'Get Me Out': Making Babies Through The Ages.

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'The Quants': It Pays To Know Your Wall Street Math

TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

The guy who basically invented card counting to beat the house in blackjack, Ed
Thorp, took his math skills to Wall Street in the 1960s, started a hedge fund,
and paved the way for a new breed of mathematical traders who became known as
quants.

The quants were the math whizzes who, with the help of computers, came up with
the complex formulas for hedge fund investments and for designing complex
investment vehicles like mortgage derivatives and credit-default swaps, things
that were behind the market collapse of 2008.

My guest, Ed Thorp, is one of the people profiled in the new book "The Quants:
How a New Breed of Math Whizzes Conquered Wall Street and Nearly Destroyed It."
Later, we'll meet the author, Scott Patterson. He's a staff reporter at the
Wall Street Journal.

Scott Patterson, Ed Thorp, welcome to FRESH AIR. Ed, let's start with your
story, since you're considered the father of the quants, like, one of the first
quants; and with you, it all started with mathematical formulas you came up
with for counting cards in blackjack in casinos.

So let's go back to the casino days and start there. First of all, why did you
even want to do it? Why did you want to come up with a mathematical formula for
dealing with roulette tables and blackjack?

Mr. ED THORP (Author, "Beat the Dealer"): Well, as a mathematician, I had been
told there were certain things that were impossible to do, and one of them was
to beat gambling games with any kinds of mathematical methods. And when I
happened to accidentally come across a statistics paper, which told how to play
blackjack rather well, but still not able to beat it, I got intrigued. And
after I worked on it for a while, I saw that there was, in fact, a way that was
almost certain, in my opinion, to beat it.

So then, when I went to MIT, I used the new, big computers that were just then
coming available to make calculations. And from those, I was able to devise the
first card-counting systems, take them out to the casinos, use them, and found
they worked.

So that got me interested in applying mathematics to real-world problems, in
particular ones that involve ideas from gambling and from – eventually, ideas
for investing.

GROSS: Did you like gambling as much as you liked math?

Mr. THORP: No, the fun of gambling for me was going out and seeing a
mathematical system that I'd thought up actually work and generate real profits
in the real world, instead of just being something that was an abstract
collection of symbols on a piece of paper.

GROSS: Okay, so getting back to blackjack, which is a game where you have to
reach 21, and if you go over 21, you lose, and the one who comes closest to 21
wins; what kind of cards did you have to count to have the edge over the house
in a casino?

Mr. THORP: What I found was that each card could be assigned a weight,
basically a number from one to 11, positive or negative. And with those
weights, you counted cards as they fell, and you could use the total count that
you had so far to figure out how good or bad the deck was for you, and I found
that you could greatly simplify this.

You could, for instance, just take cards that were small – two, three, four,
five, six – and call them plus-one when they fell, and you could take big cards
like 10s and aces and call them minus-one when they fell, start with zero and
just sort of keep track of the total count. And that would give you a very good
indication of whether the deck was good for you or bad for you.

When the count was plus, you'd bet bigger, and when the count was negative,
you'd bet as little as you could to just keep your seat.

GROSS: So when you were counting cards, could you keep all this in your head,
or did you have, like, a little, hidden computer?

Mr. THORP: No, I actually sat down for a summer and had my wife and brother
deal me cards and blow smoke at me and try to distract me. So I got very
comfortable doing it, and I could just almost do it in my sleep. It just became
automatic.

GROSS: So wait, when you decided to try this out, to try your card-counting
system at casinos, you needed some money, somebody to help bankroll you, and
the person you found, named Manny Kimmel - Scott Patterson, in his book,
describes him as a racketeer with his fingers in everything from numbers games
in Newark to East Coast horse tracks. So did you know he was connected to
organized crime when he bankrolled you?

Mr. THORP: No, I discovered all this 30 years later. What happened was I gave a
paper to the American Mathematical Society in Washington, D.C., and there was a
huge burst of interest - national newspaper stories and so on - and many people
contacted me.

And he wanted to put up $100,000 to bankroll a test of my system in the casinos
in Nevada. And there had been a lot of ridicule from casinos and from the
newspaper op-ed page in the Washington Post, and so I decided that the best
thing to do was to prove that it actually worked. If I said it worked and never
proved it, how did I know for sure?

