Starting at the turn of the century, most African American midwives in the South were gradually excluded from reproductive health care. Gertrude Fraser shows how physicians, public health personnel, and state legislators mounted a campaign ostensibly to improve maternal and infant health, especially in rural areas. They brought traditional midwives under the control of a supervisory body, and eventually eliminated them. In the writings and programs produced by these physicians and public health officials, Fraser finds a universe of ideas about race, gender, the relationship of medicine to society, and the status of the South in the national political and social economies.

Fraser also studies this experience through dialogues of memory. She interviews members of a rural Virginia African American community that included not just retired midwives and their descendants, but anyone who lived through this transformation in medical care--especially the women who gave birth at home attended by a midwife. She compares these narrations to those in contemporary medical journals and public health materials, discovering contradictions and ambivalence: was the midwife a figure of shame or pride? How did one distance oneself from what was now considered "superstitious" or "backward" and at the same time acknowledge and show pride in the former unquestioned authority of these beliefs and practices?

In an important contribution to African American studies and anthropology, African American Midwifery in the South brings new voices to the discourse on the hidden world of midwives and birthing.

The deprivations and cruelty of slavery have overshadowed our understanding of the institution's most human dimension: birth. We often don't realize that after the United States stopped importing slaves in 1808, births were more important than ever; slavery and the southern way of life could continue only through babies born in bondage.

In the antebellum South, slaveholders' interest in slave women was matched by physicians struggling to assert their own professional authority over childbirth, and the two began to work together to increase the number of infants born in the slave quarter. In unprecedented ways, doctors tried to manage the health of enslaved women from puberty through the reproductive years, attempting to foster pregnancy, cure infertility, and resolve gynecological problems, including cancer.

Black women, however, proved an unruly force, distrustful of both the slaveholders and their doctors. With their own healing traditions, emphasizing the power of roots and herbs and the critical roles of family and community, enslaved women struggled to take charge of their own health in a system that did not respect their social circumstances, customs, or values. Birthing a Slave depicts the competing approaches to reproductive health that evolved on plantations, as both black women and white men sought to enhance the health of enslaved mothers--in very different ways and for entirely different reasons.

Birthing a Slave is the first book to focus exclusively on the health care of enslaved women, and it argues convincingly for the critical role of reproductive medicine in the slave system of antebellum America.

Childbirth is a quintessential family event that simultaneously holds great promise and runs the risk of danger. By the late nineteenth century, the birthing room had become a place where the goals of the new scientific professional could be demonstrated, but where traditional female knowledge was in conflict with the new ways. Here the choice of attendants and their practices defined gender, ethnicity, class, and the role of the professional.

Using the methodology of social science theory, particularly quantitative statistical analysis and historical demography, Charlotte Borst examines the effect of gender, culture, and class on the transition to physician-attended childbirth. Earlier studies have focused on physician opposition to midwifery, devoting little attention to the training for and actual practice of midwifery. As a result, until now we knew little about the actual conditions of the midwife's education and practice.

Catching Babies is the first study to examine the move to physician-attended birth within the context of a particular community. It focuses on four representative counties in Wisconsin to study both midwives and physicians within the context of their community. Borst finds that midwives were not pushed out of practice by elitist or misogynist obstetricians. Instead, their traditional, artisanal skills ceased to be valued by a society that had come to embrace the model of disinterested, professional science. The community that had previously hired midwives turned to physicians who shared ethnic and cultural values with the very midwives they replaced.

From the health risks of sexual activity to those of pregnancy, abortion, and childbirth, reproduction constitutes enormous risks to a woman’s health. Ill-health conditions related to sex and reproduction account for 25 percent of the global disease burden in adult women. In sub-Saharan Africa, they account for over 40 percent. The catastrophic effects of reproductive ill-health, however, are not limited to women; for infants and adult men, they inflict 25 percent and 1 percent respectively of the global burden.

This volume offers comprehensive data and detailed discussions of the epidemiologies of three sexually transmitted diseases, HIV, and five specific maternal conditions, as well as those of congenital anomalies and perinatal conditions. Projections of the HIV epidemic are provided: by 2020 HIV is projected to double to 2.5 percent of the global disease burden.

Health Dimensions of Sex and Reproduction will serve as a comprehensive reference for epidemiologists, public health specialists, practitioners and advocates of STD and HIV prevention, and reproductive and neonatal health.

In England in the seventeenth century, childbirth was the province of women. The midwife ran the birth, helped by female "gossips"; men, including the doctors of the day, were excluded both from the delivery and from the subsequent month of lying-in.

But in the eighteenth century there emerged a new practitioner: the "man-midwife" who acted in lieu of a midwife and delivered normal births. By the late eighteenth century, men-midwives had achieved a permanent place in the management of childbirth, especially in the most lucrative spheres of practice.

