Perfect Motherhood: Science and Childrearing in America (review)

Perfect Motherhood, Rima Apple argues, meant twentieth-century women would quickly abandon essentialist understandings of mothering and tradition and come to rely on scientific authority that filtered not only through the advice of medical practitioners but also their publications. Child-rearing books, medical pamphlets, advertisements as well as word of mouth praised the wonders of modern medicine. Based on a rich array of sources that nevertheless tend to privilege the voices of literate women, Perfect Motherhood traces this growing partnership between science and childrearing that gave birth to what Apple defines as "scientific motherhood." Whether it was feeding and bathing rituals or the proper amounts of love and affection, the modern mother sought some kind of medical expertise. Apple begins her study, however, in the late nineteenth century, where she finds women turned to their neighbors' and grandmothers' advice, but also reached out to nurses and physicians. No single authority seemed elevated above another until the early twentieth century when the professionalization of motherhood meant complete deference to the latest scientific discovery or developmental theory. The doctor, who represented the epitome of medical authority, now it seemed had the final word. Letters and diaries reveal mothers' growing dependence on physicians as they distanced themselves from childrearing practices that seem increasingly archaic or undisciplined. Contributing to this turn-of-the-century transformation, Apple argues, was a decline in family size that not only made childhood seem more precious, but coupled with decreasing mortality and morbidity rates, lent credence to medical research. The early discovery of germs and vaccines, the dramatic rise in the number of hospital births in the 1950s, and the most recent emphasis on prenatal care suggests the degree to which a mother's increasing reliance on medical discourse and its practitioners appeared almost inevitable.

Despite their dependence, Apple insists, modern mothers in their pursuit of perfection were never passive victims. Instead, women's relationships with these new found voices of authority ebbed and flowed throughout the century. In the 1950s, for example, doctors often preferred mothers who were not overeducated and therefore posed no threat to their authority. Knowledgeable mothers were not the only problem, however. Not only did childrearing techniques fade in and out of fashion, but copious amounts of medical advice often put experts and institutions into direct conflict with one another. As the twentieth century unfolded, a new mother had access to enough medical resources that she could successfully carve out a position as an educated partner with her physician, nurse, or pediatrician. Women may have rejected individual theories and practitioners, insists Apple, but never science itself. Even the feminist movement of the 1970 s, which brought male-dominated medical institutions and practices into sharp critique, did not shake the foundation of "scientific motherhood." Rather feminist health organizations and practitioners contributed their own scientific discourse and fueled another generation's quest for the most up-to-date expertise.

Motherhood today seems to go hand in hand with worry, notes Apple, and a reliance on scientific-based knowledge and self-education seems logical, but the question unanswered in this study is how do we define science? Is it simply authority? And if so, what does this mean, especially as we move beyond middle-class sources in which authority and definitions of science are potentially contested terrain? Case in point is the history of midwives, who seem to have one foot in the centuries of female tradition and another kicking at the boundaries of the medical establishment. Perhaps like the seventies feminist health movement, midwives simply contribute to the dialogue. Even so, they do complicate the trope of modernity. To be sure, what it means to be a proper or modern mothers falls along lines of race, class, and region. Turn-of-the-century-educators particularly anxious about European immigrants and African Americans, for example, hoped "scientific motherhood" would "integrate the family into a wider U.S. culture"(39). Whether the goal was healthier children, assimilation, or...