GROSS: So how did you meet Kimmel in the first place?

Mr. THORP: He called me and kept pestering me and wanted to get together for a
meeting. And then I finally got together with him, and when I told him how the
system worked, he got very excited. And I used to fly down to New York and play
blackjack every Wednesday with him, to prove to him that I really could count
and that the system actually transferred money from his side of the table to
mine at a pretty good clip.

So after a few weeks of this, he was ready, and we went out to Reno and
Stateline, Nevada.

GROSS: So did you do the playing yourself, or did you communicate signals to
them when they played? How did it work?

Mr. THORP: I did the playing, but Kimmel would sit down next to me sometimes
and want me to tell him how to play his hands, too. And I would have preferred
it if he had just let me be, because one night, when we were winning a rather
large amount of money, he wouldn't quit when I got tired and felt that I had to
quit. So he lost some of the money back.

Even so, the test was very successful. We more than doubled our $10,000
bankroll, which was what I thought would happen from theory, and so everything
worked out the way it was supposed to.

GROSS: Now, as you started doing this more and more in the casinos, did the
casino people get on to you? Did they realize that you were counting cards,
that you had a method that they would prefer you did not use?

Mr. THORP: When I first started to play, they didn't understand what was
happening.

GROSS: Because no one was counting cards yet, right? I mean...

Mr. THORP: No.

GROSS: You kind of invented that.

Mr. THORP: There had been a few people, a decade before, who realized that when
you got down to the very end of the deck, if it was mostly 10s and aces, then
you could take a whole lot of hands so that your first card would be a 10 or
ace and bet a whole lot of money on those hands. So there were people who were
starting to do that. But the general idea of card counting was unknown at that
time. So yes, my book "Beat the Dealer" was the – and the paper that I
published before that was the first revelation of that to everybody.

GROSS: So before you wrote your book and revealed some of your secrets, were
the dealers mystified that you were beating the house so often?

Mr. THORP: Yes, and they came up with a lot of strange theories. In one case,
for example, they began to shuffle all the time because they thought that I was
doing something to the cards and knew what they were. And I said, you know, why
are you doing this? And they said well, we think that you can memorize every
single card in the deck and know where it is.

So I said, I don't – that doesn't make any sense to me. And so the pit boss
walked up, and I said to the pit boss, can you memorize every single card in
the deck and then tell me the order of the cards? And he said yes. So I said I
don't believe you.

(Soundbite of laughter)

Mr. THORP: I've got five dollars here which says you can't do it. And he didn't
answer. So I said, I've got $100 which says you can't do it. No answer. I said
I've got $500 which says you can't do it.

(Soundbite of laughter)

Mr. THORP: No answer. So I said I think we've settled that.

GROSS: So did anybody ever get on to you and throw you out?

Mr. THORP: Yes, they - eventually they began to tell me they didn't want my
business there anymore, and they didn't want any of my friends coming, either.
But they didn't know why. They just knew that it was bad news.

GROSS: So in 19 – I have, it was like, 1961, that you started successfully
counting cards in blackjack at casinos, and then in '62, you published your
book about card counting. So you basically outed yourself.

Mr. THORP: Well, actually, my idea wasn't to make money. It was to show that I
had an idea that worked. And I figured that between the time I started doing it
and the time I outed myself that I'd be able to make as much money as I needed
for our rather modest needs as a little family.

I was simply, you know, teaching in a university, and university professors
don't – aren't used to having a lot of money. They can live rather frugally.

GROSS: My guest is Ed Thorp, one of the math whizzes profiled in the new book,
"The Quants: How a New Breed of Math Whizzes Conquered Wall Street and Nearly
Destroyed It." We'll meet the author, Scott Patterson, and talk more with Ed
Thorp about how he took his math skills to Wall Street after a break. This is
FRESH AIR.

GROSS: If you're just joining us, my guests are Ed Thorp and Scott Patterson,
and Ed Thorp is a math genius who got his start, kind of, counting cards at
casinos and then went on to become a quant, one of the math geniuses who
figured out statistical ways of investing. And Scott Patterson has written a
new book called "The Quants: How a New Breed of Math Whizzes Conquered Wall
Street and Nearly Destroyed It." And Ed Thorp is one of the people who figures
prominently in the book.

