Perfect Motherhood: Science and Childrearing in America (review)

"Parenting today is virtually synonymous with worry," Rima Apple begins her latest book on the history of motherhood in America (p. 1). Apple has been at the forefront of establishing motherhood as a legitimate area of interdisciplinary and historical scholarship, and Perfect Motherhood is the culmination of more than two decades of the author's research on motherhood, women's health, and infant feeding.

In Perfect Motherhood, Apple demonstrates that motherhood has in fact always been synonymous with worry, though the specific concerns have changed over time. She begins by tracing the nineteenth-century shift from maternal instincts to scientific motherhood, the doctrine that has dominated child rearing since the early twentieth century. For students of motherhood, this story is a familiar one of the transition from mothers to doctors and scientists as the experts on child rearing. Apple is careful not to portray this shift as the victimization of mothers: "Mothers themselves often embraced these changes," believing that they were acting in "the best interest of their children" (p. 10). Furthermore, "mothers were not only eager for information, they also promised to follow the medical instructions they were given" (p. 78). Apple's findings closely parallel those of previous scholars, including Katherine Arnup and Cynthia Comacchio in the Canadian context, and Jane Lewis and Ellen Ross for Britain.¹ The child welfare movement was an international one, and its members frequently traveled to international conferences, sharing their research on infant and maternal mortality. Their theme was consistent: mothers (and their babies) must be placed under the supervision of trained medical staff, preferably physicians, and they must adhere closely to the advice they received.

Perhaps Apple's most significant contribution lies in her examination of the period from 1960 to the present. Although other books have considered contemporary experiences of motherhood, none has grounded that analysis in historical scholarship and research. Apple documents a shift from an authoritarian to a collaborative relationship between doctors and mothers. This did not herald a rejection of scientific or medical advice; rather, it represented the emergence of a partnership, albeit an unequal one, between women and physicians. The necessity for advice was a constant, but mothers' expertise, derived from their experience, is now validated and their cooperation actively sought.

Mothers today are faced with mountains of advice, much of it conflicting. As Apple notes, while the sources of information have changed—with the Internet, parenting magazines, and television—neither the volume nor the contradictions are new. Today, mothers are increasingly encouraged to participate in the construction and dissemination of this advice, through mothers' groups, Web sites, online publications, and print.

In the conclusion, Apple calls for a "radical change in our health-care system"—a change that she acknowledges will not come easily, but one that is essential to ensure the well-being of every mother and child; it is a change that requires "sufficient housing, adequate wages, safer neighborhoods, and better schools" (p. 169). Like their predecessors, today's child-rearing experts offer little in the way of concrete help for mothers and children. In the twenty-first century, Apple argues, advice alone is no longer enough.