Of course it makes sense that the critical eye cast on death in the book The American Way of Death should one day take on the business of birth. It just didn't occur to the author. "I never had any intention of writing about childbirth, though one knew of course that the American Medical Association was rather hellish," muses Jessica Mitford upon the publication of The American Way of Birth (Dutton). "I wasn't remotely interested until I ran into the midwife I mention in my first chapter. I tried to do her as an article, but then it became a book."

One advantage of Birth over Death is that it's easier to write from experience. Mitford tells us of her own deliveries, from a politically ultra-correct confinement in a socialist clinic in pre-war East London to more exquisite birth-givings in Northern California. In between was a travail in Columbia Hospital in Washington, D.C., where "the anesthetic given. . .was unlike anything I'd heard of before or since—possibly a short-lived fad of the moment. It consisted of hot air pumped up one's rectum, rather agony while being administered, but it must have served its purpose, as I remember almost nothing about the actual birth except for the joyful moment when the nurse handed me the baby, wrapped in pink for a girl."

Jessica "Decca" Mitford charts The American Way of Birth.

From this passage, even if that's not the word I'm looking for, old loyalists will readily see that the Mitford style is undimmed. They will also expect, and they will jolly well get, some condign thrashing of greed and sloth and exploitation as practiced by the medical profession upon women in their hour of second-greatest extremity. She sticks up doughtily, but without any particular holistic superstition, for the wisdom and practicality of the home-birth midwife. And she has stern words for the professional doctors' lobby in its campaign against these compassionate and minimalist free lances. "Why the implacable hostility of the medical establishment to their practice? A possible answer, as Deep Throat told Woodward and Bernstein: 'Follow the money.' "

If many of those loyalists have the notion that Mitford still lives in England, it may be because so many Mitfords do. The fabulous and not-so-fabulous Mitford girls range in ability and adorability from the late, divine Nancy and the current Duchess of Devonshire all the way to Unity, who pined to be the mistress of Hitler, and Diana, who succeeded in marrying the British Fascist leader Sir Oswald Mosley. (Decca herself—an old nursery name by which Jessica has been known all her life—once had a chance of killing the Führer, but, as she ruefully recounts, rather muffed it.) At any rate, the household of Lord and Lady Redesdale, the Mitford parents, grew quite accustomed to new arrivals. Having taken out American citizenship in 1944 because, as she winningly recorded, the American Communist Party expected it of one, Mitford has been the scourge of the petty American racketeer ever since. Bennett Cerf of Random House found himself covered in ridicule for sponsoring a fool-and-his-money scheme called the "Famous Writers School." The California Department of Corrections has yet to recover from the exposure of its medical experiments, for profit, on live prisoners. And most pricey morticians have at one time or another taken Decca's coffin measurements just for the exercise, and the relief. The American Way of Death was one of those books that not even the cleverest P.R. consultant could offset.

Iconoclast in every other respect, Mitford may be the only transplanted Brit to live in Oakland, California. For this she can thank her husband, Bob Treuhaft, who moved there to defend local Reds and strikers. "It's a hellhole, of course," she says cheerfully, "except you can really live a small-town life, know the chief of police by name, and have real, personal enemies. I'm now 75 and Bob is 80, so it looks as though we'll stay."