Scott, I guess I'll ask you first, since you wrote the book "The Quants." What
is a quant?

Mr. SCOTT PATTERSON (Author, "The Quants: How a New Breed of Math Whizzes
Conquered Wall Street and Nearly Destroyed It"): A quant is somebody who uses
mathematics and computers to essentially predict the future of the market, kind
of like a weatherman uses computers and models to predict what the weather's
going to be tomorrow or next week.

A quant on Wall Street is using very similar techniques to predict where a
stock is going to go, where all sorts of other securities are going to go. They
do a lot of other things, too, but essentially it comes down to using math and
computers to predict the future.

GROSS: So what are some of the major changes that the entrance of quants onto
the Wall Street scene made on Wall Street?

Mr. PATTERSON: Well, the quants really started rising in the '60s. I think Ed
Thorp was probably one of the first, if not the first, quant, but they really
took off in the '70s with the introduction of a formula called the Black-
Scholes Option Pricing Formula, and this is a mathematical model that was used
to price options on stocks, and it became very, very popular.

It was applied to all sorts of other securities across Wall Street, and as more
and more people started using this formula, which was coded into computers, it
became a very dominant force on Wall Street. And the guys using this formula
started pushing aside the old-school traders, the guys who sort of traded by
the gut and, you know, used their intuition to figure out where the market was
going to go. And you know, in the '70s and '80s, more and more of these guys
were showing up on the trading floors on Wall Street, starting up hedge funds,
and because they were able to predict the future of securities more accurately,
they were making more money than the other guys.

GROSS: Ed Thorp, why did you want to take your math skills to Wall Street after
kind of conquering the casinos?

Mr. THORP: Well, I thought that the ideas I had developed in card counting and
roulette, and the analysis of other gambling games would carry over, in large
part, to the securities markets. And the biggest casino in the world appeared
to me to be Wall Street.

So I thought it would be intriguing to try these things out there and see what
happened. And coincidentally, I'd come across an idea about warrant hedging
that I'd thought up after reading some literature on the market.

When I came out here to University of California Irvine, where I happen to be
sitting right now, talking, as a founding faculty member in 1965, I ran into
another faculty member there named Sheen Kassouf, an economist, and he'd been
thinking along the same lines, and he'd actually been doing some investing in
these warrant hedges that made sense to me.

So we teamed up and worked on our ideas and improved them and wrote a book
called "Beat the Market," and then I went on to use the ideas in that book and
some further ideas to create a hedge fund, the first – actually, the first
market-neutral hedge fund that was ever created.

GROSS: What's a market-neutral hedge fund?

Mr. THORP: It's one which takes positions that will hopefully make you money,
no matter which way the market goes. So the market risk has been eliminated by
hedging, by having both long positions on one side and short positions on the
other.

So if the market goes up, your long positions will make extra money to pay off
the losses that your short positions will lose, and if you've got the right
kind of a hedge, when the prices errors in the securities disappear, some money
will come out - some extra money.

GROSS: And Scott Patterson, what was the impact on this hedge fund that Ed
Thorp created on the market and the way the market thought? Did this lead to a
lot of other similar hedge funds?

Mr. PATTERSON: Absolutely. Ed's hedge fund, which he founded in 1969, had a
tremendous impact on Wall Street. Not immediate, because I think in the
beginning, most people didn't really understand what he was doing. He was
fairly small for a while, but as more and more people started seeing the
success of his hedge fund, Princeton Newport Partners, they started using
similar strategies.

If you think about this idea that Ed came up with of a market-neutral hedge
fund, it was a revolutionary idea. It's a way of betting money on Wall Street
that can reap you huge profits, no matter which direction the market is going.
And this really became the core idea of what the hedge fund industry became.

Ed's fund never lost money in a calendar year, and so he really did know what
he was doing, and I think that over the years, a lot of the lessons that he
tried to teach people got lost, and the bets that the hedge fund started making
became bigger, wilder and more reckless. And the hedging that Ed came up with,
the hedging strategies, you know, they sort of gotten left by the wayside.

GROSS: So what was the first sign, Scott Patterson, that the quants were
actually making some big mistakes that were creating turbulence in the market?

