Cohen, What I Thought I Knew and Other Plays (NoPassport Press, 2016).
Leslie Reagan, Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America (University of California Press, 2012).
Elizabeth Reis, Bodies in Doubt: An American History of Intersex (Johns Hopkins University Press, 2009).
Johanna Schoen, Abortion After Roe (University of North Carolina Press, 2015).
Sharon Hays, The Cultural Contradictions of Motherhood (Yale University Press, 1998).
Stefan Timmermans and Mara Buchbinder, Saving Babies?: The Consequences of Newborn Genetic Screening (University of Chicago Press, 2012).