Why did women desert the traditional midwife? How was it that a domain of female control and collective solidarity became instead a region of male medical practice? What had broken down the barrier that had formerly excluded the male practitioner from the management of birth?

This confident and authoritative work explores and explains a remarkable transformation--a shift not just in medical practices but in gender relations. Exploring the sociocultural dimensions of childbirth, Wilson argues with great skill that it was not the desires of medical men but the choices of mothers that summoned man-midwifery into being.

The World Health Organization is currently promoting a policy of replacing traditional or lay midwives in countries around the world. As part of an effort to record the knowledge of local midwives before it is lost, Midwives and Mothers explores birth, illness, death, and survival on a Guatemalan sugar and coffee plantation, or finca, through the lives of two local midwives, Doña Maria and her daughter Doña Siriaca, and the women they have served over a forty-year period.

By comparing the practices and beliefs of the mother and daughter, Sheila Cosminsky shows the dynamics of the medicalization process and the contestation between the midwives and biomedical personnel, as the latter try to impose their system as the authoritative one. She discusses how the midwives syncretize, integrate, or reject elements from Mayan, Spanish, and biomedical systems. The midwives’ story becomes a lens for understanding the impact of medicalization on people’s lives and the ways in which women’s bodies have become contested terrain between traditional and contemporary medical practices. Cosminsky also makes recommendations for how ethno-obstetric and biomedical systems may be accommodated, articulated, or integrated. Finally, she places the changes in the birthing system in the larger context of changes in the plantation system, including the elimination of coffee growing, which has made women, traditionally the primary harvesters of coffee beans, more economically dependent on men.

Recent anthropological scholarship on “new midwifery” centers on how professional midwives in various countries are helping women reconnect with “nature,” teaching them to trust in their bodies, respecting women’s “choices,” and fighting for women’s right to birth as naturally as possible. In No Alternative, Rosalynn A. Vega uses ethnographic accounts of natural birth practices in Mexico to complicate these narratives about new midwifery and illuminate larger questions of female empowerment, citizenship, and the commodification of indigenous culture, by showing how alternative birth actually reinscribes traditional racial and gender hierarchies.

Vega contrasts the vastly different birthing experiences of upper-class and indigenous Mexican women. Upper-class women often travel to birthing centers to be delivered by professional midwives whose methods are adopted from and represented as indigenous culture, while indigenous women from those same cultures are often forced by lack of resources to use government hospitals regardless of their preferred birthing method. Vega demonstrates that women’s empowerment, having a “choice,” is a privilege of those capable of paying for private medical services—albeit a dubious privilege, as it puts the burden of correctly producing future members of society on women’s shoulders. Vega’s research thus also reveals the limits of citizenship in a neoliberal world, as indigeneity becomes an object of consumption within a transnational racialized economy.

The physical process of birth is no longer as mysterious as it once was. But many unanswered psychological questions still surround the birth of a child. In this remarkably appealing and personable book, pediatrician Aidan Macfarlane takes a careful look at a large number of these important psychological unknowns.

On Macfarlane's agenda: Can a woman's emotional attitude toward pregnancy cause “morning sickness,” influence the smoothness of labor and delivery, or shape the child's behavior after birth? Can the mother-child relationship be adversely affected by separation immediately after birth? Is the quality of the birth experience improved by home delivery? What are the psychological effects of pain-killing drugs on mother and child? What, if anything, does the unborn infant see, hear, and feel inside the womb? Is birth a psychological trauma for the child and, if so, how can it be alleviated?

Although Dr. Macfarlane refuses to provide easy answers to any of these questions, his clear discussion of the available evidence is not without important consequences for the way in which we understand birth and manage it in our society.

As Puerto Rico rapidly industrialized from the late 1940s until the 1970s, the social, political, and economic landscape changed profoundly. In the realm of heath care, the development of medical education, new medical technologies, and a new faith in science radically redefined childbirth and its practice. What had traditionally been a home-based, family-oriented process, assisted by women and midwives and “accomplished” by mothers, became a medicalized, hospital-based procedure, “accomplished” and directed by biomedical, predominantly male, practitioners, and, ultimately reconfigured, after the 1980s, into a technocratic model of childbirth, driven by doctors’ fears of malpractice suits and hospitals’ corporate concerns.

Pushing in Silence charts the medicalization of childbirth in Puerto Rico and demonstrates how biomedicine is culturally constructed within regional and historical contexts. Prior to 1950, registered midwives on the island outnumbered registered doctors by two to one, and they attended well over half of all deliveries. Isabel M. Córdova traces how, over the next quarter-century, midwifery almost completely disappeared as state programs led by scientifically trained experts and organized by bureaucratic institutions restructured and formalized birthing practices. Only after cesarean rates skyrocketed in the 1980s and 1990s did midwifery make a modest return through the practices of five newly trained midwives. This history, which mirrors similar patterns in the United States and elsewhere, adds an important new chapter to the development of medicine and technology in Latin America.