Mr. PATTERSON: I think probably the first time that people started realizing
that something was amiss was Black Monday in October, 1987. A quantitative
methodology called portfolio insurance, which was a method based on option
pricing formulas to hedge giant portfolios of stocks, and a huge amount of
money had been put into these portfolio insurance contracts. And it was a
quantitative formula, and on Black Monday, they created a cascade effect
because as the market started to fall, more people started selling stocks to
balance out the portfolio insurance contracts, and it created a feedback loop.

GROSS: So Scott Patterson, what were the lessons learned on Wall Street by the
quants after Black Monday in 1987?

Mr. PATTERSON: That's a good question. If you look at what Ed was doing, Ed was
using similar models to those that led to the blowup on Black Monday. The
difference between what he was doing and what a lot of practitioners on Wall
Street were doing, is that Ed actually has a common-sense feel for the market,
and he's also highly risk averse.

He's always thinking about big disasters that could happen. You know, I've
talked to him about, you know, things he thinks about. He worries about, you
know, a nuclear bomb hitting New York City or some horrible event happening in
Tokyo or all sorts of scenarios that could throw his models off-kilter, and he
adjusts for that.

The lessons that Wall Street should have learned decades ago in 1987 is that
the models don't incorporate these giant moves, and they also don't take into
effect the fact that they change the market when you have billions of dollars
flowing into these models. Everybody's doing the same thing.

If it starts to unravel, you have this giant feedback loop, and you know, we've
seen it over and over again. So you, did they learn anything? I think, you
know, maybe they did for a while, but they forgot it pretty quickly.

GROSS: Let's jump ahead to the mortgage meltdown crisis of 2008 and the
collapse of the stock market. Ed, as one of the first quants, what role do you
see the quants as having played in the development of the credit-default swaps
and the securitized mortgages that got us into so much trouble in 2008, that
caused the collapse of housing market and the stock market?

Mr. THORP: I think that the quants are actually, surprisingly, fairly far down
the food chain here. The sell side on Wall Street is always wanting to invent
new products that sound good, and they go out and make a lot of money selling
them. And the quants are their experts who craft these products.

The quants on Wall Street now, in large part, don't have market sense, and they
don't have a long history of experience with what's wrong with models. They
simply take the math. They, themselves, are wowed by it, and they build a
machine which, in their imaginary world, must work just fine and must be safe
and sound. But in fact, with the securitized pools that were put together to
underlie these things, terrible, unsound mortgages were put into the pools, and
that's not directly the fault of the quants, except that the quants should, if
they were poking around and curious, have known how unsound these things were.

It's more the fault of the sell side, who didn't care what was in there and
figured they would sell it off, and they wouldn't be caught holding the bag,
and of the regulators in government who simply looked the other way.

GROSS: Ed Thorp and Scott Patterson will be back in the second half of the
show. Patterson is the author of the new book, "The Quants: How a New Breed of
Math Whizzes Conquered Wall Street and Nearly Destroyed It." Ed Thorp is one of
the first quants and is profiled in the book. I'm Terry Gross, and this is
FRESH AIR.

(Soundbite of music)

GROSS: This is FRESH AIR. I’m Terry Gross back with Scott Patterson, the author
of the new book "The Quants: How a New Breed of Math Whizzes Conquered Wall
Street and Nearly Destroyed It."

Quants are math whizzes who, with the help of computers, predict the future of
securities and create complex investment vehicles like the credit default swaps
and mortgage derivatives which were behind the market's collapse in 2008. Also
with us is one of the first quants, Ed Thorp. Before using his math skills for
investing, he used his math counting cards in casinos to beat the house in
blackjack.

So Ed Thorp, as a quant, did you participate in the creation of any of these
exotic vehicles that got us into trouble through the securitized mortgages and
the credit default swaps and all the stuff that lead to the housing bubble and
bust and the stock market collapse?

Mr. THORP: Actually, no. In 1985 when these first mortgage pools were being put
together, I analyzed them as possible investments for our hedge fund and there
were two things that I found unanalyzable: The first one was to determine the
quality of the mortgages and the pools and that would require going out and
looking at hundreds of thousands of different houses and mortgage documents to
try to figure out what was going on. That was so costly and time consuming as
to be unfeasible.

Another thing that was important was how fast investors would prepay and that
was unpredictable. It depended upon what the future of interest rates was. If
interest rates went way down, they'd prepay and they'd refinance with a new
lender at a lower rate. And if interest rates went way up, they'd hang on to
the low rate mortgages and they would not prepay. And this was - prepayment
rate was very important in how much these securities were worth.

And the last thing was the default rate. That's where you had to go out and
check all the contracts and do a lot of analysis. You couldn’t predict the
default rate even then because that depended on general economic conditions. If
- the default rate in the 1930s was far different than the default rate in the
1920s, for example, and the same thing in the '60s versus the '70s. So these
were things that could not be quantified or analyzed and yet they were
pretending that you could, so we stayed away from all those.

GROSS: So Ed Thorp, were you invested in the market a lot either personally or
through your own hedge fund in 2008 during the stock market collapse?

Mr. THORP: Yes. At 2008, unfortunately, I didn’t have any place to hide. I did
not have a hedge fund then, so I wasn’t managing more than a very small part of
my own money. The small part, I managed it fine. I made about 18 percent that
year, but most of the money I had was in other things - other people's hedge
funds and so on. I was trying to retire and live the good life.

GROSS: So you lost a lot of money with the money you had invested in other
people's hedge funds?

Mr. THORP: A significant amount. We've mostly recovered but not quite all of
it.

GROSS: So what are some of the ways that you feel the mathematical models that
you helped create didn’t foresee the housing bubble and therefore the housing
collapse?

Mr. THORP: Well, the problem is that the people using these methods and models
didn’t use them correctly. They thought they applied to things they didn’t
apply to. It would be as though I were talking about gambling odds and somebody
were to ask me, what's the chance of a plague of locusts? Or you know, what's
the chance that seas will run red with blood? I was actually asked that once in
a murder trial and my answer was: Those are one time events. They're out of the
collection of assumptions you make when you make probability estimates. And so
probability estimates have nothing to say about events like this. You can't
stipulate the probability that one of these things will happen. And these huge
tail events - that is, way out on the tails of a probability distribution -
come for reasons that are kind of outside the assumptions and the experience of
the models.

GROSS: Ed Thorp, as far as you can tell now, how are quants being used on Wall
Street? Are these mathematical models relied on as heavily now after the stock
market collapsed as they were before?

Mr. THORP: My impression is: pretty much. There is a giant industry now. Many
thousands of people who otherwise would've gone into engineering and science
have gone over to Wall Street to work on these things because the pay is better
and it's fun. And they're still there. They have a vested interest in staying
there. And I think people - a lot of people think that we're just going to go
back to business as usual in this country, that this is all going to blow over
and we're not going to have any significant increase in regulation. We're not
going to have any significant listing of off-the-book derivatives on exchanges
like the commodity futures exchanges and that we'll set ourselves up for
another big fall. That's what I'm afraid will happen.

GROSS: So how's that affecting how much you want to have invested in the
market?

Mr. THORP: Well, it’s tough. The question is, you know, where do you go?
There's - we only have one world we live in. If we had a market on Mars you
might think about going there. But I think it’s going to be very difficult. And
I personally find it hard to guess exactly when some bad thing will happen and
how long it will take and what will trigger it. Just like in this last crash,
you know something bad is going to happen, you just don’t know when or how.

GROSS: And Scott Paterson, author of the book "The Quants," what's your
impression of the role quants are playing now on Wall Street?

Mr. PATTERSON: Well, it - to me, it looks like they're taking off as fast as
they can, looking for new places to invest. And one area that you see the
quants really, really taking off is in the world of high-frequency trading,
which is super fast trading using supercomputers. It's really having a massive
impact on the stock market and raising a lot of concerns with regulators. These
high-frequency traders can send, buy and sell orders to stock exchanges at
rates that would make your head spin, thousands of orders per second. And there
are some concerns that the orders are flying so fast that they could trigger
some kind of destabilizing selloff on the market.

It's actually very worrisome. I share Ed's concerns that the lessons haven't
been learned. That people - the rewards on Wall Street are so phenomenal that
if you’re allowed to bet enough money over, say, a period of a year or so, you
could be set for life. And if you lose the money, then it’s not your problem.
It's the taxpayers' problem. And that's a huge systemic issue that we have that
everybody today is trying to come to grips with.

GROSS: Now, just one more thing. Ed Thorp, I read about you that you have
signed up to have your body cryogenically frozen when you die…

Mr. THORP: Mm-hmm.

GROSS: …in the hopes that science will have reached the point eventually that
you can be unfrozen and brought back to life. Knowing you as I've come to know
you during the course of this interview, I assume you’ve played the odds and
figured out what the odds are that you will be brought back to life. So what
are the odds?

Mr. THORP: I would say that the longer I live, the further along science will
be, so the odds get higher and higher. But I say right now, two percent.

GROSS: That's pretty low isn't it?

Mr. THORP: I think so. But it’s better than zero.

GROSS: Mm-hmm. What are the odds you think you'll be happy if the two percent
turns out to be true and you’re brought back to life?

Mr. THORP: Maybe 50-50.

(Soundbite of laughter)

Mr. THORP: Depends on how good a job they do and what the world's like then.

GROSS: Precisely.

Mr. THORP: That's one of the uncertainties.

GROSS: Okay. I want to thank you both. Scott Patterson, Ed Thorp, thank you
both for being with us.

Mr. THORP: Thank you for having us.

Mr. PATTERSON: Thank you, Terry.

GROSS: Scott Patterson is the author of the new book, "The Quants: How a New
Breed of Math Whizzes Conquered Wall Street and Nearly Destroyed It." Ed Thorp
was one of the first quants and is profiled in the book.

Coming up, we talk with Randi Epstein about her new book "Get Me Out: A History
of Childbirth From the Garden of Eden to the Sperm Bank."

This is FRESH AIR.
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'Get Me Out': Making Babies Through The Ages

TERRY GROSS, host:

The new book, "Get Me Out," is a history of childbirth. It's about the advice
women have been given about pregnancy and birth, why so many women died during
or after birth before modern medicine, how modern medicine changed the
experience of childbirth, and the changing views of feminists regarding the
pros and cons of painkillers.

My guest is the author of "Get Me Out," Randi Epstein. She's a medical
journalist.

Randi Hutter Epstein, welcome to FRESH AIR. I think we forget how dangerous
childbirth used to be. Not that it still doesn’t have it’s dangers, but the
mortality rate for mothers and children was so much higher in the past. What
were some of the most common problems for women giving birth?

Ms. RANDI EPSTEIN (Medical Journalist; Author, "Get Me Out"): The big problems
were hemorrhaging - bleeding to death - and childbed fever, of course, was the
huge problem. Now, if you go back and look at the statistics which other
historians have done, statistically, it was not this huge epidemic of childbed
fever.

GROSS: Explain what childbed fever is.

Ms. EPSTEIN: Okay, childbed fever. We didn’t know. We named childbed fever for
women years ago who would give birth, spark a fever in the next couple days,
some would recover but others would die and no one knew what was happening. So
that's why they just named it childbed fever. We didn’t know what it was.
Today, we now look back, or we’ve figured it out along the way when we
discovered germs, that a lot of these women were infected with germs. There was
- and a lot of the cause was from doctors who might've done an autopsy or
delivered someone else's baby, they were rushed, then they came and delivered
yours. They weren't washing their hands so they were just sort of passing
things from one woman to another. And remember, this was before we knew about
germs and the germ theory, so the few doctors that started saying, shouldn’t we
wash up in between patients? They were kind of seen as a little kooky.

GROSS: In writing about the history of childbirth, you write about how forceps
changed childbirth both for the person delivering the baby and for the woman
having the baby. Forceps were invented by a family that kept these instruments
secret from the rest of the medical world. Tell us what you know of the story
of how the forceps were invited.

Ms. EPSTEIN: Sure. I mean what - there were all these whacky forceps that date
back years and years ago, generations, hundreds of years ago. Most of those
forceps really ripped the baby, didn’t work so well. What we think are sort of
the first of modern forceps that were safe for both the mother and the baby
were invented by this family called the Chamberlains who go back to the late
1500s. And they passed on their secret forceps from son to son to son who all
became male midwives. Their popularity really grew in the 1800s. Although they
had been doing this for years, there weren't a lot of men in the business for
the first generations of the Chamberlain family. And one of the things I think
that a lot people feel about the Chamberlains is what a bunch of jerks.

I mean they had what supposedly was saving lives of babies and women and they
didn’t share their secret with anyone, with their colleagues. But actually,
that was standard practice in those days. Doctors were highly competitive. So
if you had something that worked you kept it to market your own business and
that's exactly what the Chamberlains did. And they were not well-liked by their
colleagues. But they became, by the 1800s, the doctors who rich, wealthy women
would seek out if they decided to choose the route of male midwife.

GROSS: And where were the Chamberlains? Were they in England, in the United
States?

Ms. EPSTEIN: They were in England. They were originally from France but they
came over to England and that's where they set up shop, in England.

GROSS: So when forceps really started to catch on to people beyond the
Chamberlain family, you say that the doctors who were delivering with forceps,
because of the kind of cultural taboos of the era, couldn’t really see what
they were doing. Would you describe the kind of sheet that would separate the
woman and the doctor and what that was like?

Ms. EPSTEIN: Sure. Now this has to do with male doctors whether or not they
used forceps. There were other forceps starting to be invented but when women
started to think, gosh, I'll get a man in the room because he seems so
professional, or for one reason or another, her husband thought it was more
professional to have a medically-trained person in the room, we still could not
fathom that this male doctor would see you naked. So what they would do is
cover the woman with a sheet and basically it was set up so it looked like she
had a tent over her. So the doctor really couldn’t see what he was doing. And I
think the scariest was those with a forcep in their hands and they would put
their hands under the sheet and deliver the baby without seeing anything.

And the oddest part of all of this is that part of medical training in some of
the medical schools in America and in England and in France required young
apprentices to watch a baby being born. So basically, what these medical
students did is they would walk into a birthing room and they would watch their
mentor sticking his hands under sheets and pulling a baby out. But I'm not sure
how much they learned from that experience.

GROSS: Now you write in your book that after forceps started catching on that
other doctors and inventors came up with, you know, odd tools and gadgets.

(Soundbite of laughter)

Ms. EPSTEIN: I know where this is going.

GROSS: You know where this is going...

(Soundbite of laughter)

GROSS: ...to help women deliver and the most bizarre one that you mentioned,
and you have an illustration of it, is do-it-yourself forceps?

Ms. EPSTEIN: Oh it's great. It didn’t catch on. I do think it didn’t catch on.

GROSS: Thank goodness. Yeah.

Ms. EPSTEIN: But it is there. I mean one of the things I do have to say before
I get to this do-it-yourself forcep, is all these books that I looked at, I
can't judge except for this, that said it didn’t last. It's hard to judge what
advice women listened to and what, you know, what was in the books that we
really - that women took to heart because there's books now that we just sort
of ignore.

But these do-it-yourself forceps, I think that it was partly done because,
again, we talked about that immorality of doctors just getting in there and
sticking their hands in a woman, and I think that people thought well, gosh,
with forceps maybe we could make this more culturally acceptable to keep these
male doctors farther away from this naked woman. So they did come up with these
contraptions that all had your basic forceps, which sort of looked like these
two big ladles attached together, and then some of them had all these strings
and pulleys attached so that the doctors could be far away - sort of like when
you see workmen with scaffolding and all those poles outside a building and
somehow get the baby out.

But the Italian one where I, you know, it’s just - it's hard to explain without
the picture, but it’s a forcep and all these strings that tie it around a
bedpost so apparently a woman can just keep pulling and then the baby will
shoot out. And I'm not sure who catches it on the other end.

GROSS: My guest is Randi Hutter Epstein, author of the new book "Get Me Out: A
History of Childbirth From the Garden of Eden to the Sperm Bank." We'll talk
more after a break. This is FRESH AIR.

(Soundbite of music)

GROSS: If you’re just joining us, my guest is Randi Hutter Epstein. We're
talking about her new book "Get Me Out: A History of Childbirth."

One of the threads in your book is how women have dealt with the pain of
childbirth and how cultures have dealt with it. Of course, you say this all
goes back to Eve in the Old Testament. What was Eve's contribution to pain and
childbirth?

Ms. EPSTEIN: Well, I blame her for starting it all. I mean, you know, she ate
the apple, she was punished, and then they said now birth will be painful so
she started it. Whether we believe the story or not, I mean that's sort of in
our culture. And since then, we’ve grappled with, is pain a good thing or a bad
thing? So for years it was thought of as sort of a hazing process, that it was
part of your heavenly duty to give birth through pain, to survive it and then
you could become a mother. So a lot of the things that were done to maybe try
to alleviate the pain were considered heresy in a way.

And it wasn’t until - we say that it wasn’t until Queen Victoria gave birth
using ether that some other women said, hey, well, the queen did it. It's got
to be good enough for us. So she is thought of as giving the green light to
drugs for delivery. And in terms of culture you asked me about, I still think
that how we use pain medication is a cultural response. At the turn of the
century, around the 1910s, a group of women here - in New York, actually -
heard about a new technique in Germany that was called twilight sleep, and
basically you were knocked out during delivery.

Interestingly, this became this feminist crusade: We deserve to be knocked out.
We deserve not to have to remember anything about childbirth. And what I think
is fascinating is, jump a few decades ahead to the 1970s, and feminists were
saying: We deserve to be awake. We deserve to remember everything about our
pregnancy. So to me, again, this has nothing to do with scientific evidence or
improvements in medical technology. It's what women themselves wanted in the
birth of their children.

GROSS: Now, let's contrast the feminist movement that – of the early 1900s that
asked for painkillers during childbirth. Let's contrast that with the later
1900s and in the '60s and '70s when women started demanding to be awake during
childbirth and to be more active participants in childbirth and endure the pain
that came with that with the help of prepared techniques, like breathing. So
tell us how the Lamaze technique of breathing during childbirth, to help
control pain and relax muscles, how did that get imported to the United States?

Ms. EPSTEIN: Well, that came over - well, it was really two things. That came
over from someone called Grantly Dick-Read, who was a doctor. He never was
board certified as an Ob/Gyn and he became this birthing guru. And there are
women today who are very involved in natural childbirth who really look back on
him as this wonderful doctor that was preaching natural childbirth while all
the other doctors were saying, no, you know, let's use drugs. We're in charge.
He really started talking about natural childbirth in the late 1940s. If you
read what he was writing, he was saying things basically opposite what the
doctors were saying, that modern women are too frail to give birth.

He was sort of saying, you know, you’re so neurotic. You are just too - and he
used that word. He said these women are too neurotic. They should be able to
give birth and it’s the Christian way to give birth, is through pain. So his
message wasn’t as 1970s as we'd like to think it was. That said, women did pick
up on this anti-doctor sentiment that he had. And what I do think, both looking
back at the turn of the century and looking back at the 1970s, the real issue
isn't so much pain or no pain, drugs or no drugs, the real issue is doctor-
patient relationships. And in both cases you'll see that women were angry with
their doctors so they were demanding the opposite of what their doctors wanted
to do. And I think that's what motivated some women - not all, but motivated.

Yes, of course, in the 1970s there were women that said, you know, we're
worried about the drugs and we're worried about the side effects, but I also
think there was an anger against authority then, too, the way there was the
anger in the 1910s and '15s by some women against some doctors. So I think that
propelled both movements.

GROSS: What development do you think is most changed in childbirth now?

Ms. EPSTEIN: I think for better or for worse, all the assisted reproductive
technology - and I'm not talking in-vitro fertilization. I'm talking really a
lot of the genetic diagnosis and looking at embryos and analyzing them before
we put them - transfer them into a woman. Of course, for better, it would be
phenomenal to be able to say, look, I have this devastating genetic disease in
my family. Please make sure the embryo does not have that disease. I think
that's terrific. It would be great to break a cycle of a disease. But on the
other hand, I think that so many people feel that they’ll be able to choose the
perfect baby.

And one of the threads I think going through my book is that this search for
perfection has been going on forever. You know, thousands of years ago, we
thought if we have sex in a certain way or if we think happy thoughts then we
will have the perfect child. And now I think it's, if we choose the right sperm
from our Ivy League donor who was a musician and an athlete and we choose the
egg of this gorgeous Ivy League, brilliant woman then our child has to be
perfect. And I think that that can lead to parents being let down by the end
result.

GROSS: Well, Randi Hutter Epstein, thank you very much for talking with us.

Ms. EPSTEIN: Oh, this has been a pleasure. Thank you so much.

GROSS: Randi Hutter Epstein is the author of "Get Me Out: A History of
Childbirth From the Garden of Eden to the Sperm Bank."

You can download podcasts of our show on our Web site freshair.npr.org. And you
can follow us on Twitter and friend us on Facebook at nprfreshair.

GROSS: I'm Terry Gross.
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